1 2 CITY COUNCIL 3 CITY OF NEW YORK 4 -------------------------------x 5 THE TRANSCRIPT OF THE MINUTES 6 of the 7 COMMITTEE ON HEALTH 8 -------------------------------x 9 10 May 1, 2008 Start: 1:17 p.m. 11 Recess: 4:21 p.m. 12 City Hall Council Chambers 13 New York, New York 14 B E F O R E: 15 JOEL RIVERA 16 Chairperson, 17 COUNCIL MEMBERS: Maria Baez 18 Helen Foster John Liu 19 Michael McMahon 20 21 22 23 24 LEGAL-EASE COURT REPORTING SERVICES, INC. 17 Battery Place - Suite 1308 25 New York, New York 10004 (800) 756-3410 2 1 2 A P P E A R A N C E S 3 COUNCIL MEMBERS: (CONTINUED) 4 5 Helen Sears Kendall Stewart 6 Maria del Carmen Arroyo Rosie Mendez 7 Darlene Mealy Letita James 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 3 1 2 A P P E A R A N C E S (CONTINUED) 3 Monica Sweeney, M.D., M.P.H. 4 Assistant Commissioner Bureau of HIV/AIDS Prevention and Control 5 NYC Department of Health and Mental Hygiene 6 Isaac Weisfuse Deputy Commissioner 7 NYC Department of Health and Mental Hygiene 8 Colin Casey Office of Senator Thomas K. Duane 9 29th Senatorial District New York State Senate 10 Darrell P. Wheeler, Ph.D, MPH 11 Associate Dean of Research Hunter College of Social Work 12 Robert E. Fullilove 13 Research Panel Member Columbia University 14 Leo Wilton, Ph.D 15 Binghamton University 16 Marjorie J. Hill Chief Executive Officer 17 Gay Men's Health Crisis 18 Dennis DeLeon Latino Commission on AIDS 19 Jose M. Davila 20 Executive Director Bronx AIDS Services 21 Donald R. Powell 22 Gay Men of African Descent, Inc. 23 Kalvin Leveille 24 Frank Leon Roberts 25 4 1 2 A P P E A R A N C E S (CONTINUED) 3 Joseph Jefferson 4 Community Health Specialist People of Color In Crisis 5 Larry Tantay 6 APICHA 7 David Tobo Group Facilitator 8 Bronx AIDS Services 9 Soraya Elcocic Harlem United 10 Kenyon Farrow 11 Community HIV/AIDS Mobilization Project 12 Steven Gordon Ali Forney Center 13 Dwon White 14 POCC 15 Basil LUCAS, MSW POCC 16 Black Gay Network 17 Omari Wiles POCC 18 AIC Youth Council 19 Marcell Gumbos POCC 20 Vincent Filliatre 21 Marcelo Soares 22 Gregory A. Cruz 23 Senior Trainer Leadership Training Institute 24 Xavior Ford 25 5 1 COMMITTEE ON HEALTH 2 CHAIRPERSON RIVERA: First we will be 3 conducting an oversight hearing on the rise of HIV 4 and AIDS among young men of color who have sex with 5 men. 6 Secondly, the Committee will vote on 7 Resolution No. 1351, sponsored by my colleague, 8 Council Member Darlene Mealy, which would declare 9 May 15th, 2008, as Huntington's Disease Awareness 10 Day in New York City. 11 The increase in HIV and AIDS 12 diagnoses among young men of color who have sex with 13 men represents a critical emerging public health 14 issue. 15 In stark contrast to reduce rates of 16 HIV and AIDS in most other groups, young men of 17 color who have sex with men have actually 18 experienced staggering increases between 2001 and 19 2006. 20 A new diagnosis of HIV doubled among 21 men who have sex with men aged 13 to 19, and 22 increased 30 percent among all men who have sex with 23 men under the age of 30. 24 In 2006 alone, men of color under the 25 age of 20 who have sex with men accounted for 90 6 1 COMMITTEE ON HEALTH 2 percent of the new HIV diagnosis. We are 25 years 3 into the AIDS epidemic. This trend of rising HIV and 4 AIDS diagnoses of young men of color is extremely 5 troubling. With our hearing today, we will hope to 6 learn what may be causing this disturbing trend and 7 about innovative strategies to reduce risk and 8 promote treatment. 9 We will also examine what we can do 10 further to reduce the incidents of new cases of HIV 11 and AIDS and reach out to this very vulnerable 12 group. 13 As I stated earlier, we will also be 14 voting on Resolution No. 1351, sponsored by Council 15 Member Darlene Mealy, which would declare May 15th, 16 2008 as Huntington's Disease Awareness Day in New 17 York City. Huntington's Disease is a familial 18 disease that results from degeneration of brain 19 cells, which can cause uncontrolled movements, loss 20 of intellectual faculties, and emotional 21 disturbance. 22 The National Institute of 23 Neurological Disorders and Stroke estimates that in 24 the United States about 30,000 people have 25 Huntington's Disease. It is our belief that a local 7 1 COMMITTEE ON HEALTH 2 day of awareness in New York City would highlight 3 the impact on this disease and how it has affected 4 those who suffer from it and their families, as well 5 as the importance of research efforts to find a 6 cure. 7 Before we begin on the testimony, I 8 would like to introduce my colleagues who are here 9 today. 10 We have Council Member Maria Baez, 11 Council Member Darlene Mealy, Council Member Helen 12 Sears. We also have Council Member Kendall Stewart 13 with us and I want to give this opportunity, this 14 moment to Council Member Mealy to say a few words 15 about her resolution. 16 COUNCIL MEMBER MEALY: Good morning, 17 everyone. 18 Good morning, everyone. 19 THE AUDIENCE: Good morning. 20 COUNCIL MEMBER MEALY: I want to thank 21 our Chair and all my colleagues here, and I want to 22 thank everyone for being here, because every 23 illness, every health issue is so important. 24 And I want to just say again, to 25 Adira Siman, Counsel to the Health Committee, for 8 1 COMMITTEE ON HEALTH 2 collaborating this meeting with us. I'm going to get 3 right to it because I know we have little bit of 4 time and you have a full schedule. 5 Every person is important, and every 6 person is as important as the next, and so when an 7 obscure disease ravages lives and create terrible 8 suffering, we are compelled to rise and speak out 9 and generate interest and push medical communities 10 to look closer and raise their awareness. 11 That is why I am here today, to help 12 amplify the voices of those who suffer from this 13 terrible neurological disease known as Huntington's 14 Disease. 15 Fellow members, if I could have your 16 vote in support of my resolution declaring May 15th, 17 Huntington's Disease Awareness Day, it would be 18 greatly appreciated. 19 And we know this is a brain cell 20 disease that you never know who may have it. So, I 21 hope that this Health Committee can pass this 22 resolution, and I thank you for giving me the time. 23 And I must say, I know someone 24 personally who went through this disease and they 25 have lost family members. So, this is a disease that 9 1 COMMITTEE ON HEALTH 2 everyone should be aware of, and I know it's a lot 3 of other diseases out here that a lot of people do 4 not hear about, but they are here. 5 So, I thank you for this opportunity, 6 Chair Rivera. 7 CHAIRPERSON RIVERA: Thank you very 8 much. 9 We are just going to gather some more 10 members so we can have the vote. 11 We have been joined by Council Member 12 Tish James and Council Member John Liu as well, and 13 we are just going to rally the members to come up 14 for a vote. 15 COUNCIL MEMBER MEALY: I just want 16 everyone to know that this disease is so real that 17 we do have someone here, Bertha Johnson. 18 Could you stand up and let people 19 know at least the disease is real and you have lost. 20 I just want her to stand up and let 21 you know this is a disease that is real, and please 22 keep in mind, because you never know, it could pass 23 down to your generation. So, I thank you Bertha 24 Johnson. And this has been a long-time friend. We 25 went to church 20 years ago and here it is now, who 10 1 COMMITTEE ON HEALTH 2 would have known that this disease was so prevalent, 3 so strong, that she lost. I went through with her -- 4 she has the pictures of her two, young man and a 5 woman. 6 And like he said, God bless you. 7 Thank you for being here. 8 CHAIRPERSON RIVERA: Since we don't 9 have the quorum for the vote yet, we're going to 10 start with the actual hearing on the HIV and AIDS. 11 We're going to call the first panel 12 up, but once we have quorum, we will vote quickly 13 and continue on with the regular hearing. 14 We're going to call Dr. Isaac 15 Weisfuse, the Deputy Commissioner for the Department 16 of Health and Mental Hygiene, and Dr. Monica 17 Sweeney, Assistant Commissioner from the DOH as 18 well. 19 If you could just come forward, state 20 your name for the record and you may proceed with 21 your testimony. 22 DEPUTY COMMISSIONER WEISFUSE: Good 23 afternoon. My name is Dr. Isaac Weisfuse. 24 ASSISTANT COMMISSIONER SWEENEY: Good 25 afternoon, Chairman Rivera, and members of the 11 1 COMMITTEE ON HEALTH 2 Health Committee. I'm Dr. Monica Sweeney, Assistant 3 Commissioner for the Bureau of HIV Prevention and 4 Control with the New York City Department of Health 5 and Mental Hygiene. 6 On behalf of the Department, thank 7 you for the opportunity to discuss the HIV/AIDS 8 epidemic among men who have sex with men, or MSM of 9 color in New York City. 10 Today I will identify and assess the 11 extent of the epidemic, describe DOHMH programs and 12 initiatives, and identify some of the key challenges 13 that we face in addressing the problem. Public 14 health measures have been effective in preventing 15 the spread of HIV/AIDS in New York City, with the 16 number of new HIV diagnoses each year falling by 17 nearly one-third between 2001 and 2006. 18 A decline has also occurred for many 19 demographic groups, but it is most notable among 20 injection drug users, who in 2006 accounted for 248 21 new HIV diagnoses, a 70 percent decrease from 835 22 new diagnoses made in 2001. 23 The risk of acquiring HIV perinatally 24 has also decreased dramatically. Of 447 HIV-exposed 25 births in 207, just five infants have been reported 12 1 COMMITTEE ON HEALTH 2 as being born with HIV. 3 In the past 18 years, the number of 4 children in New York City diagnosed with HIV 5 infection before age 13, has fallen from a high of 6 370 in 1992 to 11 in 2006, the last year for which 7 complete data is available. And among all men who 8 report having sex with men, the number of HIV 9 diagnosis has declined by 2.6 percent between 2001 10 and 2006. 11 Despite this progress, recent data 12 has shown that some specific groups remain 13 particularly vulnerable. 14 While HIV non-AIDS among MSM older 15 than age 30 has declined by 22 percent over the past 16 six years, the opposite is true for younger MSM. 17 The number of HIV diagnosis among 18 young MSM increased by 32 percent, from 300 HIV 19 diagnoses in 2001 to 502 in 2006. 20 Among the youngest category, age 13 21 to 19, new diagnoses have nearly doubled. 22 The under 30 group now accounts for 23 44 percent new diagnosis among MSM in New York City. 24 Up from 31 percent in 2001. 25 Blacks and Hispanics bear a 13 1 COMMITTEE ON HEALTH 2 disproportionate share of this burden among all MSM 3 under age 30. 4 Blacks received twice as many HIV 5 diagnosis as whites in 2006, and Hispanics receive 6 55 percent more diagnosis than whites. 7 The disparity is even more striking 8 among adolescents. More than 90 percent of the MSM 9 under age 20 diagnoses with HIV in 2006 were black 10 or Hispanic. Eighty-one out of 87. 11 Geographically, every borough except 12 Staten Island, has seen an increase in HIV rates 13 among MSM under age 30 since 2001. The largest 14 increases occurred in Manhattan, 57 percent, Queens 15 49 percent. 16 The increase in Manhattan was 17 concentrated in East and Central Harlem, up 115 18 percent, from 26 to 56. And in the Chelsea Clinton 19 areas, up 56 percent, from 25 to 39. 20 The increase in HIV rates is 21 consistent with recent increases in syphilis among 22 men in New York City. And taken together, the 23 information points to the probability of increased 24 risky sexual behaviors among men who have sex with 25 men. 14 1 COMMITTEE ON HEALTH 2 It is also consistent with 3 epidemiologic reports from other large cities. Many 4 theories have emerged to explain the recent increase 5 in HIV/AIDS among young MSM, and particularly young 6 MSM of color. 7 Some point to the relative success of 8 antiretroviral therapy, most young MSM grew up after 9 the introduction of highly effective medication. As 10 a result, some young MSM falsely believe that HIV is 11 easily manageable by taking a few pills a day and 12 does not otherwise negatively impact one's life. 13 They may not have had the experience of losing close 14 friends as in decades past, and this HIV treatment 15 optimism can minimize the impetus for reducing risky 16 behaviors. 17 Other theories to explain the 18 increase relate to changes in the way young MSMs for 19 finding sexual partners, for example, through the 20 Internet. And mistaken assumptions about the 21 likelihood that partners are uninfected, which leads 22 to low rates of condom use. 23 The prevention of HIV is central to 24 the Department's overall plan to improve the health 25 of New Yorkers. 15 1 COMMITTEE ON HEALTH 2 Take Care New York, a health policy 3 agenda for the City that prioritizes specific steps 4 to improve health include knowing one's HIV status, 5 as one of the top ten priorities. 6 To advance this step, the Department 7 embarked on a broad-based plan to expand and 8 routinize rapid HIV testing in New York City. 9 Not only does the expansion of rapid 10 HIV testing have the potential to greatly increase 11 the number of people who know their HIV status, but 12 will help us to identify young MS of color with HIV 13 earlier in the course of their disease, in order to 14 improve their health outcomes and reduce the spread 15 of HIV to others. 16 The Department considers HIV testing 17 an effective form of prevention. Research shows that 18 people who find out they are HIV positive reduce 19 their risky behaviors by approximately 50 percent, 20 and it actually goes up to 68 percent when they are 21 having sex in a sero discordened group. That is, if 22 one partner is positive and one is negative, that 23 increases to 68 percent reduction in risky 24 behaviors. 25 The earlier people learn of their 16 1 COMMITTEE ON HEALTH 2 status, the earlier they are able to benefit from 3 life-saving treatment and reduce their viral load, 4 making them less infectious to others. 5 The scale up of HIV testing is 6 occurring on many fronts. The Department provides 7 free and anonymous rapid HIV testing and counseling 8 services in all ten STD clinics. 9 In 2007, the STD clinics performed 10 more than 60,000 HIV tests. Approximately double the 11 number of tests done in 2003 when it did 12 approximately 33,000 tests per year. 13 STD clinics have also been using a 14 new test to screen for individuals who are newly 15 infected with HIV. These individuals often have high 16 viral loads, and are, therefore, highly infectious. 17 Identifying these individuals 18 increases opportunity for primary care where both 19 treatment and counseling will help further prevent 20 the spread of HIV. 21 The ten DOHMH tuberculosis clinics 22 also offer rapid HIV testing to their clients, and 23 rapid HIV testing is now routinely offered to 24 inmates upon admission to New York City jails where 25 the number of people undergoing voluntary testing 17 1 COMMITTEE ON HEALTH 2 has increased from 5,000 in 2003, to about 25,000 in 3 2007. 4 Outside of our own facilities and the 5 DOH, thanks in large part to the continued 6 commitment of the Speaker and the Council, the 7 Department contracts with hospital clinics, and 8 community-based organizations for rapid testing 9 services. 10 Many of these testing sites are 11 located in areas of the City that have been 12 disproportionately affected by HIV/AIDS. And 13 together, these sites conduct close to 50,000 rapid 14 tests, conducted close to 50,000 rapid tests in 15 calendar year 2007. 16 The US Centers for Disease Control 17 and Prevention also recognizes the importance of 18 expanding HIV testing to help curtail the epidemic. 19 In October of 2007, the CDC awarded 20 the Department of Health and Mental Hygiene, a $5.4 21 million grant to expand HIV testing among 22 populations that are disproportionately affected by 23 HIV, which is in New York City, includes primarily 24 African-Americans. 25 The funding now supports new service 18 1 COMMITTEE ON HEALTH 2 and programs, including evening HIV testing hours at 3 DOHMH STD clinics in Jamaica, Chelsea and Fort 4 Greene. 5 CDC funding is also being used for a 6 Bronxwide HIV testing initiative, which will attempt 7 to ensure that all Bronx adults who don't know their 8 HIV status are tested. A new social network based 9 recruitment model for HIV testing focuses on 10 populations that are sometimes difficult to reach by 11 standard models, such as young MSM of color. 12 With support from the CDC, DOH's 13 funding six community-based organizations, four of 14 which specifically target MSM of color, to recruit 15 for individuals for testing within their own social 16 networks. 17 These programs focus on vulnerable 18 populations, ranging from transgendered youth from 19 Latino sex workers. In order to further reach young 20 MSM of color for testing and treatment, the 21 Department is collaborating with the Health and 22 Hospitals Corporation and New York University to 23 conduct HIV testing at two New York City bath 24 houses. 25 Prevention through the promotion of 19 1 COMMITTEE ON HEALTH 2 condom use is a key priority for the Department. 3 Since the launch of the New York City 4 Condom in February 2007, male condom distribution 5 increased from 250,000 per month, before 2005, to an 6 average of more than 3 million condoms per month 7 now. 8 As part of our distribution strategy 9 to promote safer sex to young MSM of color, the 10 Department is continuing to conduct targeted 11 outreach and established partnerships with New York 12 City clubs, bars and other businesses, where MSM 13 frequent. 14 Sixty-eight venues where MSMs go are 15 currently participating in our new New York City 16 Condom Program, and our outreacher worker continues 17 to identify and approach new venues. 18 DOHMH staff also participate in the 19 Connect to Protect Coalition, and the New York City 20 Association of Homeless and Street Involved Youth 21 Organizations. 22 These networks bring together 23 government agencies, community-based organizations 24 and interest groups serving young MSM of color and 25 other vulnerable youth throughout the City. 20 1 COMMITTEE ON HEALTH 2 Their goal is to provide a more 3 comprehensive service landscape for this diverse 4 population which is at risk for HIV infection. 5 I would now like to turn to the 6 Department's HIV Prevention Programs, which are more 7 specifically tailored to young MSM and young MSM of 8 color. 9 In 2007 the Department recontracted 10 it's CDC HIV prevention portfolio to provide a 11 greater proportion of funding to community-based 12 organizations that conduct behavioral interventions 13 or develop anti stigma campaigns that target 14 high-risk populations. 15 Fourteen are funded behavioral 16 intervention activities specifically target MSM, and 17 five activities focus exclusively on MSM of color. 18 These programs focus on the promotion of safer sex 19 behaviors, risk-reduction, skill building, avoidance 20 of substance use or substance use relapse, and 21 provision of peer education around HIV prevention 22 and sexual help. 23 In addition, our portfolio currently 24 supports two community-based organizations, Gay Men 25 of African Descent and Hispanic AIDS Forum to 21 1 COMMITTEE ON HEALTH 2 develop and disseminate anti-stigma campaigns 3 specifically addressing discrimination against MSM 4 of color. 5 The Department is also planning to 6 use a targeted media and social marketing campaign, 7 to reach young MSM of color. 8 In the past seven months we have held 9 six focus groups to develop culturally sensitive HIV 10 prevention campaigns that will resonate with this 11 population. The Department is also planning an 12 internet campaign which will include testimonials 13 about condom use and an illustration of the 14 long-term health effects of HIV and its treatment. 15 I would also like to highlight that 16 the HIV prevention planning group, called the PPG, a 17 Citywide consortium of community members, that 18 advises the Department on HIV prevention activities, 19 has one of its eight workgroups devoted exclusively 20 to key issues of relevance or concerns among MSM. 21 Despite these efforts, many 22 challenges remain in addressing the HIV/AIDS 23 epidemic among young MSM of color. 24 As a society and a community, we must 25 address the new and potentially dangerous community 22 1 COMMITTEE ON HEALTH 2 norms that may have resulted from the success of 3 antiretroviral treatment. 4 There is a need for a better 5 understanding of the ways the Internet affects 6 risk-taking behaviors, and to evaluate the impact of 7 the broad range of prevention strategies and 8 programs currently employed in New York City and 9 other jurisdictions. 10 Young MSM of color must also 11 negotiate safer sex activities. Controlling the 12 spread of HIV/AIDS requires a coordinated effort at 13 the federal, State and local levels. Unfortunately, 14 today's fiscal climate is further constraining an 15 already limited pool of available public funding. 16 With this in mind, it is our 17 collective responsibility to direct resources as 18 efficiently and effectively as possible to control 19 this epidemic. 20 The Department appreciates the 21 Speaker's and the Council's commitment to the issue, 22 but we remain concerned that some of the nearly $20 23 million in Council funding for HIV programs, 24 including the FY 2008 budget may not have its 25 intended impact. We look forward to working with the 23 1 COMMITTEE ON HEALTH 2 Council, to working with you in the coming weeks to 3 develop an HIV budget for Fiscal Year 2009 that 4 maximizes these limited resources. 5 I am happy to answer any questions 6 that you have at this time, and thank you. 7 CHAIRPERSON RIVERA: Thank you very 8 much. 9 We've also been joined by Council 10 Member Maria del Carmen Arroyo, Council Member Helen 11 Foster, Council Member Mike McMahon, any other 12 members. 13 At this point in time I want to call 14 for a vote so we can get the resolution vote done 15 with. 16 COUNCIL MEMBER MEALY: I just want to 17 reiterate to my colleagues that Huntington's Disease 18 Awareness Month will be a great asset for this whole 19 nation. So, I just hope you can support me in this 20 resolution. 21 We have some who just came in. We 22 have someone, a living proof that this disease is 23 real, and I just hope I have your support. 24 And thank you, Chair. 25 COUNCIL CLERK MARTIN: Resolution 24 1 COMMITTEE ON HEALTH 2 1351. Council Member Rivera. 3 CHAIRPERSON RIVERA: I vote aye. 4 COUNCIL CLERK MARTIN: Baez. 5 COUNCIL MEMBER BAEZ: Aye. 6 COUNCIL CLERK MARTIN: Foster. 7 COUNCIL MEMBER FOSTER: Aye. 8 COUNCIL CLERK MARTIN: McMahon. 9 COUNCIL MEMBER McMAHON: Aye. 10 COUNCIL CLERK MARTIN: Sears. 11 COUNCIL MEMBER SEARS: Aye. 12 COUNCIL CLERK MARTIN: Arroyo. 13 COUNCIL MEMBER DEL CARMEN ARROYO: 14 Aye. 15 COUNCIL CLERK MARTIN: By a vote of 16 six in the affirmative, zero in the negative and no 17 abstention, item is adopted. 18 Members, please sign the Committee 19 report. 20 Thank you. 21 CHAIRPERSON RIVERA: Thank you very 22 much. 23 Do we have testimony from you as 24 well, or? 25 DEPUTY COMMISSIONER WEISFUSE: No. 25 1 COMMITTEE ON HEALTH 2 CHAIRPERSON RIVERA: No. Okay. 3 COUNCIL CLERK MARTIN: Council Member 4 Liu. 5 COUNCIL MEMBER LIU: I vote yes. 6 COUNCIL CLERK MARTIN: The vote now 7 stands at seven. 8 CHAIRPERSON RIVERA: You know, there 9 is a serious concern as to why is there an increase 10 taking place within this young generation, young 11 population, and I hear the testimony that you gave 12 on the amount of time and distribution, the amount 13 of work that's being done, you know, with some of 14 the nightlife organizations. But it's alarming, 15 because we know that, you know, education is key. We 16 know that we need to do everything within our power, 17 understanding the fiscal constraints that we have, 18 you know, to make sure that we inform our younger 19 population about the dangers. And we don't want to 20 see some of our youngest and some of our brightest 21 fall victim to something so horrendous. And I think 22 that we just want to know, what else do you expect 23 that we can do? 24 Because obviously, what we have been 25 doing has not had its impact and has not had its 26 1 COMMITTEE ON HEALTH 2 effect. 3 So, is there any plans on the drawing 4 board to restructure, redirect or reallocate funding 5 to better target, you know, the young population, in 6 terms of education, in terms of doing workshops, in 7 terms of working with other organizations, in terms 8 of getting celebrity endorsements, you know, to talk 9 to the young population? 10 What else can we do to be creative? 11 You know, because when you have a 30 percent 12 increase in some population, a 50 percent increase 13 in some and within Central Harlem, 115 percent 14 increase, you know, in new cases, that's something 15 that's alarming and something that unless we change 16 the way we operate, it will probably continue to 17 happen. 18 Is there any new plan being developed 19 on the drawing board? 20 ASSISTANT COMMISSIONER SWEENEY: One 21 of the reasons that we're emphasizing testing, is 22 because by having people know their status, it will 23 impact the epidemic, because a quarter of the people 24 in New York City don't know that they're positive. 25 And when people don't know that they're positive, 27 1 COMMITTEE ON HEALTH 2 they continue to engage in behaviors that once they 3 learn their status they decrease. 4 So, ramping up testing is a very 5 important strategy for having people know their 6 status. And once they know their status, to link 7 them to treatment and keep them in treatment, and 8 that way we can interrupt the epidemic. 9 If people have risky behaviors when 10 they're in treatment, and maintained in treatment, 11 they are less likely to pass on the epidemic. They 12 are more likely to use condoms when they know their 13 status. So, testing, expanding testing is a major 14 part of one of our strategies. 15 The other major part of the strategy 16 is having communication with the group we're trying 17 to reach. That's why we've held focus groups around 18 New York City with MSM of color and Hispanic MSM and 19 black MSM, we have held focus groups with the 20 affected group to get the language from them, to get 21 the strategies from them that they think will work. 22 So, we're working with the group that we are trying 23 to reach to get the strategies out there, using the 24 language that they will hear. Instead of it coming 25 from us, it's coming from the group that is 28 1 COMMITTEE ON HEALTH 2 involved. 3 And, so, these are the major things 4 that we're doing. We're working with a group at NYU 5 to reach the even younger group, the 13 to 17 year 6 olds that we couldn't have in focus groups because 7 of parental consent. 8 So, we are looking at it from all of 9 the angles and the age groups to address the 10 increase. 11 DEPUTY COMMISSIONER WEISFUSE: I would 12 just like to add in follow-up to that question, and, 13 you know, expanding a little bit on Dr. Sweeney's 14 testimony, that the reason why we're doing these 15 focus groups is to get the message right so that we 16 can produce a media campaign, which we're hoping to 17 do in late spring or early summer. 18 So, that's very important work and 19 this, we hope, will get it out there, bring to more 20 people the attention the growing problem, as well as 21 what to do about it. 22 CHAIRPERSON RIVERA: Also in your 23 testimony you mentioned the internet. You know, what 24 are we doing to focus on MySpace, the Face Book, the 25 Friendster (phonetic) in this area, not to obviously 29 1 COMMITTEE ON HEALTH 2 do anything crazy, but just to have an open forum in 3 terms of education on these websites. 4 Has the Department, you know, opened 5 up a home page on MySpace or Face Book, you know, to 6 educate and give information, distribute e-booklets, 7 e-phamplets or e-seminars on the rapid increase of 8 HIV and AIDS? 9 ASSISTANT COMMISSIONER SWEENEY: I 10 hope that this will be an opportunity when we launch 11 our Bronxwide that you will come and hear the 12 exciting things that we're doing to address where 13 young MSMs meet other partners. 14 These are things that we're doing. We 15 want to go public with it in a specific time and in 16 a specific forum, and I hope that you'll be there. 17 CHAIRPERSON RIVERA: Okay. When is 18 that going to be again? 19 ASSISTANT COMMISSIONER SWEENEY: June 20 27th. 21 DEPUTY COMMISSIONER WEISFUSE: Also, I 22 would add, I think we are going to be using some of 23 the materials that we developed from these 24 interviews and the result of the focus groups to put 25 on the internet in a, hopefully in a video format so 30 1 COMMITTEE ON HEALTH 2 people can see people speak about it. 3 ASSISTANT COMMISSIONER SWEENEY: One 4 other thing I forgot to mention is that at the end 5 of last year, we had two days of an open forum with 6 young MSM where they came together without an 7 agenda. They were invited to the forum, and it was 8 an agenda-less meeting, so that they could put 9 forward what their concerns were and that was very 10 well received and we did an evaluation afterward and 11 they felt that it was a very valuable forum to have 12 them come and speak without an agenda. There was no 13 agenda from the Department of Health. 14 CHAIRPERSON RIVERA: Okay. 15 And before I move on from my 16 colleagues, in the last part of your testimony, you 17 mentioned the $20 million that the Council allocates 18 for HIV and AIDS programs, and that you feel it is 19 not going to have the intended impact. 20 Can part of that be the fact that the 21 money is not baselined in the budget and that 22 organizations are not aware of whether or not it 23 will be continuously funded. 24 Because I think that if there is 25 concern that it won't have the impact, maybe we 31 1 COMMITTEE ON HEALTH 2 should, you know, reconsider the fact that the money 3 has not been baselined by the Executive Branch of 4 government to be moved forward immediately so that 5 organizations would not have to worry about is this 6 money forthcoming or is the money in jeopardy? 7 Especially in the current budget climate that we're 8 currently under. 9 ASSISTANT COMMISSIONER SWEENEY: My 10 concern is, is that the projects that some of the 11 community-based organizations participate in are, we 12 sort of refer to them as soft projects, which has to 13 do with health fairs and sometimes capacity building 14 in the organization, and we are interested in more 15 direct services to the people that are impacted, 16 infected and affected, and that's what we are hoping 17 that more of the money can be directed toward 18 programmatic initiatives, rather than capacity 19 building, and health fairs and those kind of things. 20 CHAIRPERSON RIVERA: Health fairs I 21 find to be very beneficial because it engages in 22 community and opens up a conversation and a 23 dialogue. So, that concerns me, the fact that you 24 don't see as health fairs being a good source of 25 information for a neighborhood. 32 1 COMMITTEE ON HEALTH 2 Is there any data to indicate it's 3 not beneficial? 4 ASSISTANT COMMISSIONER SWEENEY: A lot 5 of it has to do with my experience in that when I 6 used to organize health fairs, that the people who 7 participated usually were the people who were 8 already engaged, and we were not able to bring in 9 the people that were harder to reach. 10 And, so, that although it was a 11 highly visible community activity, it did not reach 12 the heard to reach that we are targeting. 13 CHAIRPERSON RIVERA: Okay. I may want 14 to readdress, but I also want to give the 15 opportunity to my colleagues. We have a list of 16 members who signed up. 17 Council Member Helen Foster, then 18 Sears, then Council Member Tish James. 19 COUNCIL MEMBER FOSTER: Thank you. 20 Thank you, Chair, for holding this very important 21 meeting on this topic. 22 Good afternoon, Dr. Sweeney. 23 ASSISTANT COMMISSIONER SWEENEY: Good 24 afternoon. 25 COUNCIL MEMBER FOSTER: I have a 33 1 COMMITTEE ON HEALTH 2 couple of questions. 3 First, on the first page of your 4 testimony when you mention the numbers going up in 5 Manhattan. Were those numbers higher because this is 6 where people were treated, or this is where they 7 live? 8 ASSISTANT COMMISSIONER SWEENEY: These 9 are the numbers where they were diagnosed. So, it's 10 where they live. 11 COUNCIL MEMBER FOSTER: It's where 12 they live. Because why I ask that, and it goes into 13 the $20 million question, is that being a Bronx 14 Council Member I am sometimes concerned, because 15 many conversations I have dealing with the rise of 16 HIV and AIDS among men having sex with men are from 17 Manhattan organizations that are actually servicing 18 members from my community, because there aren't, or 19 there aren't identified places within the community. 20 And, so, while the health fairs are, 21 I agree with you, we are engaging people that are 22 already engaged, we need to start putting money so 23 that people can be treated where they live, and 24 especially in Bronx County, and I know you mentioned 25 we're having that take-off, we don't see that. And I 34 1 COMMITTEE ON HEALTH 2 know personally we have expert providers, because I 3 work with them, but the money isn't getting to the 4 community-based organizations. 5 So, I'm a little concerned with us 6 redirecting. Maybe we need to be more specific on 7 how it's used, but I definitely think there is a 8 need for people to be treated where they live, and I 9 don't see that all the time. 10 My second question, as soon as I find 11 them, with the men that we are identifying, what are 12 the statistics in terms of age, and income, and 13 specific areas of the City, and of course, I'm 14 interested in the Bronx, where they come from; do 15 you have that data? 16 ASSISTANT COMMISSIONER SWEENEY: That 17 data is available, I don't have it here with me, but 18 we would be happy to get it to you. 19 The age that we are called young MSMs 20 is under 30, and the largest increase was seen in 21 the age group 13 to 19, so many of them are before 22 they would have expected to finish their education, 23 or to have jobs and so forth. 24 I don't have specific data for you, 25 but I will get you what we have. 35 1 COMMITTEE ON HEALTH 2 COUNCIL MEMBER FOSTER: Could you 3 please get it to the Committee? 4 ASSISTANT COMMISSIONER SWEENEY: Yes. 5 Yes, I will. 6 COUNCIL MEMBER FOSTER: I think that 7 would be very interesting. 8 ASSISTANT COMMISSIONER SWEENEY: Yes, 9 I will. 10 COUNCIL MEMBER FOSTER: And how are we 11 engaging the men, if the mindset is that I -- well, 12 let me take a step back. How do we identify men 13 having sex with men? 14 ASSISTANT COMMISSIONER SWEENEY: Self 15 identification. 16 COUNCIL MEMBER FOSTER: Okay. 17 Now, is there any way that we can 18 reach out to young boys, especially the age of 13 to 19 19, that are having sex with men, never would 20 classify themselves as being gay, and so therefore 21 don't fall into that radar of self-identification? 22 ASSISTANT COMMISSIONER SWEENEY: We 23 use the term men who have sex with men instead of 24 gay, or homosexual, to try and talk about the 25 behavior and not a label. 36 1 COMMITTEE ON HEALTH 2 COUNCIL MEMBER FOSTER: Right. 3 ASSISTANT COMMISSIONER SWEENEY: So, 4 that's why we use the terminology, men who have sex 5 with men. 6 COUNCIL MEMBER FOSTER: What I'm 7 trying to figure out how we can reach -- I know, for 8 example, in a certain area in my community, we have 9 homeless boys that are having sex with men for 10 money. So, nothing in their thinking goes off a man 11 having sex with men. 12 So, I'm trying to see how we can 13 expand our target group so that we can make sure our 14 target group so that we can make sure, especially 15 with the 13 to 19, that we're getting them in. I 16 agree, we all need to know our status, but if I'm 17 not even thinking that way, you understand what I'm 18 saying? 19 ASSISTANT COMMISSIONER SWEENEY: One 20 of the things we try to do is to make sure that we 21 have partnerships with people in the community who 22 are culturally sensitive to the group that they are 23 trying to address. And, so, each time that a program 24 is created or someone does something, it is geared 25 not Citywide, it's not a Citywide kind of thing, it 37 1 COMMITTEE ON HEALTH 2 is focused based on the group that they are 3 targeting. So, that's why we have contracts with 4 people who are identifying, sex workers, for 5 example. 6 COUNCIL MEMBER FOSTER: Yes, that's 7 the word. 8 ASSISTANT COMMISSIONER SWEENEY: And 9 Gay Men of African Descent and the Hispanic AIDS 10 Forum, to mention a couple, so that they can be 11 culturally sensitive to the group that they're 12 trying to reach, in the area that they're trying to 13 reach them. And that's done best at the local level. 14 COUNCIL MEMBER FOSTER: What can we 15 do, as City Council members, to get the word out? 16 And the reason I specifically ask that, I have five 17 community council meetings that meet in my office a 18 month. 19 I have great contact with my clergy. 20 Areas that I think are really the forefront of 21 disseminating information in our communities, that 22 maybe aren't going to be the ones that contact DOH 23 or anything like that, or even know what CDC is, and 24 how can we be more of assistance in making sure we 25 get the information out, and that it's done, as you 38 1 COMMITTEE ON HEALTH 2 said, not only culturally sensitive, but sensitive 3 to the needs in the area? 4 ASSISTANT COMMISSIONER SWEENEY: There 5 are two things that I can tell you now, is, one is 6 we are working with many organizations in the City, 7 but specifically about the Bronxwide testing, and we 8 are going to need all of the assistance of all of 9 the City Council Members throughout the City but 10 through this Bronxwide testing in the Bronx, and 11 you, the Council members, have entres into areas 12 where it could be on your agenda at any time that 13 you are calling a meeting for something, HIV could 14 be something that a few minutes of your agenda could 15 be given to. 16 And so that if it becomes a priority 17 where you're concerned, so that you address it 18 wherever you are, that would help to raise the 19 awareness of everybody that you're dealing with. And 20 even if it's not the 13- to 19-year-old who is there 21 with you, maybe somebody else who is there with you 22 will get the message and take it back. 23 We're also engaging the clergy in the 24 Bronx. We're working with every group of 25 organizations, no matter what their services are, to 39 1 COMMITTEE ON HEALTH 2 raise the awareness. We're doing it throughout the 3 City, but we're concentrating on the Bronx right 4 now. 5 COUNCIL MEMBER FOSTER: Well, I think 6 just a few things in closing. You have obviously the 7 Chair who is from the Bronx, but you have three 8 additional members of the Health Committee that are 9 from the Bronx. And probably more so than any 10 borough we are all very situated in terms of the 11 need and the infection rate and what can be done. 12 I would like to emphasize in closing, 13 Chair, that we have a discussion on the redirection, 14 as you call it, of the $20 million, because I firmly 15 believe that we have to start treating our HIV/AIDS 16 people in the communities that they live in. And 17 especially if we're going to target this population 18 where the mindset isn't there, we've got to make it 19 where they're not traveling to it. 20 I know that part of the Highbridge 21 area that I represent, I can't even begin to talk to 22 someone about being compliant with meds, when I'm 23 dealing with no home, no job, it's holistic. And if 24 we don't start focusing on the community so that 25 it's kind of one-stop shopping, I think we're going 40 1 COMMITTEE ON HEALTH 2 to continue to see the numbers rise, especially in 3 the Bronx in areas we represent. 4 Thank you, Chair. 5 CHAIRPERSON RIVERA: Thank you very 6 much. 7 Next we have Council Member Sears and 8 then Council Member James. 9 COUNCIL MEMBER SEARS: Thank you, Mr. 10 Chair. Thank you very much for your testimony. My 11 questions will be very brief. 12 I'm very concerned about the category 13 that already you're talking about, from 13 to 19. I 14 serve also on the Juvenile Justice Committee, and as 15 you were talking, I was wondering if there is any 16 connection for you to do rather testing for the 17 youth that are in secured and unsecured facilities, 18 because they're exactly within that age group. And 19 we're talking about networking, we're talking about 20 reaching out, we're talking about how do we educate 21 more than anything else, and they do have classes 22 within their facilities, they're not long range 23 because they're not to remain there for any length 24 of time, but it seems like it might be a wonderful 25 source to educate. 41 1 COMMITTEE ON HEALTH 2 And I don't know if you have done 3 this, if you have a connection with the juveniles? 4 ASSISTANT COMMISSIONER SWEENEY: One 5 of the members of the Prevention Planning Council is 6 from the Department of Juvenile Justice. We need to 7 do outreach to better engage that population and the 8 person who serves on the Committee. And we just had 9 a conversation about it last week, to find a way to 10 better engage that person to be active. 11 COUNCIL MEMBER SEARS: They also get 12 some funding from the State, so I would think that 13 the State would be a resource to look at, because 14 they get so much per diem for those that are in the 15 facilities? And they have also, have cut back in 16 different ways, and I think that there needs to be 17 advocacy to obtain more monies for those that are 18 there. And certainly if you initiate some kind of 19 educational program, the State should be responsible 20 for funding some of that. Because you did use the 21 word "epidemic," because it is on the rise in that 22 age group, which leads me to the next question about 23 the fact that the City Council does do this funding. 24 Have you had a decrease in the 25 federal government or the State in our funding to do 42 1 COMMITTEE ON HEALTH 2 some of the programs that you are -- particularly 3 that this age category, it's increasing? 4 ASSISTANT COMMISSIONER SWEENEY: Our 5 prevention dollars coming from the federal 6 government have been fairly steady. Not with 7 increases or decreases, but fairly steady over the 8 past few years that we're speaking about. 9 COUNCIL MEMBER SEARS: And the State? 10 What do you get from the State? 11 DEPUTY COMMISSIONER WEISFUSE: Let me 12 jump in there. 13 COUNCIL MEMBER SEARS: Yes, I know 14 that you can. 15 DEPUTY COMMISSIONER WEISFUSE: One of 16 the main ways we get funds from the State is through 17 something called Article 6, which reimburses the 18 Health Department for Public Health Services on a 19 certain ratio. So, if we spend 67 cents, they will 20 give us the extra 33 cents. 21 They recently in the budget adopted 22 by the State have decreased that somewhat two 23 percent. Two percent may sound like just two 24 percent, very small, but when you make it across 25 the, you know, the Health Department's budget and 43 1 COMMITTEE ON HEALTH 2 our reimbursement, it does come out to some money. 3 So, because of that recently adopted 4 budget, you know, decreased a little bit of their 5 support. Overall, not just HIV, but overall for the 6 agency. 7 COUNCIL MEMBER SEARS: That means that 8 probably in looking at the monies that are from the 9 City Council, I think we need to look in budget 10 negotiating, when we have those cuts and it's 11 overall, it is affecting the programs that basically 12 we look at for AIDS. Because there needs to be more 13 money coming in educational programs. And 14 particularly I agree with my colleague, Councilwoman 15 Foster, my district is in Queens, and part of that 16 district is Jackson Heights, very much would like to 17 see that in particularly in that age category, that 18 they have locations, and I know we have Elmhurst 19 very close by within the district, the fact is, 20 though, that the youth are not going to travel all 21 over. And they don't mind seeking advice, and 22 education in the areas they live in, because 23 invariably they look for somebody to go with and 24 generally they can, we also have one of our 25 colleagues who is very strong on the homeless youth. 44 1 COMMITTEE ON HEALTH 2 Do you do anything in the homeless shelters for the 3 youth, the teenagers? 4 When I say do anything, either 5 reaching out when they're there? Giving out 6 literature. 7 ASSISTANT COMMISSIONER SWEENEY: Yes. 8 COUNCIL MEMBER SEARS: Perhaps having 9 a conference or something there, some educational 10 programs that take place? 11 ASSISTANT COMMISSIONER SWEENEY: We do 12 have testing programs in conjunction with the 13 Department of Homeless Services, and we participate 14 in the Connect to Protect Coalition, and the New 15 York City Association of Street Involved Youth 16 Organizations. So there are coalitions that we have 17 with these organizations. 18 COUNCIL MEMBER SEARS: One other 19 question is that we have a lot of senior centers in 20 the City, and so many of them are grandparents of 21 young grandchildren. I mean, I can give you the ages 22 of mine, they're very young. Much younger than that 23 age group, but I know that when I visit them they 24 have teenagers, they have those starting at 13 and 25 11 and ten. It would be very helpful if you were 45 1 COMMITTEE ON HEALTH 2 able, and I don't know if you do, so I'm raising the 3 question, that you would have information for 4 grandparents about exactly educating their young 5 grandchildren on the issue of HIV/AIDS. Has that 6 been a resource to you? 7 ASSISTANT COMMISSIONER SWEENEY: We do 8 not have a specific program on grandparents 9 educating their grandchildren. 10 COUNCIL MEMBER SEARS: Well, then I 11 think that's something we need to look at. 12 ASSISTANT COMMISSIONER SWEENEY: I 13 think so, too. Thank you. 14 COUNCIL MEMBER SEARS: And actually, 15 we have my colleague Carmen Arroyo here, who always 16 solicits programs for the seniors and I think that 17 that is something that we need to look at 18 collectively in order to -- it is an enormous 19 resource. Enormous. 20 ASSISTANT COMMISSIONER SWEENEY: Thank 21 you. 22 COUNCIL MEMBER SEARS: The 23 largest-growing population are the seniors, and they 24 are a very wonderful source for their grandchildren. 25 And young girls as well. I know this issue is on men 46 1 COMMITTEE ON HEALTH 2 having sex with men, but certainly we had a hearing 3 here, and there were young girls and young women 4 that came, and talked about looking at the new faces 5 of AIDS. They were younger. They were educated. So, 6 we musn't put AIDS into a category that is only for 7 a certain group of people. It is not. And that's why 8 it's so important to reach out to each and every 9 one, that we can advocate in such a way that it has 10 an absolute effect on what it means. So, I think 11 that you have some resources, the City does, that 12 could have a major impact on reaching particularly 13 that age category. 14 ASSISTANT COMMISSIONER SWEENEY: And 15 we will do that. 16 COUNCIL MEMBER SEARS: Thank you. 17 Thank you, Mr. Chair. 18 CHAIRPERSON RIVERA: Thank you very 19 much. Next we have Council Member -- oh, no, we're 20 going to call the roll again for Council Member 21 Stewart and Council Member Mendez to vote on the 22 resolution. 23 COUNCIL CLERK MARTIN: Reso 1351, 24 Council Member Stewart. 25 COUNCIL MEMBER STEWART: I vote aye. 47 1 COMMITTEE ON HEALTH 2 COUNCIL CLERK MARTIN: Mendez. 3 COUNCIL MEMBER MENDEZ: I vote aye. 4 COUNCIL CLERK MARTIN: The vote now 5 stands at nine. 6 CHAIRPERSON RIVERA: Thank you very 7 much. 8 Now we have Council Member Tish 9 James. 10 COUNCIL MEMBER JAMES: Thank you. 11 Let me just say that with all due 12 deference to the comments that have been made, when 13 you see stats such as this, 115 percent increase in 14 East and Central Harlem, when you see if the fact in 15 2006, 90 percent who were diagnosed with HIV being 16 black and Hispanic, this is a black and Hispanic 17 issue, and therefore in the City of New York and the 18 State of New York and throughout this country we 19 should declare a state of emergency. And the fact 20 that we have denied and have not admitted to the 21 fact that we've got a real problem just goes to the 22 issue of racism and homophobia in the City of New 23 York. 24 The fact that this room is not packed 25 and the fact that there are not cameras in this 48 1 COMMITTEE ON HEALTH 2 room, there are two, and I thank you for being here, 3 but the fact that all of the media and major 4 channels are not here again goes to the issues that 5 confront this large, this population. And this 6 population is real and I represent a large majority 7 of the members in this room and in the City of New 8 York who I call my friends, and I'm going to stand 9 up each and every time and talk about this tragedy 10 of epic proportions and the fact that our government 11 continues to put its head in the sand. 12 And we were just handed the budget 13 this morning by the Mayor of the City of New York 14 who has refused to put in his budget, the $20 15 million from the City Council, and has refused to 16 put any of his own money, which is targeted towards 17 this audience. And, again, it goes to the racism and 18 homophobia, which is in this institution and in this 19 building. And in this City Council, I might add. 20 So, with that, let me just say that I 21 have been educated by a lot of the advocates and a 22 lot of my friends, and I also know that speaking to 23 individuals in my community who are often rejected 24 and neglected, who suffer from depression, suffer 25 from homelessness, suffer from denial and who engage 49 1 COMMITTEE ON HEALTH 2 in self-destructive behavior. 3 The question I have, Dr. Sweeney, and 4 you know because I love and adore you because of all 5 the work that you've done in Brooklyn and you and I 6 have worked very closely together, you mentioned 7 target groups, and my question is, you talked about 8 six focus groups who are developing culturally 9 sensitive HIV prevention campaigns, and I'd just 10 like to know who those six groups are, if you can 11 identify them? 12 ASSISTANT COMMISSIONER SWEENEY: These 13 focus groups were organized for us by an agency and 14 we had them select people of a certain age, that's 15 the target population, under 30 to 18. As I said, we 16 could not go from 13 to 17 without parental consent. 17 So, they advertised on sites, 18 internet sites, where men usually go on and 19 recruited men to participate in these four focus 20 groups. It was not an organizational -- they were 21 not organized as an organization, but focus groups 22 that were selected groups, similar to the way it is 23 done for advertising. You select the audience that 24 you are trying to appeal to and you have them come 25 in and talk to you about the product. In this 50 1 COMMITTEE ON HEALTH 2 instance the product is, social marketing is what 3 we're trying to do. 4 COUNCIL MEMBER JAMES: And the name of 5 the agency? 6 ASSISTANT COMMISSIONER SWEENEY: 7 What's the name of the agency? Global Strategies. 8 COUNCIL MEMBER JAMES: And was there 9 any communication or consultation or coordination 10 with the community-based organizations that are on 11 the ground doing the work each and every day? 12 ASSISTANT COMMISSIONER SWEENEY: Not 13 for the focus groups, no. 14 The focus groups that we did with the 15 community were in a different venue. That's the 16 Prevention Planning Council focus groups, actually 17 the open forums they're called, and a work group for 18 MSMs. 19 COUNCIL MEMBER JAMES: You also in 20 your testimony talked about you were funding six 21 community-based organizations, four of which 22 specifically target MSMs of color, MSM of color; 23 what are those? Could you identify those four 24 organizations? 25 ASSISTANT COMMISSIONER SWEENEY: Sure. 51 1 COMMITTEE ON HEALTH 2 The gay men of African descent. I wrote them down 3 before I came and how I don't know where they are. 4 Gay Men of African Descent, People of 5 Color In Crisis, Harlem United, Bronx AIDS Services, 6 GMHC, and Hispanic AIDS Forum. 7 COUNCIL MEMBER JAMES: The fact that, 8 again, 115 percent increase in Harlem, again 90 9 percent of individuals diagnosed with HIV in 2006, 10 being black and Hispanic, and we're only funding 11 four organizations. 12 In this budget that was just issued 13 this morning, was there any advocacy on the part of 14 your agency to increase the funds? Did anyone bring 15 it to the attention of the Mayor of the City of New 16 York that we've got an epidemic in the City of New 17 York. It doesn't look like his face, but it 18 certainly looks like mine. 19 ASSISTANT COMMISSIONER SWEENEY: The 20 amount of funding, we put in for various needs -- 21 what was the question? 22 COUNCIL MEMBER JAMES: I guess I got 23 the answer to the question. There is no additional 24 funding for this target, for this specific group in 25 the budget, the Executive Budget that was issued 52 1 COMMITTEE ON HEALTH 2 this morning? No? Okay. 3 And the monies from the City Council, 4 the $20 million which is clearly inadequate, though 5 I'm certain everyone appreciates it, is not 6 baselined as well in this budget as well, right? 7 Right. 8 ASSISTANT COMMISSIONER SWEENEY: So, I 9 guess Council Member Foster mentioned it and I'm 10 going to -- no, I think it was the Chair mentioned 11 it earlier, I believe we have to have discussion 12 about the redirection of these funds to 13 organizations that are on the ground doing the work, 14 each and every day, the work of the angels. And I 15 think, hopefully going forward we could increase 16 these funds. I recognize that in this fiscal 17 climate, it's going to be very difficult. 18 I would hope that when this 19 Administration and the federal government comes to 20 an end, thank God, 200 and some odd days, that we'll 21 get out of Iraq and focus on the issues, the weapons 22 of mass destruction in our communities, and the 23 weapons of mass destruction in our community are in 24 this room. 25 (Applause). 53 1 COMMITTEE ON HEALTH 2 COUNCIL MEMBER JAMES: I didn't come 3 here for applause; I came here for action. But I 4 thank you for that. It's just amazing. I've got 5 three, I think there are three housing programs in 6 my district and I welcome them. They're focused on 7 men of color, young, gay, black men of color in my 8 community. I go visit with them, and every time I 9 have time in my schedule I go have dinner with them 10 and just chat and just talk about issues. It just 11 breaks my heart that in a society such as this that 12 we ignore this population. We consider them dreaded. 13 We're doing a disservice to society and it's a 14 disgrace before God. 15 Thank you. 16 ASSISTANT COMMISSIONER SWEENEY: I 17 really wanted to say that we look forward to working 18 with the Council in the weeks ahead to develop an 19 HIV budget for FY 2009. 20 CHAIRPERSON RIVERA: Thank you. 21 We have Council Member Arroyo next. 22 COUNCIL MEMBER DEL CARMEN ARROYO: 23 Thank you, Mr. Chair. 24 Hi, Doctor. Thank you for being here. 25 I'm a little frustrated with your testimony and I'm 54 1 COMMITTEE ON HEALTH 2 going to try to get some clarity on the numbers that 3 you're reporting. 4 But, first, the definition of young 5 men, while I understand that 30 is young, the spread 6 of the age groups is significant. Is there specific 7 strategies for subsets of that age group? 8 ASSISTANT COMMISSIONER SWEENEY: At 9 the present time we have strategies for, we're 10 working on the strategies for 18 to 30 based on 11 feedback from the focus groups, Hispanic, Black that 12 we worked with. 13 We are working with a group, as I 14 mentioned earlier from NYU, who is working with the 15 13 to 17 year old age group to capture the voice of 16 the 13 to 17 year old. We were not able to do that 17 because of issues around parental consent. So, the 18 strategy that we're presently dealing with deals 19 with focus, the results of the focus groups that we 20 did work with, and they were 18 to 30. 21 COUNCIL MEMBER DEL CARMEN ARROYO: It 22 concerns me that regardless of what strategy we come 23 up with that we're going to miss what seems to be 24 the younger category, 13 to 19, or having the 25 highest incidence of HIV, yet they're missing in 55 1 COMMITTEE ON HEALTH 2 this focus group discussion, in being able to 3 provide ideas for the City, the Department to be 4 able to strategize around how to get them 5 identified, or more importantly, provide services to 6 keep them HIV negative, which I think is the goal 7 here. 8 ASSISTANT COMMISSIONER SWEENEY: We 9 have it down as 13 to 19, but when you separate it 10 out, the greatest number is in the 17 to 19 year old 11 age group, and we were able to have the 18 and 19 12 year olds in, but because of parental consent issues 13 and we don't want to interview and have interactions 14 with minors without parental consent where it's 15 indicated. 16 But based on what we learned from the 17 18 and 19 year olds who are a major part of that 18 group, that's how we're focusing until the results 19 are finished with the 13 to 17 year olds, and that 20 is going to be forthcoming. 21 In the next six months we'll have the 22 results from the studies for the 13 to 17 year olds. 23 COUNCIL MEMBER DEL CARMEN ARROYO: So 24 there isn't a targeted strategy for the 13 -- 25 ASSISTANT COMMISSIONER SWEENEY: For 56 1 COMMITTEE ON HEALTH 2 the 13 year olds, no. 3 COUNCIL MEMBER DEL CARMEN ARROYO: -- 4 To 17 year olds. 5 ASSISTANT COMMISSIONER SWEENEY: 6 Right. 7 COUNCIL MEMBER DEL CARMEN ARROYO: 8 Because of lack of parental consent? 9 ASSISTANT COMMISSIONER SWEENEY: 10 That's right. 11 COUNCIL MEMBER DEL CARMEN ARROYO: 12 Okay. 13 ASSISTANT COMMISSIONER SWEENEY: 14 That's right, we cannot interview them without 15 parental consent, that is correct. 16 COUNCIL MEMBER DEL CARMEN ARROYO: The 17 numbers that you report on the first page of your 18 testimony. In some cases you indicate percentage 19 increase, in other cases the number of HIV diagnosis 20 increased by 32 percent in the age group, nearly 21 doubled between 13 and 19; what are the numbers 22 because it's not clear. It's 32 percent overall but 23 nearly doubled between the 13 19-year-old group, and 24 the under 30 group. So, you keep going back and 25 forth between the subset on the 30 and including the 57 1 COMMITTEE ON HEALTH 2 whole group, so I'm really confused. 3 ASSISTANT COMMISSIONER SWEENEY: On 4 page two, the number of HIV diagnosis among young 5 MSMs increased by 32 percent from 380 -- 6 COUNCIL MEMBER DEL CARMEN ARROYO: I 7 have it on page one, that's what I'm looking at. 8 ASSISTANT COMMISSIONER SWEENEY: Okay. 9 In -- 10 COUNCIL MEMBER DEL CARMEN ARROYO: In 11 the third paragraph. 12 ASSISTANT COMMISSIONER SWEENEY: If 13 you look at 13 to 29, which is the under 30 age 14 group, 13 to 29 went from 380 in 2001 to 502 in 15 2006. That's the total number. 16 COUNCIL MEMBER DEL CARMEN ARROYO: 17 Thirteen to 29. 18 ASSISTANT COMMISSIONER SWEENEY: 19 Right. But now I can give you the numbers of 13 to 20 19 and then 20 to 29 and then over 30. 21 From 13 to 19, the number went from 22 42 to 81. And from 20 to 29, from 338 to 421. 23 COUNCIL MEMBER DEL CARMEN ARROYO: 24 Okay. But you indicate that for the 13 to 19 year 25 old, it nearly doubled and we still don't have a 58 1 COMMITTEE ON HEALTH 2 targeted strategy for those. For that age group. 3 ASSISTANT COMMISSIONER SWEENEY: At 4 age 17, if I change that from 13 to 19 and put 17 to 5 19, which if you -- 6 COUNCIL MEMBER DEL CARMEN ARROYO: Dr. 7 Sweeney, I'm reading from your testimony. 8 So, here is my concern, that the 9 group that seems to have the highest incidence of 10 HIV infection, newly diagnosed, are those that are 11 between the ages of 13 and 19, yet we do not have a 12 strategy targeted for that population. 13 ASSISTANT COMMISSIONER SWEENEY: 14 Except the age groups that are not minors, which is 15 18 and 19. And until we have definitive data, from 16 the 13 and 14 and 15 year olds and 17 year olds, 17 which we expect to have within six months, then the 18 strategy will be targeted to them, based on what 19 they say, because the whole purpose of having focus 20 groups is to try and get the voice of the people 21 that we're listening to. As a Department, having us 22 do a target and language, would not necessarily be a 23 language and a strategy to reach the group that 24 we're trying to reach. 25 COUNCIL MEMBER DEL CARMEN ARROYO: I 59 1 COMMITTEE ON HEALTH 2 recognize that. That's why I'm bringing it up as a 3 concern. So, you're anticipating having something 4 formulated for the 13 to 19 year old group by when? 5 ASSISTANT COMMISSIONER SWEENEY: We'll 6 get the results in the research being done to find 7 out what they're thinking and how to reach them in 8 about six months. 9 COUNCIL MEMBER DEL CARMEN ARROYO: All 10 right. So, you'll get the research? 11 DEPUTY COMMISSIONER WEISFUSE: Could I 12 just jump in for a second -- 13 COUNCIL MEMBER DEL CARMEN ARROYO: 14 Mm-hmm. 15 DEPUTY COMMISSIONER WEISFUSE: -- To 16 try to clarify one point? 17 COUNCIL MEMBER DEL CARMEN ARROYO: 18 When will we have a strategy for that population? 19 When do you anticipate being able to come back to 20 this Committee and say, okay, we've got the focus 21 group data back, and this is what they're saying we 22 should be focusing on. 23 DEPUTY COMMISSIONER WEISFUSE: Okay. 24 COUNCIL MEMBER DEL CARMEN ARROYO: 25 When do you think you'll do that? 60 1 COMMITTEE ON HEALTH 2 DEPUTY COMMISSIONER WEISFUSE: Well, 3 there are two halves, if you will, to the 13 to 19 4 year old group. We are within weeks of having a 5 strategy that addresses, you know, 18 and 19 and 6 probably 17 year olds. If you look at the 7 distribution among the 13 to 19 age group, is very, 8 very heavily weighted to 17, 18 and 19 year olds. 9 So, we are within weeks of having a marketing 10 campaign that will address that group. 11 The other group that Dr. Sweeney is 12 talking about, which is the younger part of that 13 group, 13, 14, 15 and 16, and a little bit of 17, is 14 something that is taking longer. 15 So, I would say that we will have 16 within weeks the marketing campaign for the older 17 part of that, and it will take some time longer for 18 the younger part. So, I just wanted to clarify. 19 COUNCIL MEMBER DEL CARMEN ARROYO: 20 That's what I'm asking. 21 What, in your best guess, when do you 22 think you will be able to roll out a strategy for 23 the younger population? 24 ASSISTANT COMMISSIONER SWEENEY: Here 25 is the situation. I would like to be able to tell 61 1 COMMITTEE ON HEALTH 2 you right now when that would be, but a lot of it 3 depends on what the research shows, and without 4 having that, I wouldn't say how long it will take. 5 But as soon as we have the information from the 6 research group, then we will begin working on 7 developing that strategy, based on what they find 8 out for the younger age group. 9 COUNCIL MEMBER DEL CARMEN ARROYO: So, 10 I suggest, Mr. Chair, that we engage in this 11 conversation again. 12 I'm sure, with the great minds that 13 we have at the Department of Health, understanding 14 the challenges with regards to the population we're 15 talking about, the younger group, that you can 16 estimate when you have a program ready to roll out. 17 I will not accept that you can't tell 18 us when. So that you need to deliberately think 19 about mapping out stages along the way, at the end 20 of which we should have a very focused strategy for 21 the younger population, because those are the ones 22 that Council Member Foster referred to, as out there 23 not identifying themselves as men having sex with 24 men, and are doing so because they are homeless or 25 having difficulties in their life that put them in 62 1 COMMITTEE ON HEALTH 2 the position of putting themselves at risk, and how 3 do we get to them? Because the younger ones are the 4 ones that are out there doing exactly what Helen 5 Foster referenced earlier. 6 So, we need to hear from the 7 Department very specifically when do you anticipate 8 being able to have that strategy mapped out, taking 9 everything into consideration even not knowing what 10 the research is going to bring back, we know that 11 something has to be done, when will we be able to 12 anticipate having something roll out. 13 A question on the issue of 14 community-based organizations. On page three of your 15 testimony:"The Department recontracted it's CDC HIV 16 prevention portfolio to provide a greater proportion 17 of funding to community-based organizations." 18 Certainly not in my community, 19 because the funding is not going to the 20 community-based providers in the 17th Council 21 district, many of whom who have lost a significant 22 amount of funding from the Department of Health, 23 MHRA, or whoever else is putting funding into 24 communities. 25 So, I want you to tell me, how much 63 1 COMMITTEE ON HEALTH 2 of it went where, and if you can't do that now, you 3 can certainly provide that information to the 4 Committee. Because your testimony is contrary to 5 what I am experiencing as a member of the 17th 6 Council District, and I suspect that many of my 7 colleagues on this day and in this body, are having 8 the same experience. Funding for HIV prevention 9 education is going to Citywide groups that are not 10 community-based. 11 Our constituents are having to travel 12 great distances to obtain the service, that would 13 enable them to modify behavior to keep them out of 14 harm's way. 15 ASSISTANT COMMISSIONER SWEENEY: 16 Council Member, we will provide you with a list of 17 where and how the money was, new portfolio was 18 distributed. 19 COUNCIL MEMBER DEL CARMEN ARROYO: 20 Okay. I suspect if you hang around for the testimony 21 that's coming to follow the Department of Health, 22 you're going to hear quite the contrary from the 23 providers in the audience. 24 (Applause.) 25 COUNCIL MEMBER DEL CARMEN ARROYO: So, 64 1 COMMITTEE ON HEALTH 2 we talked a little bit about your statement at the 3 end, the FY '08 budget may not be having, or the 4 funding that we make available, it's intended 5 impact, I urge the Department to rethink its 6 strategy on how we designate funding to 7 community-based providers. 8 And I'm really concerned with the 9 data that you report, because on the face of this, 10 my colleagues in Queens and Manhattan ought to be 11 very, very concerned, because according to this 12 data, the largest increases happened in Manhattan 13 and in Queens. But you're focusing your strategy or 14 your efforts on the Bronx. 15 It seems counter-intuitive to me, to 16 read in your testimony that the highest incidence of 17 infection among this population is in Queens and 18 Manhattan, but you are concentrating on the Bronx. 19 So, help me understand why there is a disconnect in 20 that information. 21 ASSISTANT COMMISSIONER SWEENEY: 22 Concentrating on the Bronx is an initiative that we 23 are doing with expanded testing. But we're doing the 24 expanded testing Citywide. There is a Citywide 25 expansion of HIV testing. What is going on in the 65 1 COMMITTEE ON HEALTH 2 Bronx, which has many institutions who work well 3 together, and are collaborating with us, we are able 4 to maximize the impact that the initiative will 5 have, and we're doing it because they came to us and 6 wanted to collaborate with us to do a Bronxwide 7 initiative, having already geared up in the Bronx to 8 do an initiative and they ask for our support. 9 COUNCIL MEMBER DEL CARMEN ARROYO: 10 When you say "they" you mean? 11 ASSISTANT COMMISSIONER SWEENEY: 12 Organizations in the Bronx. 13 COUNCIL MEMBER DEL CARMEN ARROYO: 14 Which are the organizations in the Bronx? 15 ASSISTANT COMMISSIONER SWEENEY: One 16 is Monetfiore. 17 There are many. I can't name right 18 now all of the partners, but Montefiore is certainly 19 one of them. Community Health Network. We are 20 working with the churches -- I shouldn't say 21 churches, I should say with faith-based 22 organizations, with community health centers, with 23 hospitals, and so because there was already this 24 group willing to help jumpstart this, we decided to 25 try the Bronx and to work with the Bronx to do this. 66 1 COMMITTEE ON HEALTH 2 But Citywide expansion of testing is 3 going on throughout New York City, not just the 4 Bronx. 5 COUNCIL MEMBER DEL CARMEN ARROYO: But 6 the highest occurrences, according to your 7 testimony, is in Manhattan and Queens. 8 ASSISTANT COMMISSIONER SWEENEY: 9 Right. 10 COUNCIL MEMBER DEL CARMEN ARROYO: But 11 what are you doing specifically for Manhattan and 12 Queens? 13 ASSISTANT COMMISSIONER SWEENEY: We 14 have what's called district health offices in 15 high-prevalence areas, in both -- in Manhattan, and 16 we are gearing up testing in those areas and working 17 with the organizations there. 18 We're giving technical assistance to 19 areas that are already not doing rapid testing in 20 those areas, and we have just started a conversation 21 with Elmhurst about ramping up testing as well. 22 So, we are working in all the 23 boroughs to do expanded testing. 24 COUNCIL MEMBER DEL CARMEN ARROYO: 25 Okay. So, one of the things I would like to see, 67 1 COMMITTEE ON HEALTH 2 because I'm really having a hard time understanding 3 this, so based on this data, the infection rate in 4 our City has shifted. 5 ASSISTANT COMMISSIONER SWEENEY: The 6 new infection -- 7 COUNCIL MEMBER DEL CARMEN ARROYO: 8 Yes. 9 ASSISTANT COMMISSIONER SWEENEY: The 10 increase in infections. 11 COUNCIL MEMBER DEL CARMEN ARROYO: In 12 this population has shifted where before it was 13 predominantly in Brooklyn and the Bronx and certain 14 areas in Brooklyn and Bronx and now is in Manhattan 15 and Queens. 16 What I'd like, Mr. Chair, is to see 17 how these numbers get derived, what data is being 18 looked at to have Dr. Sweeney put this in her 19 testimony, what is the supporting documentation? 20 Otherwise we're targeting the wrong neighborhoods. 21 And I suspect, and I'm concerned, 22 something like this could be taken out of context. I 23 suspect there is something is wrong with these 24 numbers, because the reality in my community and the 25 District that Helen Foster and I represent continue 68 1 COMMITTEE ON HEALTH 2 to have the highest incidence of HIV and AIDS 3 infection in this City. 4 This testimony contradicts that. 5 ASSISTANT COMMISSIONER SWEENEY: These 6 are the numbers for change in new infections, not 7 the prevalence. The prevalence is the number that 8 are in the community. 9 COUNCIL MEMBER DEL CARMEN ARROYO: 10 Okay. So, I'd like, Mr. Chair, if we can get an 11 explanation of how these numbers get derived, 12 because if that is the case, then we are seeing the 13 face of HIV and AIDS is changing in our City and 14 it's affecting communities that it was traditionally 15 not affecting, in particular, Queens. Okay? 16 Thank you, Mr. Chair. 17 CHAIRPERSON RIVERA: Thank you very 18 much. 19 We also have Council Member Mendez, 20 James and Stewart, but I also would like to mention, 21 we have nine panels, consisting of four people to 22 testify so if we can try and limit our questions for 23 this current panel, so we can give an opportunity 24 for those who came here to testify. Because if not, 25 we'll be here until about eight, nine o'clock 69 1 COMMITTEE ON HEALTH 2 tonight. 3 COUNCIL MEMBER MENDEZ: Yes, Mr. 4 Chair. And I'll keep my questions brief. 5 One of my questions is particularly 6 between the age group of 13 to 19, are we asking 7 them what sex is? Because when I talk to young 8 people in my district, they don't think that oral 9 sex is sex, so you know, we need to know what young 10 people are defining as sex so that we can then gear 11 prevention for them. 12 ASSISTANT COMMISSIONER SWEENEY: The 13 sex that we're primarily documenting with these new 14 incidences has to do with sex that causes 15 transmission of HIV, and I will quote a leading 16 expert in the United States that says if the only 17 epidemic -- let me start over. That said if the only 18 cases of HIV we had were from oral sex, the epidemic 19 would be over. What we are documenting is the 20 transmission of sex through the -- this is men who 21 have sex with men and from the studies that have 22 been done nationally, as well as in the Department 23 of Health, it has to do with anal sex. 24 COUNCIL MEMBER MENDEZ: I'm very well 25 aware of that, but, still, our young kids need to be 70 1 COMMITTEE ON HEALTH 2 educated because if someone is HIV positive, and 3 doesn't think that oral sex is sex, and is having 4 unprotected oral sex, they are still putting 5 individuals at risk. 6 ASSISTANT COMMISSIONER SWEENEY: That 7 is correct. 8 COUNCIL MEMBER MENDEZ: You mentioned 9 global strategies. They're the one who did the 10 research. 11 ASSISTANT COMMISSIONER SWEENEY: They 12 did the focus groups on our behalf, yes. 13 COUNCIL MEMBER MENDEZ: The focus 14 groups. How were they chosen? And I think, I don't 15 know if I'm wrong, I think I've heard of global 16 strategies. Maybe you could tell me who they are. I 17 think they're like a public relations firm; is that 18 correct? 19 ASSISTANT COMMISSIONER SWEENEY: 20 That's correct. 21 COUNCIL MEMBER MENDEZ: And how were 22 they chosen? 23 DEPUTY COMMISSIONER WEISFUSE: Yes, I 24 believe they were chosen through an RFP by our 25 communications group. 71 1 COMMITTEE ON HEALTH 2 COUNCIL MEMBER MENDEZ: Okay. 3 So, I have one simple solution that 4 will require interagency collaboration, is mandatory 5 sex education in the public schools. It was required 6 -- 7 (Applause). 8 COUNCIL MEMBER MENDEZ: When I was a 9 public school student it was required. It is no 10 longer required. It would go a long way in the 11 prevention of this disease. 12 Have you had any discussions with DOE 13 about this? 14 ASSISTANT COMMISSIONER SWEENEY: There 15 is a liaison that works with DOE from the Department 16 of Health around the issue of curriculum and other 17 programs in the schools. They are liaison to the 18 Department of Health -- from the Department of 19 Health to the DOE, where the DOE makes the decisions 20 about, the final decisions about what is done. 21 COUNCIL MEMBER MENDEZ: And how are 22 these discussions going? 23 ASSISTANT COMMISSIONER SWEENEY: There 24 is a curriculum from K through 12 at this point in 25 DOE, I understand. But that's not my area of 72 1 COMMITTEE ON HEALTH 2 expertise. I don't -- I mean, about how they're 3 doing in DOE, I wouldn't be able to answer that. 4 COUNCIL MEMBER MENDEZ: Well, I would 5 like to get that information Mr. Chair, if you would 6 ask them to provide it to this Committee. 7 I don't know what the curriculum is 8 from K through 12, maybe we could try to find out 9 from DOE. But again, unless it's mandatory, and 10 we're doing it consistently in every public school, 11 it really isn't going to be helpful to our young 12 people. 13 Thank you. 14 CHAIRPERSON RIVERA: We are going to 15 request the information, and once it's provided to 16 us we will make sure your office gets the 17 information as well. 18 We have Council Member Stewart that 19 is next. 20 COUNCIL MEMBER STEWART: Thank you. 21 Doctor, have you done any study as to 22 look to see what some of the other cities are doing 23 in terms of this problem? What kind of program they 24 may have, let's say in Chicago and LA and any of 25 those large cities? 73 1 COMMITTEE ON HEALTH 2 ASSISTANT COMMISSIONER SWEENEY: We 3 have not done studies to do that, but we keep 4 informed in our Department about what is going on in 5 other places, yes. 6 COUNCIL MEMBER STEWART: And do we 7 have any information to really check to see if there 8 is an increase in New York, if the same thing is in 9 LA, or in other cities of similar size? 10 ASSISTANT COMMISSIONER SWEENEY: There 11 is data that, I know about LA, that there is an 12 increase in young MSM. I don't have all of that data 13 with me but I would be happy to provide it to the 14 Committee. 15 COUNCIL MEMBER STEWART: Thank you. 16 My last question, you know, every 17 time we have hearings like this it's around budget 18 time that we raise the issue to make sure that we 19 have adequate funding for some of these programs. 20 What is the federal government, is there any change 21 within the federal government funding or the State 22 funding? How is it affecting our program? 23 ASSISTANT COMMISSIONER SWEENEY: It 24 was previously mentioned about the two percent 25 reduction that Dr. Weisfuse just mentioned from the 74 1 COMMITTEE ON HEALTH 2 State that was on all City Health Department, not 3 just HIV but a two percent reduction. 4 And the prevention budget from the 5 federal government has remained pretty stable, 6 although we just got a two percent recision it's 7 called, but that's a reduction from the federal 8 government as well, for our prevention budget. 9 COUNCIL MEMBER STEWART: So, you were 10 saying it has a negative or positive effect, the 11 budget, the federal budget, or -- 12 ASSISTANT COMMISSIONER SWEENEY: A 13 decrease. 14 COUNCIL MEMBER STEWART: A decrease, 15 but how is it affecting what we do? How we carry 16 forth our program? 17 Is it that we have to worry about 18 supplementing the HIV and AIDS budget that we 19 allocate? 20 ASSISTANT COMMISSIONER SWEENEY: It's 21 always helpful to have more money rather than less 22 money. 23 We have to learn how to use the money 24 we have efficiently and effectively, but if you're 25 asking if we need more money, the answer is 75 1 COMMITTEE ON HEALTH 2 absolutely yes. 3 COUNCIL MEMBER STEWART: I just wanted 4 to find out basically if you're trying to protect 5 the State agency or the federal government from, you 6 know, when they reduce this money and we have to 7 always try to make the adjustment, it seems it's not 8 only in this area, but in education and 9 transportation and every area we always have to try 10 to supplement every time. So, I wanted that point to 11 come out basically, that they invariably reduce the 12 money and we always have to keep it at a State where 13 we're making a difference, we have to always 14 supplement it. Isn't that so? And in this case that 15 is what is happening, right? 16 ASSISTANT COMMISSIONER SWEENEY: Well, 17 it will help to be able to have those funds returned 18 so we will not have to decrease any of the services 19 that we're presently providing. 20 CHAIRPERSON RIVERA: Thank you very 21 much. Seeing no other questions from the members, I 22 want to thank you very much for your participation 23 today. 24 ASSISTANT COMMISSIONER SWEENEY: And 25 thank you, Council member. 76 1 COMMITTEE ON HEALTH 2 CHAIRPERSON RIVERA: Thank you. 3 ASSISTANT COMMISSIONER SWEENEY: Thank 4 you, all. 5 CHAIRPERSON RIVERA: Next we're going 6 to call on Colin Casey from Senator Thomas Duane's 7 office for remarks. 8 You can start. 9 MR. CASEY: Okay. 10 My name is Colin Casey. I'm Senator 11 Duane's liaison to the LGBT community and HIV/AIDS 12 issues. He apologizes for not being here today. I 13 will read his testimony on his behalf. 14 My name is Thomas K. Duane, and I 15 represent New York's 29th Senate District. I am also 16 a member of the New York State AIDS Advisory 17 Council, and I thank you for the opportunity to 18 present testimony before the Committee on Health 19 oversight hearing regarding the rise in HIV/AIDS 20 among young men of color who have sex with men, MSM. 21 As a long time advocate for people 22 living with HIV/AIDS, and in the fight against the 23 spread of HIV/AIDS, I applaud Speaker Quinn, and 24 Council Members Rivera and James in particular and 25 the rest of the members of the Committee, for 77 1 COMMITTEE ON HEALTH 2 holding this timely and critical hearing. 3 The hard truth is that not only is 4 HIV/AIDS still spreading three decades after the 5 epidemic began, but prevalence is disturbingly high 6 among young MSM men of color. 7 A June 2005 CDC report detailed the 8 bleak results of a study it conducted at four 9 American cities, including New York. As in earlier 10 reports, the CDC found that not only is the highest 11 rate of HIV prevalence in young black MSM, but that 12 demographic is also unfortunately the most likely to 13 be unaware of their HIV status. 14 The April 17th, 2008 Gay City News 15 Article, "An Epidemic Unabated," cited New York City 16 data indicating that 3,596 13 to 24 year olds first 17 received an HIV diagnosis from 2001 to 2006. And 18 among those who were male, 52 percent were 19 African-American and 34 percent were Latino. 20 The fact that any young people test 21 positive for HIV nearly three decades after the 22 epidemic began, given our understanding of how 23 transmission can be prevented, is devastating. 24 The fact that the overwhelming 25 majority of them are men of color underscores the 78 1 COMMITTEE ON HEALTH 2 critical challenge that we must address with 3 concerned and immediate action. 4 It is because we have known so much 5 for so long with regards to the methods of HIV 6 transmission that studies like these, which show a 7 striking rise in HIV prevalence among certain 8 demographics, are so shocking, that young people 9 like those in these studies still participate in 10 unsafe behaviors, points to a lack of specific, 11 frequently imparted information during their 12 formative years. 13 Rising HIV rates are in part a result 14 of inadequate HIV/AIDS in our school system. Molding 15 the behavior of young people before they are 16 sexually active is vital to reducing the rate of HIV 17 cases in our communities and in our City. 18 We need to be doing more and we need 19 to continue to do more for HIV/AIDS from the 20 earliest grades through high school. Explicit sex 21 education for all young people and all those who 22 continue to be at risk is essential to stop the 23 spread of HIV/AIDS. 24 We must not allow future HIV 25 prevalence studies to repeat such bleak results for 79 1 COMMITTEE ON HEALTH 2 young MSM of color or any young people. 3 The growing epidemic among young MSM 4 of color is not a new revelation to the hard-working 5 community-based organizations that focus on this 6 population. 7 In particular, the New York State 8 Black Gay Network, a coalition of 16 groups, has 9 been instrumental in pushing this issue into the 10 spotlight. 11 The network knows that education and 12 prevention programs that have proven relatively 13 successful with one group of people may not be 14 effective for another. The We Are Part Of You 15 Campaign, an effort to fight homophobia and promote 16 safe sex methods in communities of color, is just 17 one tool that the black gay network has utilized 18 since advocacy. 19 Members of the network include GMHC, 20 people of color in crisis, Gay Men of African 21 Descent, Ali Forney Center, Harlem United, and the 22 Community HIV/AIDS Mobilization Project, among 23 others. 24 Each of the member organizations has 25 done its part in educating young MSM of color about 80 1 COMMITTEE ON HEALTH 2 the harsh reality that they are a high-risk group 3 and need to protect themselves and each other. 4 For example, GMHC's I Love My Boo 5 Campaign, features positive images of men of color 6 together with the tag line, "Safer Sex Is One Way We 7 Show Our Love" on every poster. 8 It's outreach to these gay young men 9 through various volunteer-driven initiatives, like 10 Soul Food, Proyecto P.A.P.I., and Gay Gotham show 11 why GMHC is a leader in the fight against HIV/AIDS, 12 and demonstrates its understanding of and commitment 13 to ending the rise of HIV/AIDS in this demographic. 14 Gay men of African Descent's mobile 15 testing vans and Times Project are other examples of 16 a network member using innovative techniques to 17 fight the spread of HIV/AIDS among young MSM. 18 While these efforts are making a 19 difference, it's clear that the City needs to do 20 more. 21 I know that the network was 22 instrumental in securing this oversight hearing, and 23 I anticipate that its members' collective 24 experience, expertise and experience, will serve as 25 a guide for the Committee on Health today, as it 81 1 COMMITTEE ON HEALTH 2 explores appropriate reactions to this trend. 3 I'm hopeful that today's oversight 4 hearing will do much to inform the Council and the 5 general public about the grave trend of increased 6 HIV prevalence against young MSM of color, that 7 HIV/AIDS is affecting so disproportionately one 8 demographic indicates that something about current 9 methods of prevention outreach is not working and 10 cries for a response tailored to the needs of this 11 community. 12 I do not pretend to have the answer 13 to solving this problem, however, one thing that is 14 clear is that access to regular health care is 15 crucial to prevention and early detection and 16 therefore reducing further transmissions. 17 We must end the appalling lack of 18 equal access to health care across different 19 communities in our City and State, and we must take 20 this inequity into consideration as we look to 21 address this current crisis. 22 I thank the City Council's Committee 23 on Health for holding this hearing and I look 24 forward to working with you in the future to reverse 25 this devastating trend. 82 1 COMMITTEE ON HEALTH 2 Thank you. 3 CHAIRPERSON RIVERA: Thank you very 4 much. 5 Next we have a panel of researchers 6 that will be coming up and we are, because of the 7 time situation, going to be requesting the testimony 8 be kept at a five-minute interval for the 9 researchers and then after that we will have a 10 three-minute interval for more testimony. 11 We have Leo Wilton, PhD from 12 Binghamton University. We have Darrell P. Wheeler, 13 Ph.D, as well, from the Bronx, and we have Robert E. 14 Fullilove from Columbia University. 15 Gentlemen, thank you very much for 16 joining us. State your name for the record. If you 17 have testimony -- I see you have given it to the 18 Sergeant-At-Arms. You may decide amongst yourselves 19 who goes first. 20 DR. WHEELER: My name is Darrell 21 Wheeler. 22 DR. FULLILOVE: My name is Robert 23 Fullilove. 24 DR. WILTON: My name is Dr. Leo 25 Wilton. 83 1 COMMITTEE ON HEALTH 2 DR. WHEELER: In deference to your 3 time and our time limit and in respect to the 4 Committee, I will begin as we're pulling up the 5 power point, and hopefully it will come up before 6 we're done. 7 Again, my name is Darrell Wheeler. I 8 am Associate Dean for Research and an Associate 9 Professor at the Hunter College School of Social 10 Work. I am joined by my colleagues Dr. Leo Wilton 11 and Dr. Robert Fullilove, who are also scholars in 12 the New York area. 13 Given the last testimony, I would 14 like to emphasize that you are looking at seeing 15 this panel, we represent a significant proportion of 16 the men of color who conduct HIV research in all of 17 New York State. I wouldn't give a number to how much 18 we represent but if you were to scour the 19 literature, you would find our names and probably 20 very few other, in terms of men of color. 21 We're having technical difficulties, 22 and I'm going to go ahead and begin because you have 23 our powerpoints in front of you, and I would like to 24 -- I'm going to try this but we'll go ahead anyway. 25 Since the beginning of the epidemic, 84 1 COMMITTEE ON HEALTH 2 as has already been pointed out, black and Latino 3 men who have sex with men are disproportionately 4 represented in the cases of HIV and AIDS. 5 Based on several studies, including a 6 large scale study conducted by the Centers for 7 Disease Control, as we know 46 percent of the black 8 MSM tested positive, and 67 percent of those men 9 were unaware of their HIV status. 10 New HIV infections among black and 11 Latino men have increased by 34 percent between Year 12 2001 and 2006. Again, this is information that you 13 have heard in your prior panel. I would like to 14 emphasize as was keenly pointed out by the 15 Committee, testing is an important component, but 16 testing is not the only component of an effective 17 HIV portfolio. 18 (Applause). 19 DR. WHEELER: If we look at the 20 science of HIV prevention and intervention, 21 particularly that relates to African-American and 22 Latino men -- 23 It's called "epi," right down the 24 center. Would you open it up to the powerpoint 25 version, please? 85 1 COMMITTEE ON HEALTH 2 Anyway, I will continue. Behavioral 3 focus -- the HIV prevention interventions that are 4 currently in use focus primarily on what is known as 5 ABC, Abstinence, Behavioral Monogamy, and Consistent 6 and Correct Condom Use. 7 We know from the State, federal and 8 local level that this strategy has limited efficacy. 9 Interventions that are out there 10 currently, typically address behavioral change and 11 do not adequately address context which includes 12 economics, incarceration, substance issues, mental 13 health and must be addressed. 14 Go back to the third slide, please. 15 Evidence-based intervention specific 16 to Black and Latino men are urgently needed. 17 The Centers for Disease Control bases 18 its interventions on a portfolio of effective 19 interventions and that portfolio contains at best 20 two interventions that are known to be effective or 21 hold promise for African-American and Latino Men. 22 Thirty years into the epidemic we 23 have only two interventions that have ever been even 24 mildly tested on this population and shown efficacy. 25 We must act now in order to stem the 86 1 COMMITTEE ON HEALTH 2 growing rates of HIV infections and associated 3 costs. Delayed actions will result in new cases, and 4 additional costs associated with delayed care and 5 treatment. 6 We must also hold for accountability, 7 in terms of development, implementation and outcome 8 of said interventions. 9 We don't suspect that we're going to 10 find the results immediately but we must be able to 11 document the results. 12 Finally, as a panel, and I would like 13 to leave room for questions, we propose and support 14 Council funding in four core areas: community level 15 interventions, which provide community prevention 16 interventions to reduce HIV and also cut across HIV, 17 Hepatitis C, sexually-transmitted infections and 18 clinical care and treatment. 19 We promote an integrated service 20 model, which includes a provision of integrated 21 testing, HIV care, sexually-transmitted diseases, 22 Hepatitis C, mental health, and addiction within 23 community-based settings. 24 We emphasize cross-sectional 25 evaluation and research and best practices, which, 87 1 COMMITTEE ON HEALTH 2 if I might add as a final note, should include 3 members of this panel. 4 African-American and Latino 5 researchers have been systematically excluded from 6 the research base that exists within the City and 7 nationally, and if you were again to look at the 8 portfolio you would find the names of these panel 9 members consistently in that literature, and we've 10 been at the forefront of HIV prevention and 11 intervention with this population for the past 30 12 years. 13 Thank you. 14 We are ready to receive questions. 15 Please. 16 CHAIRPERSON RIVERA: Gentlemen, thank 17 you. 18 You know, we appreciate you being 19 here today because you are the minds and the brains 20 of the research industry and making sure that we are 21 being given an education and what can and should be 22 done. 23 In your opinion, based on the 24 testimony that was given to us earlier, in terms of 25 the $20 million that the City Council allocates, you 88 1 COMMITTEE ON HEALTH 2 know, in reference to HIV and AIDS, do you think 3 it's being spent wisely? Is there any ideas or 4 opinions for how we can be spending the funding? 5 DR. FULLILOVE: I think that it is 6 very clear that if we are indeed in the midst of a 7 state of emergency, the dollars haven't basically 8 followed the epidemic. That's to say that as our 9 numbers grow larger, the amount of money that we 10 have available for each of the communities that are 11 hardest hit seems to be decreasing. 12 I think the idea that we have to be 13 wiser, more targeted in how we decide to spend our 14 money, is something that members of this Council 15 have pointedly asked representatives of the 16 Department of Health to provide, and I think you 17 need to be persistent in those efforts because I do 18 worry that what we're looking at is, despite its 19 national portrait, what we're looking at is a 20 neighborhood epidemic. This begins with members of 21 your constituency. 22 And to the degree that the programs, 23 the services and the organizations that serve that 24 constituency aren't necessarily getting the 25 resources necessary to aid us in this battle is one 89 1 COMMITTEE ON HEALTH 2 way in which we continue to lose ground. 3 I think your insistence that you hold 4 representatives of the Department of Health and the 5 federal government, that you continue to hold their 6 feet to the fire with respect to how they're 7 spending the money and where they're spending the 8 money, is one of the ways in which we can be more 9 effective in this battle. 10 I worry that in the 26th year as this 11 epidemic, the fact that it is perceived as a black 12 and brown epidemic is one way in which people can 13 say, well, I guess it's not anything that the rest 14 of us need to worry about. 15 As soon as it's seen as their 16 problem, then the money that is necessary to fight 17 this battle effectively is likely to dry up. 18 We very much appreciate your efforts 19 to keep this before the public eye. And we hope that 20 you'll continue to insist that people be accountable 21 for where they spend their money and whether or not 22 they're getting the results desired. 23 CHAIRPERSON RIVERA: Council Member 24 Helen Foster has a question. 25 COUNCIL MEMBER FOSTER: Quickly. Thank 90 1 COMMITTEE ON HEALTH 2 you. 3 When you said that you are being 4 excluded from these conversations, why is that? 5 DR. WHEELER: I wish Council Member 6 James were here because I think she articulated it 7 well. There is a word that begins with R and it is 8 significant in the HIV literature, and it's 9 "racism," exists actively, and as scholars who have 10 made it through the academy in different 11 institutions, I will speak for myself, racism is 12 alive and well at all levels of the Academy as well. 13 That stated, we have experienced 14 based on our experience with the Coalition members 15 and others, we have consistently committed ourselves 16 to the efforts of HIV prevention and I think that 17 speaks to the work that Dr. Fullilove has done, I've 18 done and Dr. Wilton have done. But certainly racism 19 is alive and well. 20 COUNCIL MEMBER FOSTER: Thank you. I 21 asked the question because I knew the answer and I 22 think that it goes to exactly what Dr. Fullilove 23 said, as long as we, people of color, keep saying 24 it's racism, and this is why we don't see the 25 response, it's going to continue to be looked at as 91 1 COMMITTEE ON HEALTH 2 not a universal problem, and the fact that when you 3 look at the Committee, when you look at Tish, when 4 you look at myself, we are people of color that are 5 continuing to say, if this epidemic were affecting 6 white men the way it is affecting men of color, 7 there would be a national outcry. 8 And I think what we need to do is to 9 continue to press forward but put the focus and make 10 those that need to be responsible the Mayor, and 11 others, put their money where their mouth is and 12 start getting people that are not of color to speak 13 up about what is happening because it really is not 14 a they, those people epidemic. It's all of us. 15 Thank you very much, gentlemen. 16 CHAIRPERSON RIVERA: Thank you. 17 Any other questions on behalf of the 18 Committee? 19 Seeing none, gentlemen, thank you 20 very much for your assistance here today. 21 (Applause.) 22 Next we are going to be calling 23 Marjorie Hill from the Gay Men's Health Crisis, 24 Dennis deLeon, from the Latino Commission on Aids. 25 Jose Davila from the AIDS Bronx Services, and Donald 92 1 COMMITTEE ON HEALTH 2 Powell from the Gay Men of African Descent, 3 Incorporated. 4 MS. HILL: Okay, good afternoon, Chair 5 Rivera, the Health Committee members, the members of 6 the public. My name is Dr. Majorie Hill, I am the 7 Chief Executive Officer of Gay Men's Health Crisis. 8 GMHC is the oldest AIDS service organization in the 9 world. We provide services to 15,000 clients, 10 three-quarters of our clients are people of color, 11 about 50 percent of our clients are MSM of color, 12 and 25 percent of our clients are heterosexual 13 African-American women of 45 and older. 14 So, I just want to, in spite of our 15 name, sometimes people get distracted, just be clear 16 about the span of our services. 17 Thank you for holding this hearing 18 today on this critically important issue and for the 19 opportunity for us to address these concerns. 20 The researchers are all individuals 21 who I have known personally and professionally for 22 20 or more years. The science of HIV relies on their 23 work, however, they are not always given credit for 24 it. 25 I'm not going to go through the 93 1 COMMITTEE ON HEALTH 2 statistics that they have already identified, which 3 is about half of my presentation. I will just say 4 that this is clearly an emergency situation. We are 5 experiencing a second AIDS crisis among gay men. I 6 want to say that white gay men are also being 7 impacted by this increase, but it's especially true 8 among gay men of color. 9 The development of a proposed 10 Emergency Response Coalition for MSM of color is an 11 unprecedented level of partnership, and coalition 12 among community-based organizations. We find the 13 need to do even more collaboration and cooperation 14 as resources are being cut. 15 While we look at Citywide 16 organizations as the individuals who are collecting 17 many of those funds, I think when the Council looks 18 at some of the reallocations, you will see that some 19 of the funding is being reallocated to hospitals and 20 other institutions. 21 So, I think we need to look at it 22 beyond just Citywide community-based organizations. 23 The City has emphasized individual 24 and group level intervention, such as HIV testing, 25 and counseling, which we believe there should be HIV 94 1 COMMITTEE ON HEALTH 2 testing and counseling, but these alone will not 3 change the epidemic or reach the populations that 4 are in greatest need. 5 We join the researchers in calling 6 for more community level interventions. Those 7 interventions that are like health fairs and other 8 targeted community activities that are done with 9 support and the appropriate resources can, in fact, 10 yield very high effective results. 11 Two other things that the City should 12 be doing, first, the Council has the opportunity to 13 implement the Dignity For All Students Act to end 14 discrimination and harassment among lesbian, gay, 15 bisexual and transgender students, and support 16 supportive interventions like gay straight 17 alliances. A growing body of research shows that gay 18 affirmative interventions in schools and other 19 social institutions correlates with health 20 resiliency and positive self-image which is also 21 linked to reduce HIV risk behaviors. 22 We are pleased that the Department of 23 Education is implementing some aspects of the 24 Dignity for All Students Act, but not enough. 25 Secondly, to provide comprehensive 95 1 COMMITTEE ON HEALTH 2 sex education in the schools, including condoms. 3 While condoms have been mandated to be in all New 4 York City high schools, they are currently in the 5 nurse's office in which a student has to request 6 permission to go get one or two condoms. Clearly, if 7 we are looking at an epidemic in the ages of 13 to 8 19, we must clearly have more condoms available. 9 And finally, the issues of, there's a 10 second document you have and you can read in its 11 entirety, but it's called"Black Gay Men's Lives 12 Matter," and we produced this about two years ago. 13 Black Gay Men's Lives still matter and the issues 14 around racism and homophobia are continuing to 15 contribute to the rise in incidents. 16 Thank you. 17 CHAIRPERSON RIVERA: Thank you very 18 much. I know we all have written testimony that we 19 would like to read verbatim, but unfortunately, 20 because of the time constraint, you would we would 21 ask that everyone give us the meat and potatoes of 22 the testimony and that would be cool. 23 Thank you. 24 We're going to try to keep everybody 25 at the three-minute time frame. 96 1 COMMITTEE ON HEALTH 2 MR. DeLEON: (Not identified for the 3 record.) Thank you. I just want to address a few 4 things that were raised before we got on. 5 I think Council Member Arroyo raised 6 a question about parents and what can be done, or 7 Sears. There is something we're doing in the Bronx 8 called Parents Matter, to help parents talk to their 9 kids about HIV, and we've done it eight times at 10 different schools, and primarily the issue with 11 parents are the kids are gay. 12 And they don't know how to talk to 13 their kids about safer sex in that regard. This has 14 not been recognized by the Health Department, but 15 based on our evaluation, we think we see it as 16 working. 17 Secondly, street fairs and community 18 events, my opinion, our opinion is that they indeed 19 do work. People of Color In Crisis has an annual 20 event which draws hundreds of black gay men, Gay and 21 Lesbian Dominicans' Empowerment Group draws almost 22 1,000 Dominican and minimal groups to an annual 23 fair. They do testing. They do a variety of 24 activities. That's very important. So, I wouldn't 25 buy that line about them not being helpful enough. 97 1 COMMITTEE ON HEALTH 2 And if you could just turn to page 3 two in my testimony, I have a chart. Everyone likes 4 a chart, right? 5 What this is is a chart of the 6 prevalence, there is a difference between incidence 7 and prevalence. What this does is takes the 8 population of men over 13 who are black, who are 9 Latino, who are white and who are Asian, and then 10 figures out what is the incidence, what is the 11 prevalence of HIV in those communities. Clearly, as 12 you can see, for black gay men, it obviously is 13 extremely high, well above that of Latinos and 14 whites, but the gap between white and Latino in this 15 age group is very dramatic. 16 But when we get over 30, which covers 17 a very large group, men who have sex with men over 18 30, they're just about, except for Asians, they're 19 almost all equal. I mean, there are small 20 differences, 26.6 percent for blacks, 23.7 percent 21 per 100,000 for Latinos, and 21.8 for whites. So, 22 this is clearly a white, brown and black epidemic 23 over 30. 24 I want to thank the Health 25 Department's office of Epidemiology for helping me 98 1 COMMITTEE ON HEALTH 2 with those numbers, but we have to look at the 3 larger numerical picture to be able to really 4 understand the problem. 5 And as you can see, the one gap is 6 that white gay men are not being infected when they 7 are 13 to 19 years old, inasmuch of a number. But 8 the increase of 24 percent is true among black, is 9 true among Latino, and is true among white gay men, 10 even know the numbers are smaller. So, something is 11 happening. Gay men are being infected. Young gay men 12 are being infected in higher numbers, rising 13 numbers, across all racial groups. 14 And, so, I think there may be a 15 common denominator that we just haven't found. 16 And lastly, I wanted to point out the 17 -- we know very little about men who have sex with 18 men and how to be safe. And we know very little 19 about what causes. What we suspect is, it's a 20 convergence of factors, like homelessness and drug 21 use and these things. None of the intervention, none 22 of the recommendations from the Centers for Disease 23 Control take into account this variety of 24 interacting factors that really bring about the risk 25 for infection. 99 1 COMMITTEE ON HEALTH 2 It's very complicated and we're 3 looking for easy fixes. And quite, frankly, there 4 are no easy fixes. What we need is more research. 5 CHAIRPERSON RIVERA: Thank you. 6 Who is next? 7 MR. DAVILA: I'll be next. 8 Mr. Chairman, and honorable members 9 of the New York City Council's Health Committee. My 10 name is Jose Davila. I'm the Executive Director of 11 Bronx AIDS Services, one of the oldest AIDS services 12 organization in the City of New York. 13 We are the largest provider of 14 non-medical services for persons at risk or affected 15 by HIV/AIDS in the Borough of the Bronx, serving 16 over 8,000 clients a year. 17 As you well know, the Bronx holds the 18 unfortunate distinction of having some of New York 19 City's highest indicators of poverty and related 20 indicators, as well as the poorest health outcomes. 21 It is no different for HIV and AIDS. We also 22 continue to be the epicenter of the epidemic in the 23 City, experiencing some of the higher rates of new 24 HIV diagnosis in men of color who have sex with men, 25 women of color and substance users. 100 1 COMMITTEE ON HEALTH 2 Our prevention program in MSM of 3 color can hardly meet the demands for services and 4 resources at the federal level for those already 5 affected keep shrinking and shrinking. 6 To make matters worse, our experience 7 in working with these populations shows us that 8 there is a tremendous need for culturally and 9 linguistically relevant intervention that is unmet, 10 and it is hampering our ability to make sustainable 11 changes in risk and health behaviors. 12 As the Bronx embarks in a boroughwide 13 campaign to test everyone for HIV promoted by the 14 New York City Department of Health, which we 15 wholeheartedly support, we may discover as much as 16 3,000 new HIV diagnosis, many which will be on MSM 17 of color. 18 It is imperative that the City also 19 make adequate resources available to provide 20 prevention and care services for the potential 21 increased demand, especially when we can hardly meet 22 it with what we have in place now. 23 These are the reasons why BAS joined 24 the Emergency Response Coalition for MSM of color, 25 with other 11 organizations Citywide, and why we 101 1 COMMITTEE ON HEALTH 2 fully support the initiative that will and has been 3 presented to you today by other members of the 4 Coalition, expert researchers and members of the 5 affected population. 6 I thank you for the opportunity to 7 offer testimony on behalf of the many MSM of color 8 that come to BAS for services and whose lives we 9 strive to impact in a positive way day in and day 10 out. 11 I also thank you for your continued 12 support of our mission, and hope that you will find 13 the Emergency Response Coalition Initiative worthy 14 of your consideration. 15 Thank you. 16 CHAIRPERSON RIVERA: Thank you very 17 much. 18 MR. DELEON: Can I just make one last 19 comment? I'm sorry, just one last comment before we 20 hand it -- testing is not prevention. Testing, while 21 there may be a short-term impact of testing after 22 testing, this has never been shown among 13 to 19 23 years old as being an effective intervention. 24 The CDC will tell you it's not an 25 intervention. There are intervention, but testing is 102 1 COMMITTEE ON HEALTH 2 not a prevention intervention. 3 CHAIRPERSON RIVERA: Okay. 4 Thank you. 5 MR. POWELL: Good afternoon. My name 6 is Donald Powell, and for the past 11 years I have 7 had the opportunity and the privilege to work for 8 Gay Men of African Descent. 9 I'm here, and I just want to say a 10 few things very, very quickly. The first thing I 11 want to say is that if we're going to work with this 12 particular population, we have to acknowledge the 13 fact that they labor under the double stigma of 14 being both gay men, as well as being so closely 15 linked with HIV. 16 I think it's really interesting that 17 for the longest time we didn't even recognize that 18 we had young men who were gay in the Latino and in 19 the black communities, and now they're so visible, 20 based solely on their risk for HIV. I think that we 21 need to realize that they're whole human beings and 22 treat them as such, and that we also realize that 23 they labor under living in conditions that make HIV 24 lower on the priority list than we would like it to 25 be for them. 103 1 COMMITTEE ON HEALTH 2 Dr. Sweeney mentioned earlier that 3 because of art (sic) HIV has become more manageable. 4 I think HIV is much more manageable than being 5 homeless and wondering whose couch you're going to 6 sleep on tomorrow night, and what you're going to 7 have to do to sleep on that couch. 8 I think wondering which pantry you're 9 going to go to to get a meal from, or which 10 institution that is supposed to be there for 11 homeless and runaway youth is going to be accepting 12 and affirming of you in your sexual orientation. 13 I think, as Mr. DeLeon said, testing 14 is not prevention, it's also not the magic bullet. I 15 think our concern is while testing is very 16 important, getting individuals engaged and 17 maintained in care is also important, and so for 18 that reason, we also advocate for the expansion in 19 the inclusion, more so of clinics that are affirming 20 both culturally and around sexuality of individuals 21 who are young men who have sex with men, like 22 Project Stay, like the HEAT Program at SUNY 23 Downstate, like the KISS Program at New York 24 Presbyterian. 25 The other thing that I want to say 104 1 COMMITTEE ON HEALTH 2 very briefly is that, the Centers for Disease 3 Control can come up with as many men, many voices, 4 teens linked to care interventions, as we 5 potentially need, but if these individuals go back 6 to families, communities, faith-based institutions 7 that tell them they're an abomination, that they are 8 outside of the norm, that's the way that they will 9 treat themselves, and those things will become 10 self-fulfilling prophesies for them. 11 So, I think while we talk about 12 targeting interventions toward Y MSM, we need to 13 target interventions toward those individuals who 14 are supposed to support them, like the families, 15 like the faith-based institutions, like the school 16 system. I think one of the things that we're doing 17 at Gay Men of African Descent, we're partnering with 18 some individuals and some institutions that we've 19 never partnered with before, like the Black 20 Leadership Commission on AIDS, like the faith-based 21 response at the Health Department, and I would think 22 I would encourage the Health Department to do the 23 same. I think that while HIV is a public health 24 issue, it's also an issue for the Department of 25 Labor. 105 1 COMMITTEE ON HEALTH 2 It's also an issue for the 3 Department, for the Division for Youth, the 4 Department of Correctional Services, and I think 5 that until HIV prevention is across all those 6 particular levels, we're going to be unsuccessful in 7 fighting this. 8 The last thing that I want to say is 9 that I'm concerned that we've heard from the Health 10 Department and we've heard from providers, and my 11 concern is that had I had this forum to do over, the 12 first people that I would have had speak would have 13 been the young men themselves. 14 CHAIRPERSON RIVERA: Thank you. 15 Any questions? 16 Thank you very much. We obviously do 17 want to hear from the young men and they're going to 18 be actually the next panel coming up, and I'm glad 19 that we are, you know, still all here to hear, you 20 know, the concerns that they have and hear directly 21 from them. 22 So, thank you very much for joining 23 us here today. 24 And with that being said, we are 25 going to call the next panel, and they consist of 106 1 COMMITTEE ON HEALTH 2 Kalvin Leveille. I hope I am pronouncing it correct, 3 from the HEAT Program. Larry Tantay and Frank 4 Roberts, Joseph Jefferson and David Tobo. 5 Gentlemen, just state your name for 6 the record, then you can decide among yourselves who 7 can go first. We just need an extra chair for the 8 panel, if we can. Thank you. 9 You go first. 10 MR. LEVEILLE: Hello? All right. Thank 11 you guys for hearing us out. We really appreciate 12 this. Before I go on, I would like to introduce 13 myself. My name is Kalvin Leveille. 14 I, Kalvin Leveille, stand here before 15 you as an HIV positive Haitain-American gay male. I 16 also stand here before you as next week a college 17 graduate, peer youth advocate and an HIV/AIDS 18 educator for the past two years. 19 Let us take a second and understand 20 that HIV, the HIV infection rates are increasingly 21 rising, but this can change. 22 I always tell people that if I didn't 23 become HIV positive at the young age of 18, it would 24 have happened eventually. Why? Because I was walking 25 the path of self-destruction. I did not respect 107 1 COMMITTEE ON HEALTH 2 myself. I looked for love and security through sex. 3 I felt validated through a mere compliment that 4 another male would just give me. 5 I never acknowledged the fact that I 6 was molested at a young age. Instead, I felt proud 7 that an older male wanted me. 8 It was not until I had the privilege 9 to meet the HEAT Program, a program similar to many 10 of the organizations that sit here today. 11 I wasn't just offered the medical 12 attention that I needed, but I was also offered 13 mental health care. I learned to love and respect 14 myself the way I never did before. 15 I am living proof that mental health 16 care and social networks can do justice. But if our 17 organizations can't continue to supply the necessary 18 resources which are proven to be effective, many 19 others like me will end up positive, and other 20 infected young individuals will continue to have 21 unprotected sex. 22 We all can fix these issues. If we 23 come together and give these issues the attention 24 they deserve, because if you do not, these issues 25 will only get worse. The statistics prove that. 108 1 COMMITTEE ON HEALTH 2 Thank you. 3 (Applause.) 4 MR. JEFFERSON: Good afternoon. My 5 name is Joseph Jefferson. I'm a Community Health 6 Specialist from People of Color in Crisis. I was 7 stressed for a few weeks on what I was going to say 8 at this hearing. Chronic homelessness, HIV stigma, 9 lack of youth services, and the many other 10 afflictions that our white counterparts have never 11 endured as heavily as our community. 12 Yes, I am a black gay man. And I 13 couldn't begin to tell you how long it took me to 14 muster the courage to say those words, let alone to 15 strangers, but I must renounce my fears and 16 reservations, because I'm not here just to represent 17 the Emergency Response Coalition, but the thousands 18 of young black gay men here in New York City, who 19 seldomly have the opportunity to speak to those who 20 have the power to effect great change in their 21 lives. 22 Honorable members of the City 23 Council, you have the power to help guide these 24 young men through what they have suffered, are 25 suffering, and have suffered. 109 1 COMMITTEE ON HEALTH 2 At my agency, our Coordinator Youth 3 Development Program, where I supervise eight 4 powerful and very strong, courageous young men, I 5 have heard that each and every one of their stories, 6 and in each of their stories they have expressed 7 feelings of insignificance of being unwanted, 8 unloved and misunderstood, not because of who they 9 are but because of their sexual identity. Forced to 10 believe time and time again that HIV would be the 11 death of their hopes and dreams, but instead of 12 listening to those who reiterated this to them, they 13 rose above it, they stood strong, they survived. 14 They proved them wrong. 15 You hold the future of these young 16 men and others like them in your hands. Don't 17 destroy their future. Nurture it. Support their 18 growth. Show them you believe in them as much as I 19 do. 20 Show them... (Applause). Protect 21 them. They're going to make you proud and I promise 22 you that. Thank you. 23 MR. ROBERTS: Good afternoon, Council. 24 My name is Frank Roberts. I'm a Ph.D candidate at 25 New York University and a 25-year-old black gay man. 110 1 COMMITTEE ON HEALTH 2 I am also this semester a graduate student intern at 3 People of Color In Crisis. 4 And what I wanted to talk about 5 briefly is the importance of maintaining and 6 supporting safe spaces for Queer Youth of Color here 7 in New York City, and think about the implications 8 of an issue not typically discussed in HIV 9 prevention, which is gentrification, as an actual 10 factor influencing HIV prevalence and incidence 11 rates. 12 And the example that I am thinking 13 about in particular is the case of Christopher 14 Street, the West Village and the Christopher Street 15 Piers. 16 As many of you know, for the past 40 17 years, the West Village, particularly the 18 Christopher and the actual Christopher Street Pier, 19 has been an important safe space for many Queer 20 Youth of Color, right? So, it's been a place for 21 young people to meet other young people in a 22 relatively non-judgmental environment. It's been a 23 place where young people could in some instances 24 receive direct services, and it's also been a place 25 where people could come together and feel 111 1 COMMITTEE ON HEALTH 2 comfortable expressing their sexuality in a 3 non-hostile environment. 4 So, in other words, the West Village 5 had historically been an important community 6 building site for young MSM here in New York. 7 More importantly, it's also been an 8 important site for various outreach efforts. So, 9 various HIV AIDS service agencies, many of whom are 10 here today, ranging from the House of Latex Project, 11 of the Gay Men's Health Crisis, some of the work the 12 people of color in crisis has done in the West 13 Village, as well as, for instance, Testing Center 14 Van of the Cullen Lord Agency, have all used 15 Christopher Street as a site for actually doing 16 outreach. 17 So, however, over the course of the 18 past five years, the West Village has undergone 19 extensive gentrification by wealthy residents and 20 has become an extremely hostile place for young 21 people, right? 22 So, reports of police brutality 23 against young black men and trans people of color 24 are at an all-time high in the West Village coming 25 out of the 6th Precinct in particular. So, why does 112 1 COMMITTEE ON HEALTH 2 all this matter? What matters is, as young people 3 lose control of the West Village as a safe space, we 4 lose control of our ability to do outreach to the 5 extremely at-risk populations that often congregate 6 there. 7 So, this is one of the reasons why 8 the field of HIV prevention here in New York really 9 must become much more vocal about the potentially 10 devastating effects of gentrification on increasing 11 prevalence and incidence rates in this community. 12 So, to kind to state it plainly, when 13 you have swarms of young people roaming around the 14 City with no place to go, no place to call home, no 15 place to call community, people are much more likely 16 to engage in higher-risk behaviors, number one, 17 because they're not as likely to come in contact 18 with outreach workers that can provide them with 19 direct services and/or advice, as well as some of 20 the psychosocial issues that come with feeling 21 disconnected and alienated from the people that look 22 and feel like you. 23 So, in conclusion I think we need 24 increased funding for the relationship, for further 25 research on the relationship between people feeling 113 1 COMMITTEE ON HEALTH 2 as though they have no safe space and then that 3 translating into unsafe sexual practices. And there 4 are several ways that these issues can actually 5 translate into the realm of policy. 6 One example would be increased 7 funding for collaborations between HIV/AIDS service 8 agencies, and grassroots political organizations on 9 the ground that do work on issues such as 10 gentrification and safe space. 11 I'm thinking in particular of FIRCE. 12 Which is Fabulous Independent Radicals for Community 13 Empowerment, which is an example of a group that's 14 attempted to do that work. FIRCE doesn't provide 15 direct services, however. So, there is an 16 opportunity for an actual HIV/AIDS agency to partner 17 with a grassroots organization like that around a 18 common goal. 19 Thanks. 20 MR. TANTAY: Honorable Joel Rivera, 21 Council members and members of the Emergency 22 Response for MSM of Color Coalition, thank you for 23 this opportunity to be heard. 24 I am here to testify on behalf of 25 Asians and Pacific Islanders. Although we have been 114 1 COMMITTEE ON HEALTH 2 largely ignored because of our low numbers, the 3 Department of Health reported a 115 percent increase 4 between 2001 and 2006 in HIV infection for adult 5 Asian and Pacific Islander men who have sex with 6 men. 7 These adults or youth, with education 8 for targeting our population, this number could have 9 been prevented. However, the New York City 10 Department of Health and Mental Hygiene currently 11 does not fund any prevention services for Asian and 12 Pacific Islander men who have sex with men. In fact, 13 there is no funding through the Department for HIV 14 prevention services for Asians and Pacific Islanders 15 at all. 16 My name is Larry Tantay, and I work 17 for APICHA, the Asian and Pacific Islander Coalition 18 on HIV/AIDS, a community-based organization fighting 19 to end stigma about HIV and bring awareness to the 20 epidemic within the Asian and Pacific Islander 21 communities. 22 I work with four young API gay men to 23 reach out to thousands of gay, bisexual, queer and 24 questioning Asian and Pacific Islander teens in New 25 York City. But I first started by tenure at APICHA 115 1 COMMITTEE ON HEALTH 2 as a client and peer advocator myself. 3 Growing up in a strict Filipino 4 Catholic household, it was hard for me to express 5 myself at all, let alone my sexuality. I always felt 6 like an outsider, constantly on the fringes of which 7 ever school group organization I joined, and it was 8 this fear and rejection, this fringe mentality that 9 put me at risk, for longing for an intimate 10 connection, for some understanding led me to have 11 unprotected sex, so I could feel the acceptance of 12 my partners, feel close to someone. 13 The need for that connection became 14 more important than anything else, including my 15 health, and that fact is not relegated to me. 16 Since coming to APICHA and being 17 surrounded by people with whom I could identify, I 18 have witnessed the same fear and rejection I felt in 19 the faces of young gay men we help. Young gay and 20 bisexual Asian and Pacific Islander men all over New 21 York City are being infected. The API community is 22 not defined by zip codes, but by our ethnicities. 23 We are in every borough and we are 24 all affected. 25 Within this past week, a 21-year-old 116 1 COMMITTEE ON HEALTH 2 Chinese gay male tested HIV positive at our agency. 3 Thankfully we can still help him with medical care, 4 alternative therapy, counseling and case management. 5 And we could even help him to use 6 protection. But how can we prevent the multitude of 7 others from succumbing to this disease which is 8 still rapidly engulfing the Asian and Pacific 9 Islander community. We need a safe space where 10 people can discuss these issues with their 11 communities in Chinese, Korean, Japanese, Hindi, 12 Bengali and more. 13 We must restore outreach services and 14 educational materials and add more peer educators to 15 reach into the community of young API adults and 16 show those standing by the wayside that there is a 17 place where people will truly accept them for their 18 entire self. And you must take the API community 19 seriously and allow for research to create effective 20 intervention strategies for our population. 21 Thank you very much. 22 CHAIRPERSON RIVERA: Thank you. 23 MR. TOBO: Good afternoon. My name is 24 David Tobo, and I am a Group Facilitator who works 25 with young men of color who have sex with other men 117 1 COMMITTEE ON HEALTH 2 at Bronx AIDS Services. 3 I am Latino. More specifically, I am 4 Colombian first generation American. I am 22 years 5 old and I am gay. 6 There are many identities that make 7 up my personality, all of which I am proud of, but 8 the one I am proud of the most today is that I am 9 HIV negative. What weighs heavy on my heart about 10 that aspect of who I am is that most of my community 11 is not and sadly, every day more and more of my 12 peers, friends and other young men I work with are 13 becoming infected with HIV virus. 14 A recent report from the CDC 15 indicates among African-American young men who have 16 sex with other men, which has already been stated 17 earlier, the rate of infection has increased by 80 18 percent. This is a harsh reality check for me, to do 19 more for my community, especially through the 20 efforts of the community-based organization I work 21 for. 22 I believe in the work I do in the HIV 23 prevention field because I am living, breathing 24 proof, like someone earlier who said, that education 25 and empowerment from community-based organizations, 118 1 COMMITTEE ON HEALTH 2 such as BAS, people of color in crisis, and GMHC and 3 other CBOs aid, aided me and others like me to 4 remain HIV negative. 5 As a teenager I benefitted from POCC 6 and GMHC's drop-in groups workshops about safer sex 7 and HIV 101 and getting tested for HIV. 8 Through their efforts and peer 9 education programs, I didn't just educate myself on 10 how to remain HIV negative, I grew to empower myself 11 and educate others like me. 12 Knowing I have a voice and I deserve 13 to be heard, I am a firm believer, if others are 14 suffering, we are all suffering. 15 My community, our community is 16 suffering from HIV, and we, as a City need to step 17 up immediately. 18 We believe we need to build on the 19 already ongoing efforts. This epidemic is affecting 20 many of my peers, but it is affecting all of us. 21 The CBO I work for needs your help. I 22 need your help. Because there should be more 23 testimonials like mine, more young lives that have 24 not and will not fall to this epidemic, this 25 overwhelming epidemic. Please, if you take anything 119 1 COMMITTEE ON HEALTH 2 from what I've said today, know that we are 3 suffering from HIV. We are suffering from HIV. We 4 need to stand together. We need more support. We 5 need more services, we need to educate and empower. 6 Someone said earlier about the meat 7 and potatoes. What helped me the most was mental 8 health services and job readiness programs. Knowing 9 that I wouldn't have to worry about HIV, because I 10 was empowered enough, and educated enough by these 11 things. 12 I want to echo what a lot of other 13 people said. But mental health services and job 14 readiness programs I think are on the forefront of 15 what I need, what my community needs, but what we 16 all need. 17 Thank you. 18 CHAIRPERSON RIVERA: Thank you very 19 much. 20 First, I want to thank you for having 21 the courage and having the wherewithal and having 22 the foresight, you know, to come here and speak with 23 us today, because it is important that we hear, you 24 know, what's on your minds. You are the population 25 that this population is targeting and we need to 120 1 COMMITTEE ON HEALTH 2 figure out how we can address this issue that is 3 impacting our neighborhoods the way it is and make 4 sure that it doesn't continue to take a toll. 5 Especially because, you know, it's a generation of 6 some of our brightest and some of our best, and we 7 want to make sure that we don't lose any more of you 8 guys. 9 And I'm glad to hear that you have 10 specific recommendations, you know, for us to 11 implement within the body because that's what we 12 need to know. We're not experts up here in the City 13 Council, on any one particular issue, but we take 14 our expertise by listening to what is your concerns, 15 and, you know, we do agree mental health services 16 are important because a lot of it is how do we deal 17 with the outside world when we have so many 18 pressures coming on top of us? And job readiness, 19 you're right. Because what do we do when we 20 confront, you know, an employment situation out 21 there that is, you know, tough to begin with and 22 then with our current situation. 23 So, I think that, you know, this 24 Council and this body has to take your 25 recommendations highly and make sure we focus on the 121 1 COMMITTEE ON HEALTH 2 mental health and the job readiness programs. 3 So, I want to thank you all for 4 joining us here today. I want to give an opportunity 5 to my colleagues, if you have any questions? 6 Gentlemen, thank you very much for 7 your testimony today. 8 (Applause.) 9 CHAIRPERSON RIVERA: Next we have 10 Soraya Elcoun from Harlem United; Kenyon Farrow from 11 Community HIV and AIDS Mobilization Project; Steven 12 Gordon from Ali Forney Center; and Bruce Burgos from 13 Boogie Down Pride. 14 Okay, thank you very much. You may 15 proceed in which ever order you decide. 16 MS. ELCOCIC: Girls go first, yay. 17 Good afternoon. My name is Sorrya 18 Elcocic. I am the Deputy Director for Policy and 19 Government Relations at Harlem United Community AIDS 20 Center. And like everyone else before me, I would 21 really like to thank Speaker Christine Quinn and 22 Council Member Joel River and the members of the 23 Health Committee for pulling together this important 24 and timely and overdue hearing on HIV among men who 25 have sex with men. 122 1 COMMITTEE ON HEALTH 2 You have heard all of the data. I 3 will not take the time to repeat it all. But there 4 is one dataset I would like to emphasize. When the 5 New York State Department of Health reported that 6 the total number of new HIV diagnosed in New York 7 City declined by five percent from 2005 to 2006, but 8 new diagnosis increased among black and Latino men 9 who have sex with men, between the ages of 13 and 10 29. And when you slice that data even further and 11 look at sub populations, the story reveals that 12 clearly there is an all-consuming crisis. 13 The date of that was repeated and I 14 saw that Council members really drilled down on that 15 increase of 30, ages 30 and younger, with a 33 16 percent increase, and that that largest increase 17 occurred in Manhattan and Queens. And when you look 18 at the neighborhood in Manhattan which was reported, 19 the concentration was in East and in Central Harlem. 20 Now, Harlem United, as the most 21 comprehensive HIV/AIDS care organization providing 22 those prevention care and housing services in Upper 23 Manhattan, these numbers are devastating to us also, 24 and unfortunately not surprising. 25 Within our own HIV testing 123 1 COMMITTEE ON HEALTH 2 department, we've seen a significant spike in the 3 sero-positive rate for MSM. 4 In the past seven months from January 5 to July '07, the agency tested over 375 men who have 6 sex with men and identified 14 new HIV infections. 7 The five percent sero positive rate 8 mirrors the preliminary data identified by the DOH. 9 If you continue to do just a cursory 10 analysis of the data in Upper Manhattan, you will 11 find that one out of every 38 residents in East and 12 Central Harlem is HIV positive, compared to just 13 over one out of 100 Citywide. 14 In 2005, the New York State 15 Department of Health recognized and produced data 16 that showed that nearly 20 percent of Central 17 Harlem, nearly 25 percent of Washington Heights, 18 Inwood, and almost 33 percent of East Harlem newly 19 diagnosed cases are late tested. 20 So, I gave you a piece of data. We 21 have heard tons of data to hear what is the 22 strategy? The strategy continues to be about 23 comprehensive care. 24 While I agree with my colleagues that 25 HIV prevention or testing is not the only activity 124 1 COMMITTEE ON HEALTH 2 of the strategy we have, it is a clear strategy that 3 we must continue to use. 4 It only works, however, like syringe 5 exchange programs. If when we give somebody an HIV 6 test or offer an HIV test we are ready with the 7 psychosocial and all of the other services that that 8 young person needs. So, we know about stigma, we 9 know about homophobia. If you look at the epidemic 10 in 2008, we are talk about comprehensive care and 11 comprehensive services for mental health to 12 substance abuse, to do campaigns that deal with 13 stigma. 14 I will stop here to give my other 15 colleagues a chance to also provide testimony, but I 16 think one of the other important pieces that I would 17 like to say is that one of the reasons I think that 18 all of us, health care providers, government, people 19 in the community doing this work, we would have all 20 hoped that we would have been able to decrease the 21 incident in these communities. 22 I think one of the things that we 23 have to look at is that we no longer can support 24 one-shot deals. These resources which are critical 25 and important need to be ongoing and sustainable. 125 1 COMMITTEE ON HEALTH 2 MR. FARROW: Good afternoon. My name 3 is Kenyon Farrow and I am the Director of 4 Communications for Community HIV AIDS Mobilization 5 Project or CHAMP, which is based here in New York 6 City, but we do national work with grassroots 7 organizations to build power and capacity to 8 advocate on behalf of communities that are most 9 impacted by HIV/AIDS. 10 And so, I want to talk specifically 11 about some of what I think is happening kind of on a 12 national level in terms of research, and where I 13 think New York City ultimately being the epicenter, 14 of the epicenter, quite frankly, in terms of HIV 15 prevalence, some things that this body should 16 consider that I think weren't presented by the DOH 17 earlier. 18 I think one issue that came up was 19 the question of funding. One person raised the 20 question of funding at the federal level from the 21 CDC, and it's true that the CDC has basically been 22 flat funded or has suffered various decreases in 23 terms of their funding for prevention efforts. But 24 what I think we also have to consider in terms of 25 that is the fact that if you are flat funded, you 126 1 COMMITTEE ON HEALTH 2 are essentially defunded, if we know that incidents 3 numbers are on the increase. 4 And the CDC is expected this summer 5 to release new incidents data from 2006. They 6 haven't released the numbers yet but there is 7 overwhelming number of conversations happening that 8 that number that they have been projecting at 40,000 9 new infections every year for the last 15 years, is 10 going to be much higher than that from 2006. 11 So, what that's going to show us is 12 that either they have been under-projecting the 13 numbers for very long, or there was a huge spike of 14 increase in terms of new infections in the US in 15 2006. And I think that given the fact that this is 16 the epicenter of the epicenter, those numbers for 17 New York City are going to be higher and specific 18 for this community of men of color, gay men of 19 color, men who have sex with men of color, is also 20 going to see that on the increase. 21 Another thing I want to say, too, and 22 this is something I've noticed kind of in this body 23 that has made me somewhat uncomfortable, is the fact 24 that people who we are coming here to advocate on 25 our behalf who sit in these City agencies who cannot 127 1 COMMITTEE ON HEALTH 2 say the word "gay" or cannot say the word "MSM" or 3 cannot say the word "anal sex," and they're supposed 4 to be working in these areas, I think it's really 5 troubling for me, in terms of people who are 6 supposed to also be rolling out prevention efforts 7 and working with community partners to do that work, 8 they're not themselves able to even have those 9 conversations with some level of comfortability. 10 And, so, I think that perhaps the more conversations 11 or education for different people who serve on these 12 committees and at DOH I think perhaps need to happen 13 so that they're actually more comfortable with 14 talking to members of our community. 15 The last thing I'll say is that the 16 issue of violence which has not come up, I think is 17 a very important issue for us to deal with in 18 communities. 19 I will tell you for myself every day 20 and it is something that happens in the back of my 21 mind, when I get dressed every day I think 22 critically about every step I have to take, what 23 train I have to take, where I have to go, simply 24 because of people who may perceive me as being what 25 kind of violence that that may in fact, I may have 128 1 COMMITTEE ON HEALTH 2 to encounter on a daily basis, right? And, so, I 3 think in terms of our issues of wanting to do more 4 social marketing campaigns and those kind of things, 5 I think anti-stigma in terms of HIV is important, 6 but anti-stigma in terms of anti-phobia in 7 communities is also important. And that's not our 8 problem, or not our fault as gay men, right? That is 9 the problem of the communities in which we come 10 from, and so I think the efforts in terms of the 11 Department of Education, in terms of comprehensive 12 sex education, new initiative that they're 13 launching, also has to deal with a range of 14 sexuality, and we also have to deal specifically 15 with anti-violence and anti-homophobia campaigns in 16 our community. 17 So, I want to thank you very much. 18 MR. GORDON: Hello. My name is Steven 19 Gordon of the Ali Forney Center. 20 The Ali Forney Center is a non-profit 21 organization that provides housing and social 22 services for LGBT homeless youth. 23 150 youth walk through my door every 24 single week. The Empire State Coalition took a 25 survey two years ago, surveying the number of street 129 1 COMMITTEE ON HEALTH 2 youth in New York City. Forty percent identified as 3 being LGBT. 4 While 40 percent identifies as LGBT, 5 less than ten percent of all shelter beds in this 6 City are for LGBT youth. I think that is an issue 7 that needs to be talked about and looked at. 8 Our youth have a plethora of barriers 9 to service. Lack of education, lack of culture 10 competitive services (sic), et cetera, et cetera. I 11 think that we need to start with the very basic 12 needs - housing, beds, if we can start with the 13 beds, we can start with housing, then we can build 14 on preventing HIV from our youth. 15 I would also like to add that in any 16 public health class, one of the first things you 17 learn is prevention is cheaper than secondary and 18 tertiary care. 19 If we don't look at this from the 20 issues of dollars and cents, if we can start by 21 having dollars and centers for prevention, the City 22 it self can save millions and dollars in treating 23 HIV at all and at any levels. 24 Thank you. 25 CHAIRPERSON RIVERA: Thank you. Thank 130 1 COMMITTEE ON HEALTH 2 you. Thank you. 3 Is Bruce Burgos still here? 4 Okay, next we are going to be calling 5 on Basil Lucas, Dwon White, Omari Wiles and Marcell 6 from POCC. 7 Thank you. Just state your name for 8 the record. And if you have any testimony, please 9 give it to the Sergeant-At-Arms. He will distribute 10 it to us. And you may proceed in which ever order 11 you decide. 12 MR. WHITE: Hello. Good afternoon. I'm 13 Dwon. And like everybody else, we have no written 14 pieces. We're going to speak from the heart. 15 We've been through the experience. 16 We've been there. We done it, so... 17 MR. GUMBS: Hello? Well, my name is 18 Marcell Gumbs. I'm part of the ALC program, which is 19 within the POCC organization, People of Color in 20 Crisis. 21 I have listened to like what a lot of 22 the people have been speaking about, and actually, 23 what the representative from Ali Forney was talking 24 about really hit home because not so long ago I was 25 a homeless youth, and also going back to what 131 1 COMMITTEE ON HEALTH 2 Congresswoman, what Ms. Arroyo, in terms of like 3 there not being a specific strategy in attacking the 4 13 through 17 year old age group, because I'm now 18 5 and my homelessness started at age 17. And there was 6 no place where they tell me, hey, we can help you in 7 this particular way, because at 17, you don't know 8 much, and then if these organizations aren't there 9 for you, aren't traveling, aren't making it more 10 accessible for you, you don't know. 11 And it does make you more prone and 12 liable to contracting diseases, and it starts from 13 the most basic needs, such as housing, and how a lot 14 of places such as Covenant House and all these other 15 shelter organizations don't have enough beds, and 16 are not specifically LGBT friendly. 17 And just coming from a place where 18 supposedly all of these organizations are here to 19 help you, and they are here to help you better 20 yourself and for prevention, and they're not being 21 nothing to target a specific age group, which is 22 like being attacked the most, makes no sense. It's 23 like, where is this money going to? 24 And like I say, it starts with the 25 most basic needs, such as housing. And a lot of the 132 1 COMMITTEE ON HEALTH 2 times I was fortunate enough to have friends that 3 were there that let me stay over, but a lot of 4 people that I also know who do not have housing, 5 were less fortunate and had to succumb to sex work, 6 and just asking for money and putting themselves in 7 a position where they had to sleep for money and be 8 with guys just to have a place and a bed to sleep, 9 and that makes no sense, and there should definitely 10 be programs and organizations out there that should 11 cater to those needs. 12 Before the HIV and before the 13 condoms, before all of that, there are the 14 situations which made you put yourself in risky 15 situations in order to contract a virus. And I feel 16 like we're going from the end to the beginning, and 17 we need to go from the beginning, sort of front to 18 the end. There is a route and we need to focus on 19 contacting the route instead of waiting til we 20 contract it and then wanting to help. 21 (Applause.) 22 MR. WILES: How you doing? My name is 23 Omari. That's the name that I go by now, that's 24 because that's the name that the LGBT community have 25 known to accept me as, and my whole argument is 133 1 COMMITTEE ON HEALTH 2 dealing on the level of acceptance that we don't 3 have in this community. 4 When I used to go to Edward R. Murrow 5 High School, and I was a dance major there, and 6 every single day I would have to worry about what I 7 had to wear or the way I had to dance even to get 8 that acceptance. 9 A lot of people were talking about 10 the whole education thing and the level of education 11 that we should be receiving. 12 For me personally, I think that in 13 health classes, we should have sexual orientation 14 and gender identity being put out there because not 15 just us but other youth need to know that, and 16 understand it. Because that's how everyone is. 17 They're scared of something they don't understand, 18 and that's what they don't accept. So, if you're 19 scared of me, you won't accept me. But if you get 20 understand and get a chance to understand who I am, 21 what I am about, then you would accept me. Then you 22 would want to take part in my life and be a part of 23 something bigger. 24 I ask myself every single day, why do 25 I have to fight to be accepted? I'm about to turn 21 134 1 COMMITTEE ON HEALTH 2 in August, and because of being a part of POCC, and 3 it took POCC opening up a part of being called AYC, 4 Ambassador Youth Council, we have now been given a 5 chance to learn and to use our voices and our impact 6 in our society to get this awareness to know, to let 7 our youth and let them know we are out here and 8 there are people your age out here talking and 9 explaining and trying to get you to understand that 10 you don't have to do certain things, you know, to 11 get accepted. A lot of people that I know, a lot of 12 friends, they didn't get accepted by their family 13 members because their family didn't understand their 14 situation, you know? And that acceptance level, we 15 need that. That's a part of growing, that's a part 16 of being human, is being accepted by your piers, 17 being accepted by your family members, and these 18 organizations that's out here, GMHC, POCC, they 19 accept that. They take that acceptance and they 20 teach it to you and they expect you to teach it to 21 everyone else, and that's what we need. 22 UNIDENTIFIED SPEAKER: Hello? Hello? I 23 just want to touch back on basis like, Helen came 24 and asked the question to, I think Department of 25 Health, where she asked about the state of mind. And 135 1 COMMITTEE ON HEALTH 2 when you are homeless and you are in a state of mind 3 and you need a place to stay and you want to 4 survive, you're not going to think about contracting 5 HIV or getting a STD. 6 I feel like if you can take, what 7 Omari said, the gender chart, sexual identity, 8 orientation, behavior and put it into the school 9 system, it will better open minds, accept youth, 10 accept us as a coach, as a community, accept people 11 in general. And it's like we, also about a pamphlet 12 of communicating with parents, it said why parents 13 can't accept. So I don't understand us. Us, as 14 youth, we're coming up with a pamphlet on 15 communicating with parents or how to communicate, 16 better ways to communicate, we did it all on our 17 own. We went out and did our own research. We did 18 our own thing. We're going out in our own community 19 and we're fighting for a cause, something that's 20 arising. 21 So, I said, the guy he asked, he said 22 to the lady, are you protecting the federal or the 23 government for funding, when they start decreasing 24 the funding, the answer is no. We're protecting us. 25 We're protecting the rise. We're trying to protect 136 1 COMMITTEE ON HEALTH 2 the rise, and lower the rise and decrease it and try 3 to have the numbers go down to zero if so. 4 So, putting that sexual orientation 5 and gender and all of that into the school system, 6 it opens minds so that by the time of 2010, the 7 numbers won't be so hot, it will be low, low as can 8 be. So, that we won't have to like, it's hard, it's 9 really hard. I've been there. I've done it. I did 10 sex work. I have had no place to go and I did it 11 all. And I fought through all that because I'm a 12 strong person. I have friends and family and people 13 who stood behind me. And it's like we had to find 14 the base, the foundation, and the person, or in the 15 community, we've got to find where we stand, find 16 that guidance. We need help. That's what we need. 17 And the monies that we're asking for, I feel like 18 put it into the organizations that are already 19 helping with the services and prevention, putting 20 them on into that, expand something bigger, than 21 just the MSM community, and straight world, it's 22 everywhere. It's not just us, it's everywhere now. 23 I know people that have HIV that are 24 struggling, friends, family, I had someone die. It's 25 touching. It's just like we have to stand and unite, 137 1 COMMITTEE ON HEALTH 2 not only as MSM community but as a whole, as a 3 government. As people would say, a government of the 4 people, by the people, for the people, well let's be 5 the people. Let's stand for each other. Let's fight 6 for the cause. Let's not be so small minded on 7 everything. You know what I mean? That's my thing. 8 Let's fight. Give us the money, let' us do what we 9 gotta do. 10 (Applause.) 11 MR. LUCAS: Good afternoon, everyone. 12 My name is Basil Lucas and I am the social worker 13 that works with these young men at POCC. And I must 14 say to you all, Marcell, Omari, and to you, I forgot 15 your name, how proud I am of the work that you're 16 doing and the work that you've put out here, and I 17 want to tie it all together by saying it is about 18 mental health. If we can't see ourselves positively, 19 if we've been told for most of our lives that we are 20 not worth anything, how do you tell someone who goes 21 to put a condom on to protect this person? I mean, 22 that's a tall order when you have no support. 23 Another point I want to raise is, a 24 colleague of mine used the word syndemics, it's not 25 just about HIV and AIDS, it's about housing, it's 138 1 COMMITTEE ON HEALTH 2 about education, it's about employment, job 3 readiness, and if we don't have those supports in 4 place, this will be a fight, you'll be back here 5 year after year after year, and we don't want to do 6 that. The time is now, the moment is now, HIV is 7 here, it's now, it's an epidemic, and young men are 8 dying, people are righting, and that's why we're 9 here. We're asking you because what you see before 10 you can be in your communities tomorrow. 11 So, we thank you for hearing us 12 today, and, again, I want to applaud everyone that 13 has spoken today, because what I'm trying to tie 14 together is that we're all saying the same thing. 15 This is the time to fight and make this a different 16 time for all of us. 17 Thank you very much. 18 (Applause.) 19 CHAIRPERSON RIVERA: Thank you very 20 much. 21 The last panel we have, Terry Evans, 22 Gregory Cruz, Vincent Filliatre, Marcello Soars. 23 I apologize if I am messing up the 24 names. 25 Xavier Ford. Again, so, Terry Evans, 139 1 COMMITTEE ON HEALTH 2 Gregory Cruz, Vincent, Marcello and Xavier Ford. 3 MR. FILLIATRE: Good afternoon, 4 Council members. My name is Vincent Filliatre. 5 First, I'd like to thank Arroyo, Foster, I can't see 6 that far, and the young woman that was sitting here, 7 my hat is off to you. I am a fifty-year-old black, 8 gay man that was adopted by a white French gay man, 9 and if it wasn't for him, the abuse and the neglect 10 that was done to my family as a gay man, I would now 11 be a dead hooker. I would be a dead gay hooker. 12 So, I'm an actor. I'm a case in point 13 of focus groups. I don't understand. This is like 14 redoing my kitchen, how can we subcontract what is 15 like primal in regards to people's lives? 16 It's like I'm having my kitchen done, 17 he's going to do my floors and he's going to do my 18 sink? It doesn't make sense. 19 And in these focus groups and in 20 these organizations, how many of these people are 21 actually the people that we are talking about? 22 You know, it's really great that 23 people go to expensive schools and they earn all 24 these acronyms. The acronym behind my name is I have 25 AIDS and I survived all the medication that was 140 1 COMMITTEE ON HEALTH 2 being given to us, which most of the people that I 3 loved in the beginning of this epidemic are dead. 4 They are not dead from this virus. They are dead 5 from medication. 6 I wrote a lot of things down here. 7 As far as advertising, we have an 8 advertising firm, what was it called? "Global 9 Strategies." The I Love New York, the time when that 10 whole thing was brought about, the woman, the rich 11 socialite that brought that whole I love New York 12 thing up, why isn't that being done with prevention? 13 And prevention is not testing. 14 I'm sorry. There should be pop-ups -- 15 the Internet. You try to use the Internet, there are 16 pop-ups about everything that is not related to 17 anything that I am actually looking for. Why aren't 18 there pop-ups on the Internet, about prevention? 19 I have one minute. I'm not giving it 20 up. I'm an actor. I'm using it. 21 Eighteen-years old. I participated in 22 a rally, two weeks ago at Union Square Park, GLBT 23 youth, they can't get inside of these homeless 24 shelters because they're not of age. This permission 25 thing. This whole back and forth, and the lack of 141 1 COMMITTEE ON HEALTH 2 respect for someone from the DOH to leave before 3 they actually got to hear these testimonies, 4 something's up. What's up? 5 I was a part of that ACT UP thing. I 6 was in San Francisco, nude on the back of a bus, 7 throwing raw meat at politicians. This is 20 some 8 odd years later. Our asses are creeping along. 9 Martin Luther King had a dream, I have a dream. 10 Please do something before I die. And I don't plan 11 on leaving here for at least another 25 years, so 12 you will see me for the next 25 years. 13 (Applause.) 14 MR. SOARES: Hello. My name is Marcelo 15 Soares. I would like to thank you, Council members, 16 for having this hearing. I think this is fundamental 17 that this repeats and there are also maybe a venue 18 so comments can be sent to you by e-mail. 19 I would like to just bring to 20 attention, the population that's being mostly 21 affected, between 13 and 19 years old, are 22 populations that go to New York City school system. 23 There is an HIV curriculum, and I thought there was 24 a little bit disconnection here before between the 25 Department of Health and the Department of 142 1 COMMITTEE ON HEALTH 2 Education. They really need to work together on 3 these issues. 4 There are copies of the HIV 5 curriculum on the Department of Education website. 6 But I just would like to bring some highlights from 7 research 2003 New York City Youth Risk Behavior 8 Survey data, which is also on the website. 9 Almost half of public high school 10 students are sexually active, 48 percent of all New 11 York City public school -- public high school 12 students report having sex, 17 percent of high 13 school students report having sex, having had sex 14 four or more -- I mean, sex, sex with four or more 15 partners. Five percent of students have been 16 pregnant or gotten someone pregnant. One of 24 high 17 school students who were sexually active did not use 18 a condom during sex intercourse. 19 Also, I'd like to talk to thank the 20 Manhattan Borough President, Mr. Scott Stringer, for 21 having Safer Kids, Safer Future monitoring HIV/AIDS 22 education in a New York City Public Schools Forum 23 yesterday. It was very educating. 24 After coming from that forum, I come 25 up with some suggestions about the HIV curriculum on 143 1 COMMITTEE ON HEALTH 2 New York City public schools. The curriculum needs 3 to have a more realistic harm reduction approach, 4 and should not emphasize abstinence as HIV 5 prevention to only, since the students are having 6 sex. Condoms should be made easily available 7 throughout the schools, not just in some special 8 health resource room, so kids do not feel 9 embarrassed to pick them up. Also, a variety of 10 condom makes and models, should be available and not 11 just the City condom, which has gotten a bad rap. 12 I understand the importance of timing 13 here, and I'm sorry I don't have a copy of this, but 14 I can leave this with you, if you like. Thank you 15 for having this hearing again. 16 MR. CRUZ: Hi. Thank you. Gregory 17 Cruz. I'm from Chicatelli Associates (phonetic). I'm 18 one of the Senior Trainers for the Leadership 19 Training Institute Program for HIV positive 20 individuals, and I'm also a person living with 21 HIV/AIDS. 22 I'd like to address something that 23 has not been spoken of here today. And that is Asian 24 Pacific Islanders. I heard a colleague of mine, 25 Larry, come up and talk to you. So, I'm going to 144 1 COMMITTEE ON HEALTH 2 talk to you very critically about Asian Pacific 3 Islanders. 4 We have very critical issues, and 5 those issues are like mini-racial and ethnic 6 minorities. And many minority MSM face poor access 7 to health care because of poverty, lack of 8 insurance. They have to cope with many types of 9 stigma for being a minority, for being an MSM and 10 for being HIV positive. 11 MSM of color therefore may fear 12 condemnation from many sectors. They're family, the 13 community and service providers especially. 14 Many minority MSM, such as myself, do 15 not self-identify as gay or bisexual. Thus, 16 prevention and health outreach targeting sexual 17 minorities may not be effective among our group. 18 And MSM may be especially reluctant 19 to seek services at organizations perceived to be 20 gay-oriented, for example. 21 Look at me. I am Hawaiian, Chinese, 22 Filipano, Spanish. With the last name of Cruz, who 23 would know that I was Asian Pacific Islander? 24 Minority MSM become infected at early 25 ages more than boys, and are more likely to learn 145 1 COMMITTEE ON HEALTH 2 that they are HIV positive later in the course of 3 their infection. 4 So, moreover, compared with whites, a 5 higher proportion of people of color have AIDS at 6 initial diagnosis. 7 So, who are Pacific Islanders, and 8 who are at risk? Like our counterparts through our 9 Latinos and African Americans or blacks, it is MSM, 10 and young MSM at that. 11 APS have significant lower rates of 12 HIV testing than the rest of the US population. But 13 despite these similar rates of risk behavior, they 14 often delay seeking HIV services. 15 So, what are some of our barriers to 16 prevention? Those barriers will be among APIs. There 17 is this cultural avoidance of issues, such as sexual 18 behavior, illness and death creates barriers to HIV 19 prevention. It breeds stigmatization and negatively 20 impacts the psychological and mental health of those 21 living with the illness. 22 And there is approximately 40 percent 23 of APIs who are limited in their English 24 proficiency, and few culturally competent 25 intervention programs exist for ethnically, 146 1 COMMITTEE ON HEALTH 2 culturally and linguistically diverse populations. 3 We, you have a golden opportunity to 4 keep numbers low among APIs, but that opportunity 5 may be disappearing quickly, as APIs have the 6 highest increases in HIV/AIDS diagnosed of any 7 racial group. 8 When you look at one percent two 9 years ago, and now we're at two percent, that's a 10 100 percent increase. 11 HIV prevention programs for API 12 should focus on those at greatest risk, which are 13 men having sex with men. 14 You should look at culturally and 15 linguistically appropriate prevention and health 16 care services for APIs. Stigma around HIV 17 homosexuality, sex work and drug use should also be 18 addressed with anti-stigma campaigns, something my 19 counterparts who are black and Latinos have been 20 saying. 21 And also, you need to give, given the 22 enormous diversity of APIs in the US, it's important 23 to improve surveillance. When you look at the 24 surveillance previously, we were other, and now 25 we're Asian Pacific Islander. But guess what? We're 147 1 COMMITTEE ON HEALTH 2 also Filipino, we're also Chinese, we're also 3 Korean, we're also Japanese and I can go on and on 4 and on. Thank you. 5 CHAIRPERSON RIVERA: Thank you. 6 MR. FORD: Thank you. My name is 7 Xavior Ford, and I, honorable Council Member, I sit 8 here not representing any specific agency. I sit 9 here representing men like myself who sit in silence 10 and remain to suffer without reprieve. 11 I sit here with survivor's guilt. I 12 have worked with an ASO organization since 2002, 13 when I first moved to New York City. When we talk 14 about stigma and discrimination, we need to also 15 talk about the stigma and discrimination that is 16 running rampant within these agencies that are 17 established to help men that look like me. 18 About these, a lot of these issues 19 are festering within these HIV AIDS service 20 organizations, simply because I do not fit the 21 prescribed dogma, or target population that they 22 wrote about on paper. 23 I am not homeless. I am not without 24 my mental health issues, I am an average black gay 25 man who needs services. 148 1 COMMITTEE ON HEALTH 2 I am tired of getting phone calls 3 from my friends who are now finding out that they're 4 positive, and when they ask me where would I 5 recommend to send them, I am almost into tears when 6 I say I cannot recommend a single agency that I 7 would trust to send you to. 8 Many of these organizational staff 9 members suffer from the same mental health and safe 10 sex practice activity issues that the very 11 populations suffer from. 12 The question comes up for me whether 13 it's an issue of mentoring versus modeling. If 46 14 percent is too high of a number for black, gay men, 15 what is now 86 percent representing? 16 Agencies need to be held accountable 17 for these numbers, if they will continue to collect 18 City dollars. One has to ask, at 46 percent you were 19 give money, now the numbers are 86 percent; what has 20 happened in between that time? 21 Where is the qualitative data, where 22 is the corrective action plans? 23 These questions continue to get swept 24 under the rug as we continue to chant and ask for 25 more money, more support, more voices, more 149 1 COMMITTEE ON HEALTH 2 visibility. 3 If more money is given to these 4 agencies, what are the programs that are already in 5 place, and how are they affected? Where is the data? 6 With each of these organizations 7 represented here today, I ask that a 8 community-driven assessment be done. If you really 9 need to know where these monies are going or how 10 these services are being delineated, find the 11 community. 12 Christopher Street is a great place, 13 but there are many people who never will go to 14 Christopher Street, and if you're going to talk 15 about that's where your services are, guess who you 16 are missing? 17 There is an idea that each 18 organization needs to clean their own steps before 19 they can begin to say what is wrong with community. 20 I challenge City Council to please investigate. Take 21 a look. Stop by. Ask a question. 22 For those people who subscribe to 23 these agencies and receive services, you will start 24 to notice a pattern. Look at names. You'll see names 25 across every agency, so we're all representing the 150 1 COMMITTEE ON HEALTH 2 same numbers. 3 I ask you again, please do not allow 4 this to continue to go on. 5 It is not just their fight, it is my 6 fight, and I will sit quiet no longer. 7 Thank you. 8 CHAIRPERSON RIVERA: Thank you. 9 MR. SOARES: Excuse me. I have a 10 little PS. Can I just one more observation? 11 CHAIRPERSON RIVERA: We'll do one 12 minute, because we try to keep everybody to the 13 clock. So, we'll give you one more minute. 14 MR. SOARES: Thank you. 15 New York City HIV Planning Council 16 manages $100 million of Ryan White money, which is 17 distributed in your City. 18 The Planning Council has an Advisory 19 Group of people living with HIV and AIDS, and we 20 need representation there of MSM of color. Most 21 people at the advisory group at 30 years and old, 22 one suggestion by a young MSM, who was test -- gave 23 testimony here today, suggested that young people 24 should get an incentive to come to the advisory 25 group, and this is an issue that's been going on. 151 1 COMMITTEE ON HEALTH 2 I would suggest members of this 3 Committee to look at the work of the Planning 4 Council, because it is $100 million there and the 5 Council Member is appointed by the Mayor, so I think 6 this Committee has a great interest in that work. 7 CHAIRPERSON RIVERA: Thank you very 8 much, gentlemen. 9 I just want to thank you gentlemen 10 for joining us here today. I want to thank everybody 11 else. Everything that you've said has been heard 12 and, you know, we agree that a lot of work needs to 13 be done, not enough has been done, and I definitely 14 believe that prevention is a lot more cost effective 15 than reaction, and I think that government has a 16 long way to go to show that we are going to take a 17 preventative approach, opposed to a reactionary 18 approach. 19 I want to thank you all for coming 20 here today. I know my colleague Helen Sears has a 21 statement also. 22 COUNCIL MEMBER SEARS: I just wanted 23 to correct you on the fact that AIDS is your fight. 24 If we're to succeed with AIDS, it's all our fight. 25 It certainly is ours all here. So, I really want to 152 1 COMMITTEE ON HEALTH 2 thank you for being here, and we're with you. I can 3 tell you that. Every inch of the way. 4 (Applause.) 5 CHAIRPERSON RIVERA: Thank you very 6 much. Thank you very much to everybody. Have a great 7 day and we are in the fight together. Thank you. 8 (Hearing concluded at 4:21 p.m.) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 153 1 2 CERTIFICATION 3 4 5 STATE OF NEW YORK ) 6 COUNTY OF NEW YORK ) 7 8 9 I, CINDY MILLELOT, a Certified 10 Shorthand Reporter, do hereby certify that the 11 foregoing is a true and accurate transcript of the 12 within proceeding. 13 I further certify that I am not 14 related to any of the parties to this action by 15 blood or marriage, and that I am in no way 16 interested in the outcome of this matter. 17 IN WITNESS WHEREOF, I have hereunto 18 set my hand this 1st day of May 2008. 19 20 21 22 23 --------------------- 24 CINDY MILLELOT, CSR. 25 154 1 2 C E R T I F I C A T I O N 3 4 5 6 7 8 9 I, CINDY MILLELOT, a Certified Shorthand 10 Reporter and a Notary Public in and for the State of 11 New York, do hereby certify the aforesaid to be a 12 true and accurate copy of the transcription of the 13 audio tapes of this hearing. 14 15 16 17 18 19 20 21 22 23 24 ----------------------- CINDY MILLELOT, CSR. 25