The Wellness Times

On HIV Criminalization

Last week the Director of the Ohio AIDS Coalition launched the first volley in a fight to end an historical anathema to the public health strategy to end the HIV epidemic.  Few people know this, but there are sections of our criminal code that make conduct of HIV positive persons a felony.  Loitering for example is a misdemeanor…  unless a person has tested positive for HIV, then it is a felony subject to imprisonment for years.  The natural reaction to this law is to not get tested, because if you haven’t been tested you can’t be convicted of a felony.  These laws were written in the mid 1990’s, a time of fear and a time when effective treatment for HIV was just becoming available.  Times have changed folks.

So here’s the thing, and there’s no getting around it.  A viral infection that can’t be transmitted by walking around or standing around (aka loitering) isn’t deserving of a two-year prison term.  Further, if someone is on antiretroviral medication, they can get their virus to an undetectable level, and are 96% less likely to be able to infect others.  Laws like these discourage people from getting tested for HIV, they discourage people from getting into treatment to suppress the HIV virus, and only create opportunity for passing HIV to other people.

Legislation from the seat of fear is never a public good.  The time of treating people with HIV as serious criminals, rather than encouraging people to get tested and access treatment and reach viral suppression, needs to end.  The Ohio AIDS Coalition is working to end that.

Read the letter here

An Interview with Vivian Nassali, ARC Ohio Case Aide

The Ohio AIDS Coalition (OAC) and AIDS Resource Center Ohio (ARC Ohio) are committed to providing the best service and assistance to our consumers. OAC and ARC manage to stay connected to the HIV/AIDS community through our own staff and volunteers. Vivian Nassali, an ARC Ohio staff member, brings her own personal story of HIV/AIDS to ARC Ohio and her job as a Case Aide. Vivian works with case managers to provide assistance to people living with HIV/AIDS (PLWHA) in the state of Ohio.

I had the wonderful opportunity of sitting down with Vivian to discuss her struggles with HIV/AIDS and how it has affected her work and daily life. Vivian lost her mother, Rodah, to HIV complications in 1993 when she was only five years old. Living in her home country of Uganda, Vivian says she experienced stigma due to her mother’s positive status. People would avoid her and her mother for fear of contracting HIV. Despite all the compassion she received due to her mother’s HIV status, people still kept their distance from Vivian due to their fear of HIV. As you can imagine, this was extremely difficult for a young Vivian.

Vivian stressed to me that she remembers her mother as loving, kind, and supportive, even when she was at her sickest. Even while her mother was in the hospital, she was first and foremost an adoring, caring, and warm mother.

After her mother’s passing Vivian was adopted by her aunt and immediately got involved in HIV/AIDS volunteer work. Vivian shared a memory of her as a young girl passing out condoms at an HIV event. Her volunteer work eventually led her to pursue a career in HIV/AIDS. Vivian moved to the United States when she was 14 years old and continued her HIV/AIDS volunteer and advocacy work through organizations like AIDS Walk.

Vivian has noticed that the stigma felt in 1993 Uganda is often times still felt today. She has family members that don’t understand the disease, how it is spread, or how it is prevented. She has noticed mistreatment towards those with HIV in her own family. Even her grandfather, whom she labels as an intelligent man, still has very dated ideas about HIV/AIDS. For a long time Vivian refused to tell people what her mother died from, fearing stigma or ostracism. She blames the stigma around HIV on the false information so profusely spread by the media, even stating that at times she had been caught up in what the media was saying. Her passion for HIV advocacy eventually led her to Ohio where she joined AIDS Walk, eventually taking a job with ARC Ohio. Vivian made it clear that she is passionate about her work and that passion stems from her mom’s fight against HIV.

Vivian seemed excited to change the way people view HIV/AIDS, especially through education. She believes that the ideas around “HIV has changed a lot, but people should know more…” about the disease. We discussed the idea of PrEP and she believes it may help change people’s perception of the disease, while also promoting prevention.

Vivian has brought experience and knowledge to ARC that will benefit the entire organization. We can all learn from Vivian’s background to create better programs, assistance, and education to Ohio.

Vivian is organizing a celebration space with her fellow case aides/managers at the ARC Medical Center. The Celebration space will memorialize family members and friends who have lost their fight in the battle against HIV/AIDS. The event will take place on December 6th from 4:00pm until 8:00 pm during the Short North’s Gallery Hop. A hat drive will also take place during the event to benefit ARC’s consumers throughout the winter. Contact Vivian at for more information.

I would like to thank Vivian Nassali for sitting down and sharing her story with me, she has shared a perspective that will help many people at ARC Ohio and OAC.

Meet Our Intern, Grace Ferguson

You’ve (hopefully) noticed that our blog has been a bit more active in the past few months.  A large part of that is due to our fabulous intern, Grace, who has been contributing articles on a whole range of topics.  I’ve asked her to change things up a bit and introduce herself.  So without further ado, here’s Grace!

Hello Wellness Times Readers! It is about time that I introduce myself. My name is Grace Ferguson and I am the Ohio AIDS Coalition’s intern. As a Public Health Major at THE Ohio State University, I wanted to expand my learning beyond the confines of a lecture hall and into the practical world of public health implementation. I came across OAC and the AIDS Resources Center Ohio in a Google search while I was looking for public health organizations in the Columbus Area.  The mission that OAC supports, Health Education and Prevention, stood out to me immediately, this was where I wanted to learn how to implement the tools I was hearing about in the classroom.

I started working for OAC in February of 2014 (almost nine months now!). The first project I was placed on was daunting, but I loved every minute of it. I was asked to call all of the HIV/AIDS healthcare providers in the state of Ohio and figure out which Healthcare programs they contract with. It took me months to complete, but introduced me to the hard work, dedication, and perseverance that is the Non-Profit world.

OAC has introduced me to an entire world of health care and HIV/AIDS health management that I had never even heard of before. It wasn’t until I started working for OAC that I heard of PrEP or the fiery debate behind it. Because of my research and work with PrEP at OAC I have continued to research PrEP and share my knowledge about it with fellow public health students. I was recently able to attend a community discussion, hosted by OAC and Columbus Public Health, led by leaders in the HIV field. The discussion featured proponents, opponents, and medical experts in the PrEP field and opened my eyes to some of the pros and cons circulating PrEP.  I have also had the opportunity to learn about the ins-and-outs of the insurance field. Working at OAC throughout the Affordable Care Act roll out was a very exciting time. I have been able to learn about the details of the insurance world, from enrollment, to appeals. OAC has taught me things about public health implantation that a classroom could never come close to.

When I am not researching the Medicaid appeals process, or reading clinical trial abstracts on experimental drugs, I enjoy cheering on my buckeyes on the football field. I spend the spring at Huntington Field watching the Clippers and dreaming of days when the Philadelphia Phillies are in the Post-Season again. As a Philadelphia native I miss the East Coast every day, but after spending eight years of my life in the state up north I am happy to be a resident of Ohio. My parents raised me on the coast of the Outer Banks surfing, swimming, and sharking (I like to consider myself a shark enthusiast), and I considered Kitty Hawk, North Carolina my true home. I am also proud to call myself a sister of the Gamma Phi Beta sorority and an active member of OSU student life, participating in Health Science Scholars and the OSU Sportsmanship Club. While I’m on break from school I occupy my time by hanging out (annoying) my 14 year old brother Andrew, and parents, who live in Baltimore, Maryland.

After finishing my degree (hopefully on time) I hope to pursue a Master’s in Public Health and a Law Degree. In the distant future, I hope to work in government promoting healthy behavior and disease prevention, while keeping in mind my Public health background that OAC has rooted in me so strongly.

The Affordable Care Act is Working

From Blog

Remarks by Secretary Sylvia M. Burwell "The Affordable Care Act is Working"On Tuesday, I had the opportunity to talk about the Affordable Care Act Exit Disclaimer at the Brookings Institution.

When it comes to the Affordable Care Act, it’s our belief that the three most important measures are affordability, access, and quality – and that when you consider the law through this lens, the evidence points to a clear conclusion: The Affordable Care Act is working – and families, businesses, and taxpayers are better off as a result.

Four years after President Obama signed the law, middle-class families have more security, and many of those who already had insurance now have better coverage. Fewer Americans are uninsured. At the same time, we’re spending our health care dollars more wisely, and we’re starting to receive higher quality care. 

As a country, we’ve been wrestling with the question of how to cover the uninsured for more than a century. By the time the Affordable Care Act was passed, tens of millions of Americans were uninsured, millions more had coverage that wasn’t there when they needed it, and everyone felt the effects.

Thanks to the Affordable Care Act, things are changing for the better: In just one year, we’ve reduced the number of uninsured adults by 26 percent. Said another way, 10.3 million fewer adults are uninsured today than in 2013.

This represents historic progress on an issue that has eluded our country for more than a century. There isn’t a business in America that wouldn’t be ecstatic with this kind of growth.

Those who already had insurance are better off too. If you think about a mom and dad sitting at their kitchen table, working out a family budget – it’s a big deal that they’re saving money and still getting better coverage and more financial security.

Meanwhile, millions of seniors are saving billions of dollars on their prescription drugs as we phase out the donut hole. More than 8.2 million seniors have saved more than $11.5 billion since 2010.

Ultimately, a healthier and more financially secure middle class is good for businesses, who benefit from a healthy workforce and consumers with more disposable income.

Since President Obama signed the Affordable Care Act, there is evidence that we have bent the cost curve when it comes to health care. Across the board, we have now held down health care price inflation to the lowest rate in 50 years.

I also wanted to tell you about a couple of big announcements we made this week regarding the health care law.

First, in 2015 there will be a 25% increase in the total number of issuers selling health insurance plans in the Marketplace. More choice and competition is a great thing for consumers, and it has an effect on affordability, access, and quality alike.

Secondly, we announced that because of the Affordable Care Act, we project hospitals will save $5.7 billion in uncompensated care costs this year. Hospitals in states that have expanded Medicaid are projected to save up to $4.2 billion, and to receive about 72 percent of the total savings nationally.

Taken together, I believe the evidence points to a clear conclusion: The Affordable Care Act is working. My job as Secretary is to lead our efforts to make sure it continues to work and to work better.

We have a four part strategy for moving forward: improving access and affordability through the Marketplace; improving quality for patients and spending every dollar wisely; expanding access by expanding Medicaid; and helping consumers understand how to use their coverage – including the role of prevention and wellness.

Today marks the 50 day countdown to the beginning of Open Enrollment. Join the millions who’ve already gotten covered. Get more information at

Pre-Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) is one of the newest and most effective ways of preventing HIV, and there has been a lot of hype, excitement, and misinformation surrounding the idea of pre-exposure prophylaxis. But what really is PrEP? Who can take the pill? What are the risks, and what are the benefits?

What exactly is PrEP? To understand what PrEP is, it is important to understand what Pre-Exposure Prophylaxis means. Pre-Exposure, in this case, meaning before one is exposed to the HIV infection. Prophylaxis means to prevent the spread of a disease/infection. So in this case Pre-Exposure Prophylaxis means, to prevent the PrEP Infographicspread of HIV, before one is exposed to it. The PrEP pill is being prescribed under the brand name Truvada.  Truvada is used in two different ways: 1) To treat HIV, in combination with other medications, in those over the age of 12, and 2) To reduce the risk of contracting HIV in at risk adults.  It is important to understand that Truvada is not a vaccine, but instead works by blocking HIV replication, thus preventing the establishment of infection in the body of HIV negative individuals. Studies have shown that the use of PrEP can decrease an individual’s risk of contracting HIV by up to 99%.

But who can take Truvada for PrEP? According to the CDC, ‘at-risk’ people include “HIV-negative men who have sex with men and who are at high risk of getting infected with HIV through sex, and male-female sex partners when one partner has HIV and the other does not.” There are other situations that may make one at-risk, such as injection drug use, sex work, or having recently been diagnosed with a sexually transmitted infection. At the moment, Truvada for PrEP is only recommended for those 18 years of age or older, and that are determined to be at-risk by their doctor. You must also be HIV-negative to start a Truvada for PrEP plan. Once you have started taking PrEP you must commit to HIV, STD, as well as other tests and doctor visits every three months, to ensure you maintain your HIV negative status. The Center for Disease Control “recommends that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.” (PrEP 101) The World Health Organization “strongly recommends men who have sex with men consider taking antiretroviral medicines as an additional method of preventing HIV infection (pre-exposure prophylaxis) alongside the use of condoms.” (WHO: People Most at Risk)

What are the Risks of PrEP? Many opponents of PrEP are expressing their concerns about the risks associated with taking Truvada for PrEP. A primary concern is the risk developing a resistance to Truvada, an important drug used to treat HIV; however, the iPrex study on PrEP found little to no evidence of resistance when the drug was taking as advised. A variety of side effects are possible, so be sure to discuss any potential
side effects with your doctor when deciding whether PrEP is right for you. PrEP also has a variety of benefits as well. When taking correctly and daily as prescribed, PrEP has been shown to reduce the risk of contracting HIV by up to 99%. These rates are extraordinary, but PrEP should still be used with safe sex practices, as it does not offer any protection against other sexually transmitted infections such as syphilis or gonorrhea.

AIDS Resource Center Ohio (ARC Ohio) and The Ohio AIDS Coalition (OAC) have been working diligently to promote education, research, and the use of Truvada for PrEP. Both organizations believe that with proper education, medical supervision, and the addition of safe sex practices, PrEP could be the next major step in the fight against HIV.


2014 International AIDS Conference Recap

The 2014 International AIDS Conference wrapped up in July in Melbourne, Australia. The week-long symposium is a gathering of the best and brightest in the AIDS field from across the world. Thousands of researchers, activists, and, AIDS professionals gathered to discuss the latest in HIV treatment, prevention, and policy. This year’s conference hot topics included PrEP and Hepatitis C, both of which OAC have been focusing diligently on.

A major topic of conversation was PrEP, one of the newest HIV prevention strategies. This pill, which OAC has been education Ohioans and promoting on behalf of, is a viable option for protection against HIV. Numerous studies about the effectiveness of PrEP were presented at the conference. iPrex discussed the importance of medication adherence while on PrEP.  The research found that while taking Truvada four or more days a week on a regular basis, men and transgender women who have sex with men were 100% protected against HIV. This same study, however, found that this strict adherence to the pill only occurred 33% of the time.  This study is the first to show results from PrEP in a real-world situation, without a randomized controlled trial where some participants received a placebo. PrEP works.  Adherence is key.

PrEP is an exciting new tool in the HIV prevention toolbox that has the potential to play a huge role within the AIDS epidemic.   The Ohio Aids Coalition will be co-hosting a community conversation on PrEP on September 24th from 6:30 to 8:30 at the Columbus Public Health Building. Professionals, consumers, and activists will be in attendance.  The program will have a brief PrEP 101, an expert panel encompassing all sides of the PrEP world to offer perspective and answer questions, and an interactive component that will engage folks in a meaningful dialogue about negotiating safe(r) sex practices in an era of PrEP, and a discussion on what PrEP means for the future.  Email Zach Reau at for more information or to RSVP!

Another important topic that was routinely brought up at the conference was that of Hepatitis C, a disease that is exceptionally prevalent in the HIV community. Nationally, 25% of people with HIV are co-infected with Hepatitis C. Hepatitis C is one of the leading causes of non-HIV related causes of death for persons living with HIV. This topic was met with both a positive and negative outlook. Research studies presented at the conference showed that the drugs Sovaldi and Ribavirin are known to cure those infected with both HIV and specific strains of Hepatitis C. In a study containing 274 participants, the cure rate ranged between 83 and 91 percent. Previous Hepatitis C treatments were nowhere near as successful and are associated with some pretty bad side effects.  Sovaldi has also been shown to be successful in persons who are HIV positive.  The research was not met with complete positivity though; the Fair Pricing Coalition (FPC) as well as other activists protested the prices set on Sovaldi. Sovaldi costs about $1,000 a pill, making treatment cost between $84,000 and $168,000 for 12 weeks and six months of treatment, respectively. The FPC states that Gilead, the company producing Sovaldi, is unfairly marketing the drug at too high of a price, making it unavailable to the majority of people suffering from Hepatitis C. Gilead is still standing strong behind their prices and Sovaldi. Gregg Alton, a Gilead Vice President said “It is a fantastic drug. It’s really changing the landscape of Hepatitis C and the ability to treat hepatitis C, from a largely untreatable disease to one we can cure with a more than 90 percent rate.” Activists are stating that they don’t believe Gilead shouldn’t be making a profit, but they are simply out of touch with reality. There are currently some promising Hepatitis C drugs coming through the pipeline.  Hopefully the increased competition will help lower Sovaldi prices to reasonable rates.

The 2014 International AIDS conference brought up a variety of interesting points on the fight against HIV/AIDS. Groundbreaking research in the HIV field was unveiled to allow for the medical advancement of treating HIV, social activism played its part in fighting for patients’ rights, and the world learned a little bit more about the needs of the HIV community. Overall, the conference was a huge success and brought to light the many needs of the HIV society. We have come a long way in the past 33 years but we still have a long way to go.

The next conference is set to take place next July in Vancouver, Canada. More information on the conference can be found at

CDC’s Prevention Through Healthcare Site is Up and Running!

The CDC’s new Prevention Through Healthcare website is up and running! As of May 5th, local health departments, healthcare providers, and consumers can access the site to get the latest information on the prevention of infectious diseases like HIV/AIDS.

The interactive and information filled webpage focuses on preventative healthcare. A major feature of the site is its Resources on the Changing Health System page, featuring a lot of material on Medicaid expansion, finding doctors, and health policy.  There’s even a section that breaks down the Affordable Care Act and makes it easy to understand!

Sections of the page have been designed to help state and local health departments successfully utilize the crucial prevention and healthcare improvement tools from the CDC. An extremely useful resource for health departments is the Next Steps program, designed to help “identify key strategies and activities that anticipate and address the complicated but emerging circumstances and improve population health.”  The website looks like it’ll be a great resource!

As the site focuses on the prevention of diseases through healthcare, several sections are dedicated to preventative medicine and its effect on the HIV community. These sections provide information about new discoveries and advancements of vaccines and treatments of infectious diseases.  The CDC’s website specifically discusses PrEP and the benefits it could have for the HIV community.  It looks very promising and it’s exciting to see the CDC pay attention to this topic!

Overall, the new prevention website will be a major step forward in connecting consumers, health departments, and the CDC, and at the same time making information on health insurance and healthcare easier to access.

The Ohio AIDS Coalition’s website also has a bunch of resources to help Ohioans work through healthcare enrollment. Information on Ohio’s Medicaid Expansion and help navigating the system can be found here.  We’ve also conducted an analysis of how medicines covered under Medicaid and Marketplace plans compare to the OHDAP formulary as well as an analysis of which providers accept particular insurance plans.  And make don’t forget to check out our calendar to find upcoming OAC events in your area!

Healthcare Marketplace Update

The federally run Health Insurance Marketplace officially opens on October 1st.  This will be the first day that consumers can examine the plans offered in Ohio.  Plans must be chosen by December 15 to begin coverage on January 1st, with delayed enrollment to those who choose their plans after the deadline.  Before October 1st, OAC encourages everyone to create an account at and familiarize themselves with the user-friendly site.  After October 1st, individuals should begin exploring the plans that may suit their needs.  Soon we will provide tools to assess the relevance of each plan to an individual’s needs and will work with Marketplace Navigators, Case Managers, and HIV care providers to answer any questions concerning people living with HIV/AIDS.  Plans have not yet been identified or analyzed that may offer people living with HIV/AIDS the most comprehensive or specialized care, nor will we directly recommend any plan over another; it is up to the individual consumer to make his/her choice.  The Ohio AIDS Coalition recommends to those who qualify or think they may qualify for insurance in the Health Marketplace to take their time and examine every plan that might meet their needs.  For resources on understanding Healthcare Reform and the Health Insurance Marketplace, check out our Community Resources page.

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New HIV Vaccine Proves Successful In Phase 1 Human Trial


A vaccine for human immunodeficiency virus (HIV) has proved successful in a Phase 1 clinical trial with no adverse effects in human patients, Sumagen Canada Inc. and Western University of Ontario announced today. The vaccine, which was developed by Dr. Chil-Yong Kang and his team, is the first genetically modified, whole-killed vaccine to be approved for testing in humans.

“We are now prepared to take the next steps towards Phase 2 and Phase 3 clinical trials,” stated Jung-Gee Cho, the CEO of Sumagen Co. Ltd., in a press release. “We are opening the gate to pharmaceutical companies, government, and charity organization for collaboration to be one step closer to the first commercialized HIV vaccine.”

Human Testing

The clinical trial, which evaluated safety, tolerability, and immune responses, was initiated in March 2012 and completed in August 2013. The study of the vaccine, known as SAV001-H, followed intramuscular administration in HIV-infected, asymptomatic men and women, 18 to 50 years of age. The trial studied the vaccine’s effects on volunteers as compared to a placebo group.

After receiving the vaccination, volunteers visited test sites on weeks four, six, 12, 18, 26, and 52 for a general physical examination as well as analysis of clinical chemistry, hematology, and urinalysis. Researchers observed no serious adverse events and also found a surprising boost in antibody production, which may forecast success in Phase 2 trials measuring immune response.

The antibody against p24 capsid antigen increased as much as 64-fold in some vaccinees while the antibody against gp120 surface antigen increased up to eight-fold. P24 is a structural protein that makes up most of the HIV viral core also known as the ‘capsid.’ High levels of p24 are present in the blood serum of newly infected individuals during the short period between infection and seroconversion, making p24 antigen assays useful in diagnosing primary HIV infection. A glycoprotein, gp120, is necessary for attachment to cell surface receptors and also allows for the HIV virus to enter cells.


SAV001-H, which was produced at a manufacturing facility in the U.S., is the only HIV vaccine developed in Canada and one of only a few in the world. Sumagen anticipates having the first HIV vaccine approved for market. HIV currently affects more than 34 million people who live with the virus worldwide, according to the World Health Organization. Over the past three decades, HIV has claimed more than 25 million lives.

Since the virus was characterized in 1983, pharmaceutical companies and academic institutions around the world have attempted, yet consistently failed, to develop a vaccine. What is unique about Kang’s vaccine is its use of a killed-whole HIV-1, which is similar to the vaccines developed for polio, influenza, and rabies. HIV-1 is also genetically engineered; this raises its safety profile and the possibility of it being produced in large quantities.

Sumagen is a member of Curo Group, a Seoul-based company with subsidiaries or affiliates in financial services, information technology, and other business areas. Sumagen has secured patents for the SAV001 vaccine in more than 70 countries, including the U.S., the European Union, China, India, and South Korea.

Development of Sumagen’s HIV vaccine has been supported by the government of Canada as well as the Bill and Melinda Gates Foundation.

(taken from Medical Daily)

Long Term CHER Study Backs Early HIV Drugs for Children

The five-year CHER (children with early antiretroviral) trial recently concluded, with results indicating that there may be a place for the early use of antiretroviral (ARV) drugs to help infants and children combat HIV.  Conducted in South Africa, the trial only at its halfway point in 2010, led the World Health Organization to recommend that ARV therapy be started immediately in children less than one year old who have been diagnosed with HIV, before the threshold of infection is reached.

From AFP, “Children who began an immediate course of drugs were able to interrupt their treatment, giving them a break from the powerful, potentially toxic drugs…Those who began an immediate course of 40 weeks of drugs were able to take a 33-week break before starting treatment afresh…those who took an immediate 96-week course enjoyed a break of 70 weeks.”

ARVs are responsible for the preservation of countless lives in the US, as they prevent HIV from replicating, rolling back the virus to undetectable levels and decreasing the chance of transmission.  But because of “reservoirs” in the human body, if ARV therapy is stopped for any reason the virus will quickly rebound.  Stopping ARV therapy could also contribute to drug resistance, making a patient less likely to gain the benefits from their regime.

But continuous adherence to ART (antiretroviral therapy) can have toxic effects on infants.  The CHER trial has provided hope that temporarily stopping treatment to provide relief may be possible in some circumstances.  Both Robert Colebunders of the Institute of Tropical Medicine in Antwerp, Belgium, and Victor Musiime of Makerere University College of Health Sciences in Kampala, Uganda were quick to point out, however, that treatment interruption is a risky option in poor countries which lack laboratories to monitor levels of CD4 cells.


Full story here.