Health Care Reform Provisions Benefit Those Living with HIV/AIDS
Medicare Expands Coverage for Treatment of Facial Lipodystrophy
New Study: Getting Meds that Work
Men Needed for HIV Vaccine Study
Health Care Reform Provisions Benefit Those Living with HIV/AIDS
On March 23, President Obama signed into law the most sweeping reform of the American health care system since Medicare and Medicaid. While it is not even close to being “universal” health care, there are some provisions that are beneficial for those living with HIV, as well as support for prevention. Those provisions include:
- Allowing states to immediately extend Medicaid coverage to low-income HIV-positive people who are currently caught in the gap between being considered “too healthy” to receive assistance and yet are too poor to buy their own insurance.
- Help to states to maximize the number of people who benefit from the AIDS Drug Assistance Program by improving coordination between ADAP and Medicare.
- Prevention and Wellness provisions would increase access to voluntary HIV testing and other preventative measures.
- By 2014, HIV-positive people will not be excluded from being covered due to pre-existing conditions. Coverage of children with pre-existing conditions will begin immediately.
- Insurance companies will be prohibited from dropping coverage of people who become ill.
- Elimination of lifetime coverage limits and restriction of annual coverage limits will go into effect this year.
The Senate is now in the process of debating the bill and Republicans have vowed to repeal it. A simple majority of 51 votes will be needed to pass it and those are expected to come entirely from Democrats.
It remains to be seen how great, or small, the impact of this reform will be on those living with HIV, but it will provide thousands with access to care that they don’t currently have.
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The National Association of People With AIDS (NAPWA) is urging the national HIV/AIDS community to participate in AIDSWatch 2010 in Washington, D.C. on April 26 through 28. According to the NAPWA website, “We invite you to join hundreds of AIDS advocates from across the country who will be traveling to the nation's capital to speak to their elected officials with a strong voice, united in support of a solid federal commitment to AIDS programs. Now is an especially important time in Washington as the Obama Administration and the new Congress develop their first appropriations packages and consider issues such as health care reform.”
The three-day event will provide advocates with opportunities to promote “comprehensive and quality access to health care and treatment for all people living with HIV, reducing HIV incidence by at least half by funding programs that teach proven evidence-based strategies for reducing HIV-risk, and investing in innovative research to uncover new prevention technologies while aggressively advancing our efforts to once and for all identify a cure for HIV/AIDS.”
Participants in this annual advocacy event include those living with HIV and AIDS, their families, friends, medical and care providers and other organizations. To register as a participant, go to the NAPWA website, http://napwa.kintera.org/aidswatch.
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Medicare Expands Coverage for Treatment of Facial Lipodystrophy
On March 23, officials from the Centers for Medicare & Medicaid Services (CMS) announced their decision to cover facial injections for Medicare beneficiaries who experience symptoms of depression due to severe facial lipodystrophy resulting from the drugs used to treat HIV. The decision is effective immediately.
Facial lipodystrophy is a localized loss of fat from the face, causing a “sunken” appearance in the cheeks. The condition can leave people living with HIV looking gaunt and seriously ill, which may stigmatize them and cause psychological effects, such as severe depression. This may lead to lapses in adherence to antiretroviral therapy, potentially leading to the virus getting stronger. The new decision allows for treatment of individuals who experience symptoms of depression due to the appearance changes from facial lipodystrophy.
According to the announcement, “the injections included in the coverage decision are “fillers” that have been approved by the U.S. Food & Drug Administration (FDA) to be injected under the skin in the face to help fill out its appearance. Data show that these injections can improve patient self-image, relieve symptoms of depression, and may lead to improved compliance with anti-HIV treatment.”
“Today’s decision marks an important milestone in Medicare’s coverage for HIV-infection therapies,” said Barry M. Straube, MD, CMS Chief Medical Officer and Director of the Agency’s Office of Clinical Standards & Quality. “Helping people living with HIV improve their self-image and comply with anti-HIV treatment can lead to better quality of life and, ultimately, improve the quality of care that beneficiaries receive.”
The final decision is posted on the CMS Web site at http://www.cms.hhs.gov.
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New Study: Getting Meds that Work
People with HIV taking a protease inhibitor drug combination, who have a viral load of more than 1,000 copies per ml, are invited to apply for study A5241. The study from the AIDS Clinical Trials Group (ACTG) will use drug resistance tests to determine what new medications should work best for these individuals and provide them with that optimized therapy.
ACTG will see if people going on a new drug regimen can have treatment success without taking nucleoside medications (also known as NRTIs). Usually, nucleosides are included in HIV treatment. With so many new and powerful HIV drugs on the market, however, nucleosides may no longer be necessary.
Among the medications that will be made available through the study is Isentress (raltegravir), and participants may not have ever taken a medication from its drug class, called integrase inhibitors.
A5241 is called the OPTIONS Study, for “Optimized Treatment that Includes or Omits NRTIs.” ACTG is a division of the National Institutes of Health. The OPTIONS Study is taking place at more than 50 clinics around the country. For more information or a study site near you, visit www.aactg.org. In Chicago, call Rush University Medical Center at (312) 942-5865.
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Men Needed for HIV Vaccine Study
Chicago is one of the sites for a new study from the HIV Vaccine Trial Network, HVTN 505. The study is now enrolling HIV-negative men who are circumcised and between the ages of 18 and 45. They cannot get HIV from the vaccine and will receive financial compensation for their participation. This is a randomized study, meaning that the men will be given the vaccine being studied or a placebo (fake drug). In addition, the men will receive information on how to lower their risk of acquiring HIV. For more information, call 800-575-5758 or 312-413-5897, e-mail wish@uic.edu, or visit www.hopetakesaction.org for a list of study sites around the country.—Enid Vázquez
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