Policy

‘The Fight for Fair and Just Public Policy is Far from Over’

GMHC’s policy team may currently be small, but it still punches way above its class. The agency’s many firsts and strong name recognition in the fight against HIV/AIDS means GMHC is often expected to be at or invited to the table with key decisionmakers determining HIV/AIDS policies at local, state, and national levels.

“One of the things I love about working at GMHC is that while we serve people living in New York City, we are also often involved with key policy issues at the national level,” said Jason Cianciotto, senior managing director of institutional development and strategy who also heads GMHC’s policy department.

Since its founding nearly four decades ago, GMHC has recognized the power of coalitions to affect public policies. As early as 1985, GMHC helped form the New York’s People With AIDS Coalition to give voice to those living with the disease. GMHC subsequently helped launch and support other coalitions to address the needs of communities affected by the epidemic including people of color and women. GMHC has also been part of other major AIDS coalitions, including ACT UP, to confront the medical establishment and demand accountability.

GMHC’s policy work is credited with helping promote a number of major policy changes that have benefitted millions of people living with HIV/AIDS. GMHC fought successfully for accelerated FDA approval processes for new HIV treatments and pressured drug manufacturers to lower the cost of these drugs in order to make them more affordable. GMHC’s voice was instrumental in advocating for the 1990 Americans with Disabilities Act to include protections for people living with HIV. That same year, GMHC was part of a coalition that supported the passage of the groundbreaking Ryan White CARE Act to improve availability of and access to care for low-income, uninsured, and under-insured people affected by HIV/AIDS and their families.

Today, GMHC continues to fight against the last vestiges of public policies that continue to stigmatize people living with HIV/AIDS and discriminate against the LGBTQ+ community. For example, since 2010 the agency has been a leader fighting to overturn the federal ban on blood donation by men who have sex with men.

“This ban continues to reinforce misconceptions about how HIV is transmitted, while stigmatizing and creating prejudice against gay and bisexual men,” said Cianciotto. “You don’t contract HIV because of who you are, you are exposed to it by what you do.”

Bowing to pressure from GMHC and other LGBTQ+ agencies, the Food and Drug Administration (FDA) amended its policy on blood donations in 2015 to allow donations by men who have sex with men after a 12-month “deferral” from having sex. “Very few adults are celibate for one year and this policy doesn’t apply to heterosexual men who may have been exposed to HIV because of unprotected sex or sharing a needle,” said Cianciotto.

The policy was revised again in 2020 to a three-month deferral when the need for blood and plasma donations spiked during the COVID-19 pandemic. Despite the revision to the policy, Cianciotto said gay and bisexual men continued to be turned away at blood donation centers because these centers could not pivot quickly enough to implement the revised policy. The FDA is currently working on a research study with input from LGBTQ+ organizations that will assess the impact of a revised screening questionnaire for blood donors that focuses on behaviors rather than sexual identity.

At the New York State level, GMHC continues to be a powerful voice in shaping public policies. In 2021, GMHC was part of a coalition that persuaded the governor to grant priority access to COVID-19 vaccines to people living with HIV/AIDS. The agency was also part of a group that forced the repeal of the so-called “Walking While Trans” bill, which allowed for police profiling of transgender people simply for how they looked.

“The end of this law is a critical step toward reducing the persistent marginalization of communities that have been targeted by law enforcement and contribute to high-risk behaviors for HIV infection,” said Cianciotto.

Looking ahead, Cianciotto said the agency will be focusing on preserving city and state funding for HIV services organization, protecting the 340b pharmacy program that is a significant source of revenue for HIV/AIDS healthcare agencies serving low-income communities, and ensuring broader access to PrEP and PEP.

“The fight for fair and just public policy is far from over four decades into the AIDS epidemic,” said Cianciotto. “We’ll keep working to protect funding for programs that serve people living with HIV/AIDS as well as to end discrimination against all LGBTQ+ people.”

Photo caption: GMHC remains a vital force in advocating for policy changes to benefit people living with HIV/AIDS.

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