[Viva] Fwd: [athenanetwork] Fwd: [HEALTHGAP] Call to action: sign on to stop USG discrimination against PLHIV

Tue May 15 11:02:42 PDT 2018

See below 🤗

---------- Forwarded message ---------
From: Teresia Otieno <coordinator-na at iamicw.org>
Date: Tue, May 15, 2018, 10:59 AM
Subject: Fwd: [athenanetwork] Fwd: [HEALTHGAP] Call to action: sign on to
stop USG discrimination against PLHIV
To:

Consider to sign on.

---------- Forwarded message ----------
From: 'E. Tyler Crone' tyler.crone at gmail.com [athenanetwork] <
athenanetwork at yahoogroups.com>
Date: 15 May 2018 at 08:34
Subject: [athenanetwork] Fwd: [HEALTHGAP] Call to action: sign on to stop
USG discrimination against PLHIV
To: "Athenanetwork at Yahoogroups.Com" <athenanetwork at yahoogroups.com>

---------- Forwarded message ----------
From: Erica Lessem <erica.lessem at treatmentactiongroup.org>
Date: Tue, May 15, 2018 at 8:29 AM
Subject: [HEALTHGAP] Call to action: sign on to stop USG discrimination
against PLHIV
To: tb-roundtable at googlegroups.com, Union Civil Society <
union-civil-society at googlegroups.com>, global_tb_activists <
Global_TB_Activists at googlegroups.com>, TB Civil Society <
tb-civil-society at googlegroups.com>, Health Gap <healthgap at lists.critpath.org>,
tb at lists.coregroup.org, tbhiv at googlegroups.com

Dear all,

Buzzfeed has just released an article on the discriminatory dismissal of
U.S. Peace Corps volunteers, including my stellar colleague Jeremiah
Johnson, for testing positive for HIV.
<https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.buzzfeed.com%2Fazeenghorayshi%2Fpeace-corps-hiv-prep>
<https://pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.buzzfeed.com%2Fazeenghorayshi%2Fpeace-corps-hiv-prep&media=https%3A%2F%2Fimg.buzzfeed.com%2Fbuzzfeed-static%2Fstatic%2F2018-05%2F15%2F10%2Fcampaign_images%2Fbuzzfeed-prod-web-04%2Fthese-gay-men-were-fired-from-the-peace-corps-aft-2-24084-1526394856-0_dblbig.jpg&description=These+Gay+Men+Were+Fired+From+The+Peace+Corps+After+They+Tested+Positive+For+HIV>
<https://twitter.com/intent/tweet?url=https%3A%2F%2Fwww.buzzfeed.com%2Fazeenghorayshi%2Fpeace-corps-hiv-prep&text=These+Gay+Men+Were+Fired+From+The+Peace+Corps+After+They+Tested+Positive+For+HIV&via=azeen>
<?subject=These+Gay+Men+Were+Fired+From+The+Peace+Corps+After+They+Tested+Positive+For+HIV&body=https%3A%2F%2Fwww.buzzfeed.com%2Fazeenghorayshi%2Fpeace-corps-hiv-prep%0A%0AGet+the+BuzzFeed+App:+https://bzfd.it/bfmobileapps>
<https://www.tumblr.com/widgets/share/tool?&url=https%3A%2F%2Fwww.buzzfeed.com%2Fazeenghorayshi%2Fpeace-corps-hiv-prep>

Romany Tin started feeling feverish and tired this January, six months into
his dream job teaching English at a rural Cambodian high school as a
volunteer for the Peace Corps. After a battery of blood tests two days
later, he got the news: He had HIV and would be flown to Washington, DC,
for treatment.

“At first I was just shocked,” Tin told BuzzFeed News. But after reading
about how HIV medications had advanced, allowing infected people to live
normal lives, “my mindset was literally just, *I want to make sure I can
come back*.”

But that wouldn’t be possible.

Despite effective treatment — within a month, medication had slashed the
amount of HIV in his blood to an undetectable level — the Peace Corps
notified Tin that because of his new HIV diagnosis, his assignment in
Cambodia had been terminated.

In a March 8 letter about Tin’s case reviewed by BuzzFeed News, the Peace
Corps said that “medical separation” was appropriate. His stipend would be
cut off, and he would have to wait three to six months — time he’d need to
make sure his new treatment was working well, the letter argued — before
reapplying for a post in a different country with better medical resources.
In person, Tin recalled, his Peace Corps health worker told him that
Cambodia was not on an approved list of countries where people with HIV
could serve.

“They’re such a progressive organization, but their stigma and knowledge of
HIV and how to treat it is very backwards,” said Tin, whose story was first
reported by Them
<https://www.them.us/story/peace-corps-volunteer-terminated-for-contracting-hiv>.
“I feel very mistreated. I feel angry.”

Tin is one of at least two gay men ousted from the Peace Corps this year
after testing positive for HIV. Two other gay men who used to work for the
program told BuzzFeed News that Peace Corps doctors denied their requests
for PrEP, the daily pill that protects against HIV infection, because their
sexual behavior was deemed not risky enough. And when one of those men
managed to get a second request for PrEP approved, he was then threatened
with dismissal for exactly the behavior that made him eligible for the
drug: having unprotected sex.

The Peace Corps is a federal program launched 57 years ago by President
John F. Kennedy to create a civilian army spreading American values in poor
areas of the world. Like the US military
<http://www.hivequal.org/homepage/hiv-and-the-military>, it has repeatedly
come under fire for its policies on the sexual health and safety of its
servicemembers. In 2014, for example, a new law forced the Peace Corps to
lift its 35-year ban on federal abortion assistance
<https://www.washingtonpost.com/news/federal-eye/wp/2014/12/18/spending-bill-lifts-ban-on-abortions-for-peace-corps-volunteers/?noredirect=on>
for volunteers. The year before that, a different law overturned its
ban on pregnant
volunteers
<https://rewire.news/article/2013/12/19/peace-corps-ends-discriminatory-pregnancy-policy/>.
In 2011, yet another law required the organization to address its long
track record of mishandling sexual assault cases
<https://www.washingtonpost.com/politics/peace-corps-chief-expresses-regret-for-sexual-assaults-experienced-by-young-volunteers/2011/05/11/AFjrCitG_story.html?utm_term=.c10334b2551b>
.

And in 2008, Jeremiah Johnson, a Peace Corps volunteer in Ukraine, had his
service terminated after testing positive for HIV. The ACLU
<https://www.aclu.org/cases/hiv-advocacy-behalf-peace-corps-volunteer?redirect=cpredirect/34948>
took up Johnson’s case, claiming that the Peace Corps was discriminating
against people with disabilities. In response, the organization implemented
a new policy to not automatically terminate HIV-positive volunteers but to
instead assess them on a case-by-case basis.

As for the two men booted this year, the Peace Corps told BuzzFeed News
that, “The health, safety and security of Volunteers are Peace Corps’ top
priorities.” Its 7,000-plus volunteers work in 65 countries around the
world, but there are only 18 where it can “provide appropriate medical
support” to those with HIV, a spokesperson said by email.

In addition to concerns about volunteers’ health, the Peace Corps also must
consider local legal restrictions around HIV status that could endanger the
safety of volunteers or people they work with. In some countries
<https://www.scribd.com/doc/312008825/Advancing-HIV-Justice-2-Building-momentum-in-global-advocacy-against-HIV-criminalisation>,
for example, it’s illegal for people with HIV to have sex without condoms,
or to keep their HIV status secret from their sexual partners.

“The agency considers factors including access to reliable specialists and
trusted laboratories as well as a country’s legal climate when placing
HIV-positive Volunteers,” the spokesperson said.

Still, legal experts and HIV advocates say that the Peace Corps’ medical
separation policy may violate the Americans with Disabilities Act as well
as HIV-specific anti-discrimination laws.

“The paternalistic response that it is in their ‘best interests’ does not
change the stark fact of discrimination,” Lawrence Gostin, a professor of
global health law at Georgetown University, told BuzzFeed News by email.

Forced medical separations also ignore the effectiveness of current
treatments, HIV advocates say.

“We are concerned that the Peace Corps’ policy pertaining to volunteers
diagnosed with HIV is arbitrary, not grounded in evidence, and being
implemented without critical attention to the wellbeing of the volunteers,”
said the Treatment Action Group, a think tank that has been advocating on
Tin’s behalf, in an open letter
<http://www.treatmentactiongroup.org/content/sign-letter-advocacy-end-peace-corps-hiv-dismissals>
to the Peace Corps last week.

“In practice,” the TAG letter added, “these policies mean that volunteers
who make the health-conscious decision to get tested for HIV — a practice
the Peace Corps should encourage — are, in effect, punished if they test
positive.”
------------------------------

A second gay man who was terminated from his post after getting HIV had
been teaching high school students in Southeast Asia. (Because of privacy
concerns, BuzzFeed News is using the first initial of his middle name, M.,
and not disclosing the country of his assignment.)

M. joined the Peace Corps in March of last year. In a sexual health
training session, he said he asked whether he could get PrEP and was told
Peace Corps doctors would not prescribe the medication unless he had
already had unprotected sex in the country. He hadn’t.

In March of this year, M. got his blood tested for another medical issue
and was surprised to find out he was HIV-positive.

His doctor told him that because of the country’s restrictive laws against
people with HIV, he would be putting its Peace Corps program at risk of
being shut down if he stayed at his post. So M. flew back to his host
family for a week to say his goodbyes. “We didn’t know what to do but cry,”
he said.

Once back in DC, M. was told by the Peace Corps that he could not go back
to that country, that he would be put on forced leave without his stipend,
and that he’d have to wait three to six months before re-applying to serve.
He was devastated, he said, to be forced out of his adopted country, and
furious that the Peace Corps doctors had not encouraged him to take PrEP
when he’d expressed interest in the drug.

Like Tin, M. received a letter from the Peace Corps stating that the
termination was to ensure his safety. “This condition limits your ability
to perform your Volunteer assignment and has the very real potential for
further aggravation during the remainder of your Peace Corps service,” the
letter stated. He was medically separated this month.

Two former Peace Corps members told BuzzFeed News that they were denied
PrEP while serving in Ukraine, which has one of the highest rates of new
HIV diagnoses
<http://www.euro.who.int/__data/assets/pdf_file/0007/355570/20171127-Annual_HIV_Report.pdf>
in Europe.

After 32-year-old Jeremiah arrived in 2015, he saw a Peace Corps doctor in
Chernihiv and asked about how to get access to PrEP. The doctor seemed
generally uncomfortable discussing gay sexual health, Jeremiah recalled,
and was confused about what the drug was. (BuzzFeed News is withholding
Jeremiah’s last name to protect his identity.)

The doctor eventually asked him to fill out a form, based on the Centers
for Disease Control and Prevention’s 2014 guidance
<https://www.cdc.gov/hiv/pdf/prepprovidersupplement2014.pdf> around
evaluating risk of HIV exposure. A few weeks later, according to emails
reviewed by BuzzFeed News, the Peace Corps denied his request for PrEP,
saying his answers on the form showed that his sexual behavior was not
risky enough to merit a prescription. Jeremiah was stunned.

“I was sexually active and was going to a country where they had the
highest prevalence of HIV infection in Europe,” Jeremiah said. “It was
definitely something I felt I needed.”

Months later, he visited a different Peace Corps doctor in Ukraine and made
a second request for PrEP. When filling out the form this time, “I lied and
said I was engaging in risky behavior,” Jeremiah said.

His request was approved — but before getting the drugs, he had to listen
to his doctor read a statement out loud. The letter, Jeremiah recalled,
stated that he was violating his Peace Corps contract by engaging in sexual
behavior that put himself or others at risk. And if he continued this
behavior, the doctor said, he could face dismissal. (The Peace Corps did
not answer questions about whether volunteers are contractually obligated
to use condoms. Instead the spokesperson wrote: “Peace Corps Volunteers are
expected to comply with both Peace Corps’ medical policies and the
instructions of Peace Corps Medical Officers regarding the prevention and
treatment of illness and injury.”)

Jeremiah began taking the drugs and finished his service at the end of last
year. “I think LGBT health in the Peace Corps is almost nonexistent,” he
said. “It just isn’t there.”

James Fishon had a similar experience in the summer of 2017. He was working
in a Ukrainian village near the border with Belarus, focusing on programs
for kids with HIV.

At the medical office in Kiev for a routine medical check, Fishon asked the
doctors about PrEP. Initially, as with Jeremiah, the doctor said he didn’t
know what PrEP was, and then gave him a form to fill out. Fishon stated
that he was a man who had sex with men, and that in the last year he had
had sex without condoms and had contracted a sexually transmitted infection
— all factors that make PrEP strongly recommended by the CDC.

When asked if he had yet had sex in Ukraine, he said no — and that answer
prompted the Peace Corps to deny his request. A doctor at Peace Corps
headquarters wrote an email to Fishon saying his “current sexual activity
does not meet criteria” and advised him to “use condoms every time you have
sex.”

Three months later, after filing three complaints with the Peace Corps
about potential safety risks in his village, Fishon was attacked in the
street by two men who knew he was gay and working on LGBT issues. After the
attack, he left.

“I am so disappointed in the Peace Corps because I feel like they dropped
the ball every step of the way,” Fishon said. “They talk about being an
organization that wants to be diverse and inclusive — and they like that on
the surface — but the fact of the matter is they don’t have the structure
in place to protect those people.”

On Feb. 22 of this year, hoping to go back to his work in Cambodia, Tin
appealed his termination. He argued that his viral count in two recent lab
tests was undetectable, that Cambodia has the medical infrastructure to
support the regular bloodwork he needs, and that his meds could be shipped
in from the US.

“Please don’t judge me hastily because of my diagnosis and take into
consideration everything that I have mentioned into the kindness of all of
your hearts,” his letter concluded. “I really wish to continue my service
without any interruption.”

On March 1, the health coordinator in DC told Tin that his appeal had been
reviewed by the Medical Review Board and had been denied. On March 8, Tin
was officially terminated.

He’s now back in his hometown in Southern California, figuring out what
he’ll do next.

“I feel completely healthy, mentally and physically. They know that,” Tin
said. “I could have returned to service.”

_______________________________________
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-- 

*E. Tyler Crone, MPH, JD*
Executive Director, ATHENA Initiative
Co-Founder, ATHENA Network
http://www.athenanetwork.org

Phone: +1-206-697-4789
Skype: tyler.crone
Email: tyler at athenanetwork.org <tyler at athenanetwork..org>
Follow us @ETCrone and @NetworkATHENA

*Join the movement, shape the agenda, use your voice. #WhatWomenWant*

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------------------------------
Posted by: "E. Tyler Crone" <tyler.crone at gmail.com>
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