Friday, July 29, 2005

Ronda Storms continues wreaking havoc

this is from the St. Pete Times

Commission backs off Planned Parenthood

Led by Ronda Storms, the county cuts funding to a teen educational program.

JUSTIN GEORGE
Published July 29, 2005

TAMPA - The idea came from Hillsborough County Commissioner Ronda Storms: eliminate funding for a teen educational program sponsored by Planned Parenthood.

Commissioners went along with her Thursday, while expressing none of their personal feelings about the nonprofit group that supports women's reproductive rights.

But Storms had made her feelings clear in a conversation last week, said Barbara Zdravecky, who oversees Planned Parenthood in 15 counties, including the Tampa Bay area.

Storms supports life - Zdravecky remembers hearing her say - and Planned Parenthood supports death.

"I have to say I was pretty shaken," Zdravecky said. "I'm used to taking hits. But I was surprised at her lack of humanity."

Zdravecky, other nonprofit officials and proponents had just finished lobbying the commission the night of July 21 and were standing around after nearly three hours of budget discussion.

They wanted commissioners to give them $39,500 during the next two years for Source Teen Theater, a $130,000 program in which Tampa teens teach other kids about such topics as sexual activity, drugs, gangs and family violence.

Storms remembers the conversation, too.

She had called for Planned Parenthood's removal from the budget. Zdravecky asked her to reconsider. Surely, Zdravecky asked, the commissioner must support preventing teen pregnancy, even if she doesn't support Planned Parenthood.

"There is nothing you can say or do for me to support you," the commissioner said, according to Storms' version of the conversation. "Thank you very much for your comments."

But Zdravecky pressed on.

"I am prolife and you're not," Storms remembers saying.

Storms thanked them and told them she could not support the request. She even remembers that she smiled at them.

She told them that their organization is "prodeath from its founding." She told them how Planned Parenthood founder Margaret Sanger advocated eugenics - the study of improving hereditary qualities by controlling human reproduction - as her basis for supporting abortion.

In an interview with the St. Petersburg Times, Storms continued to make her case.

"Women are dying at the hands of Planned Parenthood today," she said, noting that the organization continues to promote the abortion pill RU-486. She pointed to a news account that questioned the drug's safety.

Those are the facts, Storms said. Lobbying, she added, "is not for the thin-skinned."

"She could have walked away and not had her feelings hurt," Storms said of Zdravecky.

Zdravecky remembers a more blunt conversation where Storms said, "I am prolife, you are prodeath" twice.

"I believe anyone who professes to be a proponent of Christianity would treat me with more dignity than the way I was treated," Zdravecky said.

Storms often takes controversial stands. On June 15, she led a commission vote to distance the county from gay pride events, a policy that has generated national attention.

Planned Parenthood of Southwestern Central Florida has been in Hillsborough for at least 25 years and operates a clinic in Temple Terrace. About 95 percent of the 65,000 clients Planned Parenthood sees annually in the region aren't coming for abortion services, Zdravecky said.

Last year, 1,700 did.

Hillsborough County has funded Source Teen Theater intermittedly during the past few years. It does not fund any other Planned Parenthood programs.

During the budget discussion that led to Thursday's 5-2 vote, Storms didn't comment other than to call for the elimination of the project's funding.

Commissioner Brian Blair spoke at length about how he favored the way the Pregnancy Center of Plant City operated. He said that its crisis pregnancy counselors encourage "the young women to choose life" and that its executive director raises money without asking for county help.

After the meeting, he said he voted against the program for fiscal reasons. He said his decisions are evenhanded, pointing to his rejection of a $250,000 request from Praise Cathedral and a $112,000 request from Redlands Christian Migrant Association. But Commissioner Kathy Castor, who voted against the motion with Commissioner Thomas Scott, said Planned Parenthood's program was the only project eliminated after a high rating from a county committee that reviews nonprofit funding requests.

Castor said that Hillsborough had $8-million to give to nonprofit groups.

"Their request," she said, "was one of the more modest."

Thursday, July 21, 2005

HAART

In 1997, highly-active anti-retroviral therapy became the common treatment for HIV patients with low CD4 counts. That same year, the death rate due to AIDS was CUT IN HALF in Hillsborough County from 20.9 per 100,000 to 10.3 per 100,000

Tuesday, July 19, 2005

March of the Kitefliers

The writer of this Jobsite production (opening in August) is having a contest - write bad poetry and when 2 free tickets on opening weekend. Details at:
http://www.gonzonia.com/2005/07/17/contest-contest-contest/

Saturday, July 09, 2005

manuscript abstract

Over the last 100 years we have undergone an epidemiological transition in which the majority of mortality could be summarized by infectious disease that killed young individuals to a period in which the majority of mortality can be accounted for by chronic diseases of old age (Omran 1971). There has also been a transition in the risks factors and demographic profiles of specific diseases, such as HIV/AIDS. When AIDS was first characterized in the United States during the early 1980s, the disease was thought of as a problem within mostly homosexual communities. While the disease does still impact the homosexual community, data also clearly demonstrate that HIV/AIDS is a disease of inequality, best characterized by broader health disparities along racial and socioeconomic boundaries. It is possible that the early epidemiological production of knowledge overemphasized the relationship between AIDS and homosexuality, while underestimating the role of socioeconomic status and IV drug use (Cochrane 2004). Furthermore, over the past decade the impact of HIV/AIDS within the international community, among some of the world’s poorest countries, has escalated exponentially. The majority of AIDS cases now reside in Sub-Saharan Africa, while a growing number will be found in China and India over the coming years.

Why are poor people more likely to contract HIV? Why are certain groups, such as racial minorities, in affluent societies, like the U.S. more likely to contract HIV? During the 25 years that have elapsed since the time of the first AIDS cases, billions of dollars have been spent internationally to prevent and treat HIV/AIDS. However, this message has only been partially effective and fully adopted by a small percentage of the population. For example, many homosexual men continue to engage in high risk behavior, such as taking MDMA, having unprotected anoreceptive sexual intercourse, and interacting with multiple sex partners. On a separate scale, policy makers and educators continue to ignore pleas from public health officials and the medical community to increase condom use messages among young men and women and to create easier access to free and clean needles through needle exchange programs.

It is not an accident of history that HIV/AIDS prevention messages and treatment programs have favored some individuals while skewing the vulnerability to the disease towards other individuals throughout the world. Instead a number of historical events generated the current distribution of HIV risk and account for the epidemiological profile of current HIV prevalence disparities.

In this manuscript, I examine the natural history of the AIDS epidemic in one community – Tampa, Florida – as a device for explaining the current state of the disease and the future of HIV/AIDS policy, treatment, and risk. This book is divided into three parts. In Part 1, I explore the early reactions to the disease within the public health and medical community, gay/lesbian population, general community, and politicians through direct interviews with those physicians, administrators, officials, reporters, and citizens, as well as through examination of early newspaper clippings and other cultural artifacts. The goal of part 1 is to document the cultural context of the early AIDs community in order to create a foundation and perspective for the topics discussed in Part 2. That section focuses on the development of prevention, education, and treatment policies throughout Hillsborough County schools, businesses, hospitals, private practices, and universities - as well as how the city responded to federal and state legislation regarding AIDS. In Part 3, I draw upon my own dissertation research conducted at the Hillsborough County Health Department using the Florida AIDs surveillance dataset. In this final section, I demonstrate that within a single county, HIV+ patients may have very different health outcomes. Furthermore, the probability of having a more positive health outcome (defined by a longer time to full blown AIDs or longer period until suffering mortality) falls along similar lines to those of HIV prevention (race and socioeconomic status). However, other variables, such as neighborhood resources and social networks may predict how well a person is likely to do after receiving an HIV+ diagnosis. In this section, I focus on how cultural differences within Tampa neighborhoods may influence access to treatment programs, frequency and types of coinfection, likelihood of continued engagement in risk behavior, or premature mortality.

There are 3 goals that I hope to accomplish by writing this manuscript:

1. I hope to show ways in which we can erase health disparities that exist between socioeconomic and racial minority groups by illustrating the distribution of inequality in prevention policy that leads to a distribution of inequality in HIV prevalence and HIV outcomes. The goal of my dissertation work is to help focus future treatment efforts in order to serve all members of a HIV+ community equally, but we must also work on shifting the distribution of risk factors for HIV away from a skewed set of factors that target the poor.

2. By summarizing and documenting the official and cultural responses to an epidemic that arose and escalated rapidly, this manuscript can assist city planners and officials in coping with future epidemiological events.

3. The creation of an anthropological narrative of HIV/AIDs within a large metropolitan area provides a voice to those on the margins of this epidemic and those who have worked diligently as clinicians and observers of this disease during the past 25 years.

Dissertation Abstract

RESEARCH HYPOTHESES:

  1. The length of time from HIV infection to AIDS presentation varies among populations within Hillsborough County
  2. Some populations utilize more or less medical resources for HIV/AIDS treatment due to social stigma in their culture and community.
  3. The incidence of acquired comorbidities (e.g. PCP and CMV) and the level of risk behaviors after diagnosis (e.g. IV drug use, unsafe sex, etc) varies in these groups.

ABSTRACT

The Healthy People 2010 initiative focuses on eliminating health disparities between populations. The incidence and prevalence of HIV infection between ethnic groups and socioeconomic levels within the state of Florida varies greatly. This variation may be due to differential access to care, treatment and medication, as well as cultural and community support of HIV+ patients, neighborhood resources, and risk behaviors after HIV acquisition.

Previous studies have demonstrated variation in health outcomes among HIV+ individuals (Arno et al., 2004). Some populations experience higher incidence of comorbidity, such as PCP, and some populations may experience higher mortality rates both from AIDS and HIV-related illnesses. Furthermore, past work has shown that there are differences in health outcomes between populations, even after controlling for socioeconomic status and level of insurance. For example, black women are more likely to die of an acute MI than white women even after controlling for age, SES, and insurance (2003).

Diez-Roux et al., (2002) has also demonstrated that neighborhood resources are directly predictive of disease risk and play a significant role in changing health outcomes. The authors examined a number of neighborhood indicators and found it is possible to index neighborhoods into risk of acquiring chronic diseases and suffering from acute events such as myocardial infarction.

In this study, I will examine the health disparities present within the HIV+ community of the state of Florida in order to suggest ways to focus resources appropriately. More specifically, I will test the hypothesis that the length of time from HIV infection to AIDS presentation varies among populations and, furthermore, that some populations utilize more or less medical resources for HIV/AIDS treatment due to social stigma associated with HIV+ status in their community. In addition, I will examine the incidence of acquired comorbidities (e.g. PCP and CMV) and the level of risk behaviors after diagnosis (e.g. IV drug use, unsafe sex, etc) in these groups.

Zip-codes will be used to define a population and census data will be used to characterize that population. Using the HARS data set, HIV information will be explored in order to examine the relationship between HIV outcomes and populations.

Arno, P.S. (2002). Analysis of a Population-Based Pneumocystis carinii Pneumonia Index as an Outcome Measure of Access and Quality of Care for the Treatment of HIV Disease. American Journal of Public Health. 92: 395-398.

Diez-Roux, A.V. (2002). Investigating area and neighborhood effects on health. American Journal of Public Health. 91: 1783-89.

Institute of Medicine (2003). Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare.