XPost: ba.politics, dc.media, soc.penpals   
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   From: jedwards@yahoo.com   
      
   Prevention is 100% effective.  Stop butt-fucking each other and   
   sharing needles.   
      
   Like many HIV-positive patients, Alan Perez has struggled with   
   homelessness. After contracting the virus in 2001, he split up   
   with his partner and briefly spent time in a shelter. The Bronx   
   resident finally found a permanent place to live with the help   
   of a little-known city housing benefit.   
      
   But the benefit wasn’t easy to get: in order to qualify for the   
   rental subsidy, Perez says he had to make himself sicker.   
      
   “I took a risk. I took a big risk,” he said.   
      
   Under a housing assistance program run by the New York City HIV   
   and AIDS Services Administration, HIV-positive patients can get   
   rental benefits only if they meet low-income requirements and   
   have T-cell counts that are 200 or lower.   
      
   T cells are white blood cells that help fight off bodily   
   infections. When a patient’s plasma has fewer than 200 T cells,   
   doctors classify an HIV infection as fully developed AIDS.   
      
   "I wasn’t going to qualify for the program because my T-cells   
   weren’t that low," Perez said. "I stopped taking my meds."   
      
   Kristin Goodwin, director of policy and advocacy at Diaspora   
   Community Services, an AIDS advocacy center, said she believes   
   Perez is one of many New York City HIV patients who have   
   purposely lowered their T-cell counts in order to qualify for   
   housing. She said she first heard Perez share his story in a   
   roundtable discussion.   
      
   "Alan told a story in a group that I was in, and I just remember   
   feeling really sad that he had to make that choice," Goodwin   
   said. "Clearly he was not the only person in the room who has   
   had to make that choice. There were a lot of people that agreed   
   with him. They said, 'Yeah, I remember when I decided that I was   
   going to stay on treatment but I didn’t get my apartment.'"   
      
   AIDS researchers have long warned how dangerous it can be to   
   stop an HIV medication regimen, even for a few days or weeks.   
      
   Taking a break from treatment can result in virus mutations --   
   which can make HIV more drug-resistant in the future, according   
   to Dr. Jeffrey Laurence, director of the laboratory for AIDS   
   virus research at Weill Cornell Medical College.   
      
   "We’re talking about not taking medications that are going to   
   leave not only a person vulnerable, but his or her community   
   vulnerable," Laurence said.   
      
   Salina Smith, a spokeswoman for the Centers of Disease Control   
   and Prevention, said people who start and continue HIV drug   
   treatment are 96 percent less likely to transmit HIV to others.   
      
   The New York City HIV housing program is uniquely generous among   
   cities. Most cities do not offer housing benefits to HIV-   
   positive residents, no matter how poor or sick they are.   
      
   In an email statement to the I-Team, Laura Hart, a spokeswoman   
   for the city’s Human Resources Administration, said the T-cell   
   threshold is being re-evaluated.   
      
   "The rules for who does and does not receive housing assistance   
   were set many years ago, and as part of our reforms at HRA, we   
   are reviewing whether those long-standing policies still make   
   sense," wrote Hart.   
      
   Hart added that the city has already worked with Gov. Cuomo and   
   state lawmakers to lower the cost of housing for AIDS patients --   
    regardless of their income bracket -- and implemented a law   
   that caps rents for New Yorkers living with AIDS at 30 percent   
   of income.   
      
   According to World Health Organization guidelines, HIV-infected   
   patients should begin drug therapy whenever a T-cell count less   
   than 350 is recorded.   
      
   Laurence said using 200 T-cells as a benefits threshold is   
   particularly dangerous because that is when drug treatment   
   becomes most critical.   
      
   "Organizations in third-world countries are saying we should be   
   treating someone at 350 T-cells at the lowest," said Laurence.   
   "I’m surprised that 200 is the count that enables you to get   
   treatment and housing in a place like New York."   
      
   In October, Cuomo announced the formation of an AIDS task force   
   aiming to reduce new HIV infections in New York to just 750 per   
   year by 2020. Advocates for HIV patients are pushing the tas   
   kforce to recommend increased funding so that the city’s housing   
   benefits can be extended to patients with any T-cell count.   
      
   In 2008, NYC Council Speaker Melissa Mark-Viverito (D – East   
   Harlem) co-sponsored a bill that would have eliminated the T-   
   Cell threshold and expanded housing benefits to all impoverished   
   HIV patients in New York. The bill never made it to a vote.   
      
   Despite an inquiry from the I-Team, the speaker would not say   
   whether she would support the same bill today.   
      
   "No bill has been re-introduced on the matter in the most recent   
   session but if it was we’d be happy to review it," wrote Eric   
   Koch, a spokesman for Mark-Viverito.   
      
   By some estimates, providing housing for thousands more HIV   
   patients, regardless of their T-cell counts, could cost   
   taxpayers as much as $100 million.   
      
   Laurence said his own research shows homeless HIV-positive   
   patients are much less likely to take their medications and   
   there are real costs associated with failing to provide rental   
   assistance.   
      
   "Economically, the longer you wait to treat a person, or the   
   lower their T-cells get, the more hospitalization expenses you   
   will have, and the greater chance there is that they will   
   develop expensive opportunistic infections," Laurence said.   
      
   http://www.nbcnewyork.com/investigations/HIV-Positive-New-York-   
   City-Residents-Sicken-Selves-Qualify-Housing-Benefits-   
   284414001.html   
      
        
      
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