The study found that young, sexually active gay men and those in minority groups are least likely to know their health status, even as infection rates are climbing among men who have sex with men, while the rates of other at-risk groups – heterosexuals and intravenous drug users – are falling.

AIDS in Kentucky increased through 1995, but then dropped 40% from 1996 to 2000. This decline was partially due to advances in treatments for HIV and opportunistic infections. The treatments prolonged the lives of many patients as well as extended the time from HIV infection to AIDS progression.

Another study found that 4 out of 10 gay men are not out to their doctors about their sexuality – meaning they are far less likely to get tested for HIV.

The findings were released Thursday, ahead of National Gay Men’s HIV Awareness Day on Monday.

In 2001, for the first time since 1995, an increase was observed in the Kentucky AIDS cases and has continued to increase steadily.

2005 – 2008′s numbers showed AIDS once again spiraling out of control with white homosexual males living in Lexington and Louisville being the primary cases in the Commonwealth.

In March 2010 the Board of Directors of the Kentucky Equality Federation declared an AIDS crisis in the Commonwealth.  Kentucky Equality Federation, the Kentucky HIV/AIDS Advocacy Action Group, AVOL, and other groups  fought to fund the Kentucky AIDS Drug Assistance Program.

The Kentucky AIDS Drug Assistance Program offered assistance with purchasing medication for people who cannot afford it.  (source)

• 14% of homosexual males in Kentucky who have AIDS are aware of their status and continue to have sex with unknowing partners
• 47% of HIV positive people are not aware of their status and continue to have multiple sexual partners.
• Nearly 85% of all AIDS cases in the commonwealth are within the Bluegrass Region including Covington, Frankfort, Florence, Georgetown, Lexington, Louisville, Richmond, and Winchester.
• 76% of all Kentucky AIDS cases are between the ages of 24 – 43.
• According to the Kentucky HIV/AIDS Branch, HIV is primarily spread through sexual contact with an infected person and by sharing contaminated syringes, needles, cotton, cookers, and other injecting drug use equipment with someone who is infected.

A CDC official called for a sharper focus on testing. “This study’s message is clear: HIV exacts a devastating toll on men who have sex with men in America’s major cities, and yet far too many of those who are infected don’t know it,” said Kevin Fenton, director of the agency’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

Cities in the study include Baltimore, where the prevalence rate among men who have sex with men was highest at 38 percent, and Atlanta, where it was lowest at 6 percent.

In the District, where the general HIV/AIDS prevalence rate is about 4 percent, more than 16,000 adults, one of the highest numbers in the nation, has the virus, according to the city Department of Health. According to the CDC study, the District had a 14 percent prevalence rate among men who have sex with men.

A CDC spokeswoman said the recent study’s findings were similar to those of a National Health Behavioral Study conducted between June 2004 and April 2005, when one in four gay men tested positive for the virus. But the percentage of minorities who tested positive changed dramatically in the three years since the previous study.

Back then, 46 percent of gay black men tested positive in the smaller study, compared with 40 percent in the larger 2008 study. Black gay men outpaced white and Hispanic men in both studies.

In the earlier study, Hispanics represented 18 percent of the infected compared with 23 percent in the most recent study. White men comprised 21 percent of the infected in 2004-05 and 20 percent in the more recent study.

Leaders of the House Democratic and Senate Republican majorities have met and exchanged proposals this week.

The Kentucky Senate however dealt a fatal blow Wednesday night to a bill strongly backed by the  Governor and the  First Lady that would increase Kentucky’s high school dropout age from 16 to 18.

Senate Republican leaders sent the measure, House Bill 301, back to the Senate budget committee, a move that effectively kills it for this year’s legislative session. 

First Lady Jane Beshear’s  Communications Office had no immediate comment.

Mr. Speaker and Mr. President: “Can you Spare some ‘change’ from your 3.5 billion in road projects to save lives?”

Currently, the new budget has no funding for the Kentucky AIDS Drug Assistance Program, but an effort led by Kentucky Equality Federation effectively killed House Bill 350, a bill that would have dismantled the education and prevention efforts performed by the Kentucky HIV/AIDS Branch, a unit of the Cabinet for Health and Family Services.

In addition, House Bill 350 would have removed the requirement that podiatrists, physicians, acupuncturists, physician’s assistants, athletic trainers, chiropractors, dentists, dental hygienists, registered nurses, advanced registered nurse practitioners, licensed practical nurses, pharmacists, optometrists, physical therapists, laboratory personnel, and social workers complete HIV/AIDS education and training as a condition of being licensed to practice in the Commonwealth.

At the last moment however, House Bill 350 was attached to Senate Bill 127. “This is an underhanded technique used at the end of sessions to move pieces of legislation that haven’t moved before by hiding them in other places,” stated Kentucky Equality Federation President Jordan Palmer.

By attaching a Senate Bill to a House Bill, the Kentucky House of Representatives had to concur, they did not, effectively killing amendments and attachments to Senate Bill 127.

Lawmakers have ignored pleas from a coalition led by Kentucky Equality Federation to restore the Kentucky HIV/AIDS Drug Assistance Program, which is the only way people with HIV/AIDS without medical insurance can receive the medication that saves their lives.  The coalition was outraged that the Kentucky Senate wanted nearly 3.5 billion in new road projects, but couldn’t allocate any funds to save people’s lives.

Coalition members included the Kentucky HIV/AIDS Advocacy Action Group, AVOL, Kentucky HIV/AIDS Planning and Advisory Council, COLAGE (Children Of Lesbians And Gays Everywhere), Northern Kentucky Chapter, United We Stand – Kentucky’s LGBTI News®, The Wings Clinic, House of Ruth, Moveable Feast, GLSO, University of Kentucky OUTsource, and the University of Kentucky Gay-Straight Alliance. (press release)

House Speaker Greg Stumbo (D-Prestonsburg), said in a statement that House Democrats offered the Senate a proposal that “accomplishes the goals of being fiscally responsible and creating jobs and opportunity across the Commonwealth.”

And the midnight Thursday deadline is firm. The Kentucky Constitution requires that during 60-day sessions in even-numbered years the session must end no later than midnight April 15.

Two years ago a frantic House and Senate unplugged the clocks in their chambers and continued working for another hour. But a lawsuit stemming from that episode produced a Franklin Circuit Court ruling that said any action taken by the General Assembly after midnight on April 15th is invalid.

Yesterday, House Speaker Greg Stumbo entered into closed-door talks with Senate President David Williams (R-Burkesville), a day that started with President Williams pronouncing a budget deal all but dead.

The Democratic controlled House of Representatives would not include any new road construction projects, a deal breaker with the Republican controlled Senate. House Democrats an additional $1 billion in school, water, sewer, and other projects, but Senate Republicans refused.

House Democrats also refused the Senate’s proposed cuts for schools and to the Medicaid program.

Since lawmakers waited until the last minute to pass a budget, Governor Beshear could veto all or part of it, and lawmakers would be unable to try to override it since the session must end at midnight tonight.

The sudden breakdown came after weeklong talks over the $17 billion-plus, two-year budget.

It raised the prospect of lawmakers waiting until the last day of the 60-day session in mid-April to pass a budget, or possibly leaving without one. Lawmakers had hoped to pass the budget Friday before taking a break to allow the Governor’s Office to review bills.

Substantial power is granted to the governor of Kentucky.  Historically, the Office of Governor of the Commonwealth of Kentucky has been regarded as one of the most powerful executive positions in the United States of America. The Governor of Kentucky is the head of the executive branch, commander-in-chief of the Kentucky’s army, navy, and state militia forces.  The governor also holds veto power over the Kentucky Legislature, and appoints Cabinet Secretaries without Senate confirmation.

The Governor was granted additional powers the last time the Kentucky Legislature ended its session without a budget, it led to a Kentucky Supreme Court ruling that a governor can spend money in the absence of a budget, but is limited to do so for items directly mentioned in Kentucky Revised Statues, Kentucky Administrative Regulations, or the Kentucky Constitution.

Top legislative leaders said they still hoped to achieve a budget deal, with each blaming the other chamber for the impasse. “I hope we can leave here with a budget,” Senate President David Williams said.

House Speaker Greg Stumbo declared that House members were willing to work “up until the last minute of the last day of this session” to get a budget accord.

Sticking points included education funding and a House-passed revenue package, but the main flash point appeared to be the construction projects backed by House Democrats. Senate President Williams (R-Burkesville), said Senate negotiators balked at the House-passed construction program that would result in the state borrowing about $1.2 billion to finance the work. The bulk of the bonded projects would replace dilapidated schools.

Speaker Stumbo (D-Prestonsburg), who was the Commonwealth’s previous Attorney General, has championed the construction projects as a way to jump-start the Kentucky’s economy. He said the proposal to build new schools along with water and sewer projects would put an estimated 25,000 Kentuckians back to work amid stubbornly high unemployment.

“It’s our position that we need to be creating jobs in these recessionary times,” Stumbo told reporters.

At his own news conference, President Williams warned that the construction program would “put our state into a debt-death spiral” in uncertain economic times.

President Williams said the House divvied up school projects to reward loyal House members, and said House Democrats were mistakenly trying to spend and borrow the state into prosperity.   “It is our position that in austere times people expect shared sacrifice,” Williams said.  “And that we have to keep our debt levels down and make sure that folks in the private sector see government sacrificing the way they have to sacrifice every day.”

Both legislative leaders acknowledged that the Kentucky House and Senate would draw considerable fury from the people of Kentucky if the session ends without a budget.

Lawmakers have three working days left in the 60-day session. If they wait until April 15th to pass a budget, they would not be able to consider overriding any possible veto’s the Governor issues to the budget.

Governor Steve Beshear said Wednesday that the legislature’s top job is to pass a balanced and responsible budget, and noted that it has until April 15th to do so. “The taxpayers and I both fully expect the General Assembly to work as many hours as it takes to meet that responsibility by that date,” Governor Beshear said in a statement.

The Senate passed a $17.3 billion two-year budget that called for deeper spending cuts to almost all state agencies than the House’s $17.5 billion version.  Speaker Stumbo said House members objected to the Senate’s cuts in education, but said negotiators had appeared to be closing in on resolving that issue.

Led by Kentucky Equality Federation, the Kentucky HIV/AIDS Advocacy Group, and AVOL (AIDS Volunteers Inc.), organizations across the Commonwealth have expressed alarm and dismay that the budget will be passed that does not include funding for the Kentucky AIDS Drug Assistance Program (KADAP).

The other organizations include the Kentucky HIV/AIDS Planning and Advisory Council, COLAGE (Children Of Lesbians And Gays Everywhere), the Wings Clinic, the House of Ruth, Moveable Feast, GLSO (Lexington Gay Lesbian Service Organization), University of Kentucky OUTsource, and the University of Kentucky Gay-Straight Alliance.

The organizations stated non-profits do not have the resources to provide a safety net for the Commonwealth’s shortfall in funding.   KADAP is currently unfunded even though it has 1,300 patients enrolled, with an additional 190 men and women being placed on a “waiting list” to receive life saving medications.  More and more names are added to the waiting list daily.

Kentucky Equality Federation’s Board of Directors slammed the Kentucky House of Representatives for failing to add a mere $3.5 million to an already ‘overburdened‘ budget to fund the Kentucky AIDS Drug Assistance Program.

If lawmakers fail to pass a budget, Governor Beshear could convene a special legislative session to deal with the spending plan.  The lack of a new budget by the start of the next fiscal year on July 1st could turn off the taps of funding for some services.   “There will be parks closed, there will be some services that will be suspended,” Speaker Stumbo warned.  “There will be in many areas of state government a visible stopping of the programs and the services that the Commonwealth provides.”

The cost for HIV/AIDS medication averages around $1,200/month—more than the entire monthly income of most families enrolled in KADAP.

“We’ve heard stories from people seeking out second mortgages to pay for their meds,” say Kentucky Equality Federation President Jordan Palmer and Kentucky HIV/AIDS Advocacy Action Group (KHAAG) President Bobby Edelen.  “One person who approached us said, ‘with the uncertainty of receiving assistance I am thinking about selling off my life insurance policy’ to afford life-sustaining medications.  We’re back to the 80s.”

The nearly 1300 patients enrolled in KADAP, which is currently unfunded, receive medications through a hodge-podge of resources that are temporary and unsustainable.  In the meantime, Kentucky has the longest waiting list in the nation for drug assistance—numbering over 160 men and women—with more being added every day.

“When do we come off the waiting list?” asked one HIV/AIDS patient, “When we die?”

People with HIV/AIDS who do not have access to medications are at increased risk for opportunistic infections, more frequent hospitalization (often under indigent status), and early death.  In contrast, a person who is taking HIV medications as prescribed and taking care of their health can reasonably expect to live as long as someone without HIV.

“Not funding the Kentucky AIDS Drug Assistance Program is inhumane, shortsighted, and threatens individual and public health,” states Palmer, who met with lawmakers six times during the legislative session trying to get KADAP restored.

Palmer held several meetings with Representative Tom Burch, Chairman of the House Health and Welfare Committee, DeeAnn Mansfield, Staff Administrator, House Health and Welfare Committee for the Legislative Research Commission, and Representative Jimmie Lee, Chairman of the House Budget Subcommittee on Human Resources.

On February 17, Edelen met with House Representatives to discuss the state of KADAP and other factors causing health care disparities in those living with HIV/AIDS.

“Chairman Tom Burch, a champion for the cause of health equity, asked some very astute questions,” noted Edelen.” In those questions, he demonstrated his support for re-funding KADAP and willingness to work on some measures to eradicate the waiting list.  However, the House Appropriation and Revenue Committee did not seem willing.”

As the commonwealth’s budget makes its way through the Senate, time is running out for those who depend on KADAP for their medication.

The following is excerpted from a statement of opinion issued by the Board of Directors of AIDS Volunteers of Lexington (AVOL):

“Given the larger financial crisis facing the Commonwealth, this may seem a specific and ‘special interest’ concern. The impact, however, is far reaching. Individuals with HIV/AIDS are mothers and fathers, family providers, valued employees, consumers, and citizens. Lack of access to medication will result in more work missed, a greater strain on social service organizations as families are forced into poverty and homelessness, a burden on medical facilities who must write off astronomically expensive HIV/AIDS hospital care to indigent and low income people, plus further disenfranchisement of those Kentuckians already at highest risk. Inasmuch as the commonwealth is feeling the challenges of the current economic climate, low-income individuals and families living with HIV/AIDS are losing jobs, struggling to make ends meet, and deciding whether to use their meager incomes to buy life-sustaining drugs or to pay rent and buy food for their families.

AVOL sees an urgent need for action to restore KADAP.  This effective program of preventative care is in the best long-term interest of the Commonwealth as well as those living with HIV/AIDS. Given the potential adverse effects and medical impact, time is of the essence.”

HIV/AIDS has the most devastating impact on Kentucky’s most at-risk communities, who already face significant barriers in accessing health care.  KADAP is literally a lifeline for these men and women.

Minority populations are disproportionately at risk for HIV/AIDS.   According to statistics from the HIV/AIDS Branch of the Kentucky Cabinet for Health and Family Services, African-Americans in Kentucky make 7.6% of the commonwealth’s total population but account for 36% of all new HIV infections.  Similarly, Latino Kentuckians make up 2.4% of the population but account for 7% of new HIV infections.

AIDS organizations across the Commonwealth are expressing alarm and dismay that the budget will be passed that does not include funding for the Kentucky AIDS Drug Assistance Program.  Small non-profits do not have the resources to provide a safety net for the commonwealth’s shortfall in funding.

The following agencies, organizations, and individuals affirm that KADAP is a crucial and necessary program for Kentuckians living with HIV/AIDS:

• Kentucky Equality Federation, Lexington, KY—Jordan Palmer, President
• Kentucky HIV/AIDS Advocacy Action Group, Frankfort, KY—Robert Edelen, President
• AVOL (AIDS Volunteers, Inc.), Lexington, KY—Mark Royse, Executive Director
• Kentucky HIV/AIDS Planning and Advisory Council, Frankfort, KY—Gary L. Fowler, Community Co-Chair
• COLAGE (Children Of Lesbians And Gays Everywhere), – Northern Kentucky Chapter Julia Spiegel, Director
• Amanda Beck-Myers, MSW, LSW, Edgewood, KY—HIV/AIDS Care Coordinator
• United We Stand – Kentucky’s LGBTI News®, Richmond, KY—Casey Kurtis, Co-Owner and Publisher
• The Wings Clinic, Deborah N. Wade, MSW, Program Director
• House of Ruth, Louisville, KY—Linda Underwood, Executive Director
• Moveable Feast, Lexington, KY—Terry Mullins, Executive Director
• GLSO (Lexington Gay Lesbian Service Organization), Dennis Wheatley, President
• University of Kentucky OUTsource, Lexington, KY— Eli Gross, Director

Other OUTsource concerned members: Sara Ailshire, Erik Bentley, Watson Harding, Matthew Hufford, Matthew Layson, Vincent Purcell, Ashley Scott, Brandon (Chase) Stamper, and Breanne Weaver

• University of Kentucky Gay-Straight Alliance, Lexington, KY—Watson Harding, Co-President

Other UK Gay-Straight Alliance concerned members: Matthew Layson, Matthew Hufford, Breanne Weaver, and Erik Bentley.

House Bill 350 would end the requirement that physicians, nurses, surgeons, etc. receive HIV/AIDS training and education as a condition to maintaining a license to practice in Kentucky.

Kentucky Equality Federation is the only statewide LGBTI advocacy organization to issue action alerts and condemnations of legislation impacting those living with HIV/AIDS.  This is usually a routine practice for statewide organizations such as Equality California, Equality Massachusetts, Georgia Equality and Equality Florida among others.

With Kentucky’s economy in ruins, additional human services are expected to be cut by lawmakers before the end of the 2010 legislative session.  Kentucky allowed its AIDS Drug Assistance Program to expire in 2007 according to the Herald-Leader leaving thousands of Kentuckians that are HIV positive without a means to pay for the expensive treatment medications.

Today, advances in medication can place an HIV patient in an “undetectable” state, meaning the patient’s viral load is so low, it is virtually undetectable.  However, these life saving medications can cost thousands of dollars.

In a harsh statement, Kentucky Equality Federation and the Kentucky HIV/AIDS Advocacy Action Group condemned House Bill 350 as “ethically irresponsible and a crime against anyone living with HIV/AIDS.” (source)

* Should House Bill 350 pass, the unasked question is what’s next?  An end to continuous training and education requirements to identity cancer, infectious mononucleosis, athlete’s foot, tumors, or even H1N1?

The press release is below:

Lexington, KY – Two statewide advocacy groups, Kentucky Equality Federation and the Kentucky HIV/AIDS Advocacy Action Group today condemned House Bill 350 as ethically irresponsible and a crime against anyone living with HIV/AIDS.

House Bill 350 seeks to remove HIV/AIDS training and education requirements for licensed service providers such as physicians, registered nurses, social workers, etc. Both organizations are opposed to the legislation because treatment options change rapidly, making it imperative that all health care professionals know the physical manifestations of HIV/AIDS. It is a matter of getting people in the proper care as soon as possible. This could be the difference in a healthy outcome or multiple misdiagnoses that would end up costing more financially either for the patient themselves or for the taxpayers of Kentucky.

“Treatment options change rapidly, therefore physicians or other clinicians that do not treat HIV/AIDS as a specialty would be hard pressed to know the best treatment options for their patients infected with this disease,” stated Bobby Edelen, president of the Kentucky HIV/AIDS Advocacy Action Group.

To compound the issue, Kentucky lawmakers allowed the Kentucky AIDS Drug Assistance Program to expire. “The fact that the Commonwealth also stopped funding the low-income Kentucky AIDS Drug Assistance Program in 2007 is inhumane, shortsighted, and threatens individual and public health,” stated Kentucky Equality Federation President Jordan Palmer.

Gary L. Fowler, a special adviser to the Kentucky HIV/AIDS Advocacy Action Group, and Co-Chair of the Kentucky HIV Prevention Advisory Council (KHPAC) stated: “I would like to point out that surveillance training is necessary for us to have the best information available to stop the spread of HIV/AIDS. Kentucky has a high number of people infected with the disease that report unknown risk factors. If we do not have accurate numbers for who is being infected and what their behavioral risk factors are, we do not have a clear picture of where we need to target our prevention dollars.”

Edelen continued: “House Bill 350 does a disservice to the citizens of the Commonwealth of Kentucky by lowering healthcare standards for service providers and should be defeated. The citizens of this great Commonwealth deserve the best representation from their lawmakers to ensure the quality of healthcare is held to a higher standard than ‘minimum’ and enforced with every protection under the law.”

* Notice: This article contains a question and/or opinion of the contributor or journalist.