By Matt Simonette

Staff writer

Community HIV/AIDS advocates and Loyola Law School faculty spoke at the school April 1 about AIDS’ impact in urban America, specifically how it affects the economically disadvantaged.

Ruqaiijah Yearby of Loyola Law School first discussed disparities in health care that poor Americans with HIV/AIDS often face.

She profiled a study she worked on in Maryland, a state which moved all its Medicaid patients to HMOs. Only two specialized facilities dedicated to treatment of individuals with HIV/AIDS existed in Maryland and neither of those facilities accepted the HMOs, thus cutting off care for numerous people with the disease.

Governments often make budget decisions with “no forward thinking, no foresight,” Yearby said.

The situation, she added, is equally obtuse locally.

“On paper it looks like (patients) have great access,” she said. But, she added, county and state bureaucracies often end up raising barriers to those in need of services.

Yearby further noted the irony that the county doesn’t necessarily “need to spend more money, we just need to redirect it” to ensure the best possible use of resources.

Justin Hayford, of AIDS Legal Council, expounded on what those barriers often are. The problem, he said, is usually not government rules and regulations, but, rather, “the stuff behind the scenes that impedes access.”

“The level of stupidity and ignorance out there is mind-blowing. Most of my job is making (agencies) stick to their own damn rules,” Hayford said.

Since persons with HIV/AIDS usually cannot get insurance if they are not on a group plan through their work, Medicaid is often their only option to receive medical care.

“(But) trying to just get in the door is astonishingly difficult,” Hayford said.

Hayford also discussed other legal issues that persons with HIV/AIDS face. Discrimination, he said, still raises its head in matters of access to jobs, housing and medical resources.

“There are still cases of medical professionals who will not treat patients who have HIV,” Hayford said. He mentioned one client who was scheduled for bone surgery, only to have the surgeon refuse to perform the surgery when he learned of the patient’s status.

He also told of a business owner who phoned him upon learning that an employee was HIV-positive. Hayford said the owner was looking for a way to legally fire the employee, so that the company’s insurance premium would not dramatically increase.

People are not obligated to disclose their status to anyone in most situations. Hayford said that he advises his clients to do so only when absolutely necessary.

His story also underscored a bitter truth—insurance companies have raised premiums on group plans by up to 800 percent once someone becomes HIV-positive, according to David Munar, of the AIDS Foundation of Chicago.

Munar outlined a number of long-term goals that could improve resources for persons with HIV/AIDS, including the development of a national strategy to combat the disease.

He said that while the U.S. requires nations to which it provides assistance for HIV/AIDS to have a strategic plan in place, the U.S. itself is “not applying an outcome-based, accountability-based” plan for persons in this country.

AIDS advocates are currently trying to get the current round of presidential candidates to agree to such a plan.

“Politicians are not hearing enough about this,” Munar said.