Understanding the Issues: The Candidates on HIV/AIDS

Todd Heywood

While both presidential candidates say they want to combat HIV/AIDS, a comparison of the voting records and public statements shows John McCain has very few specifics to address the crisis.

While both candidates for president have made statements that they
want to combat HIV/AIDS, a comparison of the voting records, public
statements and other actions shows John McCain has very
few specifics to address the crisis and has a history of supporting
legislation that damages and impedes the process of addressing the HIV epidemic in America.

First, here are what Barack Obama and McCain,
respectively, have said about the HIV/AIDS crisis in general statements:

"We are all sick because of AIDS – and we are all tested
by this crisis. It is a test not only of our willingness to respond,
but of our ability to look past the artificial divisions and debates
that have often shaped that response. When you to go places like Africa
and you see this problem up close, you realize that it’s not a question
of either treatment or prevention – or even what kind of prevention –
it is all of the above. It is not an issue of either science or values
– it is both. Yes, there must be more money spent on this disease. But
there must also be a change in hearts and minds, in cultures and
attitudes. Neither philanthropist nor scientist, neither government nor
church, can solve this problem on their own – AIDS must be an
all-hands-on-deck effort." – Obama; Lake Forest, Calif.; World AIDS Day
2006; Dec. 1, 2006.

"The spread of HIV/AIDS, and the efforts of the
international community to combat it, will be remembered by history as
one of the defining issues of our time. The ethical implications of not
doing everything in our power to slow the spread of this disease are
severe. The most basic morality requires that we commit ourselves to
combating HIV/AIDS everywhere." – McCain in a 2003 speech on the floor
of the U.S. Senate.

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Obama’s plans to combat HIV/AIDS can be found here.

McCain’s plan to combat HIV/AIDS is not available on his Web site.

    National Strategy on HIV/AIDS in America

Currently the United States requires that all foreign countries
receiving HIV funding provide a comprehensive HIV/AIDS strategy that
outlines specific outcome-based measures for the success or failure of
funded programming and prevention of transmission of HIV in the grant
country. However, the United States itself, 27 years after the cases of
this epidemic were identified, still does not have a national strategy
on HIV/AIDS in America.

McCain has never addressed the issue of whether or not he would support a comprehensive HIV/AIDS strategy for America.

Obama has stated that in the first year of his administration he
will develop a comprehensive HIV/AIDS strategy for America that will
specifically encompass every department of the federal government.

    Needle Exchange Programs

In 1989, marking the "war on drugs," Congress and President
George H.W. Bush created a law preventing the funding of needle
exchange programs. However, studies have shown time and again that
providing clean needles does not increase drug abuse, and more
importantly they prevent the transmission of HIV, Hepatitis B and C,
and other diseases among intravenous drug users. Some of the studies
even indicated that needle exchange programs funnel drug users into
treatment and out of the addiction cycle.

Congress has authorized the president to lift the needle
exchange ban if the Department of Health and Human Services certifies
that needle exchange programs do not contribute to drug abuse. The DHHS
made that certification in 1998, but no president has used his
congressionally authorized power to lift the ban.

McCain has never stated whether or not he would use the congressional
power afforded presidents in 1998 to lift the ban on needle exchange
programs to address the spread of HIV/AIDS in the intravenous drug
using population in America.

Obama has stated he would lift the ban on needle exchange programs,
and he has made it part of his HIV/AIDS platform on his Web site.

    HIV Testing

One of the most crucial impacts on prevention of HIV
transmission is found in the simple acting of widespread testing for
the virus. The Centers for Disease Control has recommended routine
testing as part of an annual physical, but as with millions of
Americans without basic health insurance, very few are getting the
annual physical. As a result, testing has fallen onto community
organizations who provide anonymous or confidential testing. Any
comprehensive HIV/AIDS strategy must address the issue of access to
testing within impacted communities.

McCain has not made public statements about testing.

In a show of support for the idea of HIV/AIDS testing, Obama and his
wife, Michelle, have both taken HIV tests publicly in 2006 in a trip to
sub-Sahara Africa and have called on others to follow suit.

    Access to Treatment

In addition to testing, it is imperative from a public health
perspective to make sure that those persons testing positive for HIV
have access to adequate medical care, including access to
anti-retroviral medications, which have made HIV a manageable, chronic
disease in the United States, rather than the death sentence it used to
be. However, many HIV-positive Americans die without access to these
necessary medications because of wait lists for AIDS drug assistance
programs, which are funded only a certain amount to provide HIV
medications to patients.

McCain voted against a federal program titled Early Treatment with
HIV Act. ETHA would expand Medicaid coverage to low-income persons who
are living with HIV but have not been diagnosed with AIDS. McCain was a
co-sponsor of the original Ryan White CARE Act, which authorized
funding to states to assist in treating HIV. McCain did not sponsor the 2000 Ryan White CARE Act reauthorization. In 2003 McCain voted
against increasing funding to the Global Fund to Fight HIV/AIDS,
Malaria and Tuberculosis by $940 million. He also voted against
increasing treatment worldwide by $800 million that same year.

Obama has co-sponsored ETHA as well as the Ryan White CARE Act
legislation. He also has outlined a concise plan, within his larger
health plan, to assure access to health care for those infected with
HIV.

    Confronting Stigma

In all the issues surrounding HIV/AIDS, nothing is as painful
and important as the need to address the stigma of being
HIV-positive. Many people would rather never get tested than to hear
the words "YOU ARE– HIV-positive" from a medical care
provider. The reasons for this are overwhelming. They run the gamut of
issues from family prejudices on sexuality to taboos about sexuality in
American culture, fear of disease and death, and simple ignorance about
how HIV is spread.

While McCain has made comments about how terrible the epidemic is,
he has also taken serious actions as a senator to support legislation
that adds to the stigma of being HIV-positive in America. Among the
things McCain has supported is a 1993 ban preventing HIV-positive
individuals from coming to the United States as tourists, students or
on other visas. He also voted in 1991 to involuntarily test all
patients going in for surgery and to imprison any health care worker
who is HIV-positive and participates in surgery.

In a debate at Howard University, Obama said the following:

"One of the things we’ve got to overcome is a stigma
that still exists in our communities. We don’t talk about this. We
don’t talk about it in the schools. Sometimes we don’t talk about it in
the churches. It has been an aspect of sometimes a homophobia, that we
don’t address this issue as clearly as it needs to be."

Obama also supports the lifting of the ban on immigration and other
visas to persons with HIV, a ban passed in 1987 with the assistance of
McCain.

    Science or Dogma to Drive HIV Prevention Programs?

Since George W. Bush became president, the United States has
been aggressively supporting abstinence-only education programs. Those
programs have been shown to fail, but it has not stopped the president
and his supporters from pushing this broken agenda on this country and
the world. The recently passed President’s Emergency Plan For AIDS
Relief (PEPFAR)
included a provision that demanded that 33 percent of all HIV
prevention programs presented in other countries and funded under
PEPFAR be abstinence-only programs.

Comprehensive prevention programs include development of new
modes of prevention as well as education programs targeting groups most
at risk for HIV infection with effective programs.

Obama is the Democratic sponsor of the Microbicide Development Act,
which would fund a program at the National Institutes of Health to
develop a topical anti-HIV agent to use in conjunction with other
activities to prevent the spread of HIV. Obama also supports the
JUSTICE Act, which would assist in the prevention of HIV transmission
in U.S. prisons by allowing the distribution of condoms to prisoners.
Current law makes possession of condoms in federal prison a crime.
Obama also supports the end of abstinence-only-until-marriage
prevention programs and replacing them with programs based on proven
comprehensive reproductive health education.

Obama is also a co-sponsor of the Prevention First Act,
which would provide young Americans with information about abstinence,
contraception and condom use to reduce unintended pregnancies, disease
transmission and abortions. The bill would also lift the 33-percent
abstinence-only education component of PEPFAR. Obama has said the
United States should "rewrite much of the bill to allow best practices
– not ideology – to drive funding for HIV/AIDS programs."

Obama also is opposed to federal funding of abstinence-only programs.

"We can’t ignore the fact that abstinence and fidelity,
although the ideal, may not always be the reality – that we’re dealing
with flesh and blood men and women and not abstractions, and that if
condoms and, potentially, things like microbicides, can prevent
millions of deaths, then they should be made more widely available." –
Obama to Los Angeles Times

McCain in March 2007 was unable to tell reporters on board his
"Straight Talk Express" bus if he thought condoms were effective in
preventing the spread of HIV. The New York Times ran the following transcript of the conversation on its blog:

Reporter: "Should U.S. taxpayer money go to places like Africa to fund contraception to prevent AIDS?"

Mr. McCain: "Well I think it’s a combination. The guy I really
respect on this is Dr. Coburn. He believes – and I was just reading the
thing he wrote- that you should do what you can to encourage abstinence
where there is going to be sexual activity. Where that doesn’t succeed,
than he thinks that we should employ contraceptives as well. But I
agree with him that the first priority is on abstinence. I look to
people like Dr. Coburn. I’m not very wise on it."

(Mr. McCain turns to take a question on Iraq, but a moment later looks back to the reporter who asked him about AIDS.)

Mr. McCain: "I haven’t thought about it. Before I give you an
answer, let me think about. Let me think about it a little bit because
I never got a question about it before. I don’t know if I would use
taxpayers’ money for it."

Q: "What about grants for sex education in the United States? Should
they include instructions about using contraceptives? Or should it be
Bush’s policy, which is just abstinence?"

Mr. McCain: (Long pause) "Ahhh. I think I support the president’s policy."

Q: "So no contraception, no counseling on contraception. Just
abstinence. Do you think contraceptives help stop the spread of HIV?"

Mr. McCain: (Long pause) "You’ve stumped me."

Q: "I mean, I think you’d probably agree it probably does help stop it?"

Mr. McCain: (Laughs) "Are we on the Straight Talk express? I’m not
informed enough on it. Let me find out. You know, I’m sure I’ve taken a
position on it on the past. I have to find out what my position was.
Brian, would you find out what my position is on contraception – I’m
sure I’m opposed to government spending on it, I’m sure I support the
president’s policies on it."

Q: "But you would agree that condoms do stop the spread of sexually
transmitted diseases. Would you say: ‘No, we’re not going to distribute
them,’ knowing that?"

Mr. McCain: (Twelve-second pause) "Get me Coburn’s thing, ask Weaver
to get me Coburn’s paper that he just gave me in the last couple of
days. I’ve never gotten into these issues before."

    The Veep Choices on HIV/AIDS

Sen. Joe Biden of Delaware, Democratic nominee for vice president,
has a mixed record on HIV/AIDS issues. While campaigning for the
nomination for president this year, he would not commit to a national
strategy on HIV/AIDS, but he did sponsor the Prevention First Act,
ETHA, and Ryan White CARE Act and the reauthorization. He has also
stated that he supports needle exchange programs and supported the
funding of research for microbicides, which would prevent the
transmission of HIV. Biden also supports a move toward science-based
education programs and away from the ideological programs such as
abstinence-only. While he has supported such legislation, he has also
supported the ban on HIV-positive people traveling to the United States
and supported a 1991 bill that would have imprisoned health care
workers with HIV who participated in surgeries.

Alaska Gov. Sarah Palin, Republican nominee for vice president, on
the other hand, has a scant history on HIV/AIDS issues. While in March
she declared a Native HIV/AIDS awareness program, she has stated that
she is opposed to "explicit" sex-ed programs. She later amended her
statements in a 2006 governor’s debate, by saying:

"I’m pro-contraception, and I think kids who may not hear about it
at home should hear about it in other avenues."

 

In February of this year, Rewire published answers to a reproductive health questionnaire we distributed to all of the presidential candidates at that time including information on their HIV/AIDS positions and strategy. Senator John McCain’s campaign did not respond. You can find Senator Obama’s published answers here

News Family Planning

Judge Thwarts Ohio GOP’s Attack on Planned Parenthood Funding

Michelle D. Anderson

“This law would have been especially burdensome to communities of color and people with low income who already often have the least access to care—this law would have made a bad situation worse,” said Iris E. Harvey, president and CEO of Planned Parenthood of Greater Ohio.

An effort to defund Ohio Planned Parenthood affiliates by Gov. John Kasich (R) and the Republican-held legislature has come to an end.

Judge Michael R. Barrett of the U.S. District Court of the Southern District of Ohio on Friday ruled in Planned Parenthood’s favor, granting a permanent injunction on an anti-choice state law.

The court ruling will keep Richard Hodges, the Ohio Department of Health director, from enforcing HB 294.

The 2015 law, sponsored by Rep. Bill Patmon (D-Cleveland) and Rep. Margaret Conditt (R-Butler County), would have redirected $1.3 million in state and federal taxpayer funds from Planned Parenthood’s 28 clinics in Ohio.

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The law would have required the state department to keep federal funds and materials that the health department receives from being distributed to entities that perform or promote non-therapeutic abortions, or maintain affiliation with any entity that does.

Funding that would’ve been cut off from the state health department went to the Violence Against Women and Breast and Cervical Cancer Mortality Prevention acts, the Infertility Prevention Project, Minority HIV/AIDS and Infant Mortality Reduction initiatives, and the Personal Responsibility Education Program.

Planned Parenthood in a lawsuit argued that the Republican legislation violated the First Amendment and the Due Process Clause and Equal Protection Clause of the 14th Amendment.

Barrett had temporarily blocked the law after Planned Parenthood affiliates filed the lawsuit and requested a preliminary injunction. The judge had issued an opinion contending that some legislators passed the law to make it difficult for people to access abortion care, as Rewire reported.

Iris E. Harvey, president and CEO of Planned Parenthood of Greater Ohio, praised the judge’s temporary order.

“This law would have been especially burdensome to communities of color and people with low income who already often have the least access to care—this law would have made a bad situation worse,” Harvey said in a statement.

Kellie Copeland, NARAL Pro Choice Ohio’s executive director, said in a statement that the Ohio legislature passed the anti-choice measure in an effort to appeal to conservative voters in early primary states during Kasich’s presidential campaign.

Copeland said that while the legislation made no effort to reduce the number of abortions performed, “it actively blocked critical health care for low-income women and families.”

Planned Parenthood said those services included 70,000 free STD screenings, thousands of HIV tests for at-risk community residents, and the largest infant mortality prevention program in the state.

In the 23-page court order and opinion, Barrett, an appointee of President George W. Bush, acknowledged that the law would have deterred “patients from seeking these potentially life-saving services.”

Planned Parenthood noted that the recent ruling in Ohio makes it among the ten states where courts have blocked anti-choice laws following June’s landmark Whole Woman’s Health v. Hellerstedt U.S. Supreme Court ruling.

Roundups Politics

Campaign Week in Review: Clinton Criticizes Trump’s Child-Care Proposal in Economic Speech

Ally Boguhn

Hillary Clinton may be wooing Republicans alienated by Trump, but she's also laying out economic policies that could shore up her progressive base. Meanwhile, Trump's comments about "Second Amendment people" stopping Hillary Clinton judicial appointments were roundly condemned.

Hillary Clinton may be courting Republicans, but that didn’t stop her from embracing progressive economic policies and criticizing her opponent’s child-care plan this week, and Donald Trump suggested there could be a way for “Second Amendment people” to deal with his rival’s judicial appointments should she be elected.

Clinton Blasts Trump’s Child-Care Proposal, Embraces Progressive Policies in Economic Speech

Democratic nominee Hillary Clinton took aim at Republican nominee Donald Trump’s recently announced proposal to make the average cost of child care fully deductible during her own economic address Thursday in Michigan.

“We know that women are now the sole or primary breadwinner in a growing number of families. We know more Americans are cobbling together part-time work, or striking out on their own. So we have to make it easier to be good workers, good parents, and good caregivers, all at the same time,” Clinton said before pivoting to address her opponent’s plan. “That’s why I’ve set out a bold vision to make quality, affordable child care available to all Americans and limit costs to 10 percent of family income.”

“Previously, [Trump] dismissed concerns about child care,” Clinton told the crowd. “He said it was, quote, ‘not an expensive thing’ because you just need some blocks and some swings.”

“He would give wealthy families 30 or 40 cents on the dollar for their nannies, and little or nothing for millions of hard-working families trying to afford child care so they can get to work and keep the job,” she continued.

Trump’s child-care proposal has been criticized by economic and family policy experts who say his proposed deductions for the “average” cost of child care would do little to help low- and middle-wage earners and would instead advantage the wealthy. Though the details of his plan are slim, the Republican nominee’s campaign has claimed it would also allow “parents to exclude child care expenses from half of their payroll taxes.” Experts, however, told CNN doing so would be difficult to administer.

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Clinton provided a different way to cut family child-care costs: “I think instead we should expand the Child Tax Credit to provide real relief to tens of millions of working families struggling with the cost of raising children,” Clinton said in Michigan on Thursday. “The same families [Donald Trump’s] plan ignores.”

Clinton also voiced her support for several progressive policy positions in her speech, despite a recent push to feature notable Republicans who now support her in her campaign.

“In her first major economic address since her campaign began actively courting the Republicans turned off by Donald Trump, Clinton made no major pivot to the ideological center,” noted NBC News in a Thursday report on the speech. “Instead, Clinton reiterated several of the policy positions she adopted during her primary fight against Bernie Sanders, even while making a direct appeal to Independent voters and Republicans.”

Those positions included raising the minimum wage, opposing the Trans-Pacific Partnership trade deal, advocating for equal pay and paid family leave, and supporting a public health insurance option.

“Today’s speech shows that getting some Republicans to say Donald Trump is unfit to be president is not mutually exclusive with Clinton running on bold progressives ideas like debt-free college, expanding Social Security benefits and Wall Street reform,” said Adam Green, the co-founder of the Progressive Change Campaign Committee, in a statement to NBC.

Donald Trump: Could “Second Amendment People” Stop Clinton Supreme Court Picks?

Donald Trump suggested that those who support gun ownership rights may be able to stop Democratic nominee Hillary Clinton from appointing judges to the Supreme Court should she be elected.

“Hillary wants to abolish, essentially abolish the Second Amendment,” Trump told a crowd of supporters during a Tuesday rally in Wilmington, North Carolina. “By the way … if she gets to pick her judges, nothing you can do, folks. Although, the Second Amendment people—maybe there is. I don’t know.” 

Trump campaign spokesperson Jason Miller later criticized the “dishonest media” for reporting on Trump’s comments and glossed over any criticism of the candidate in a statement posted to the campaign’s website Tuesday. “It’s called the power of unification―Second Amendment people have amazing spirit and are tremendously unified, which gives them great political power,” said Miller. “And this year, they will be voting in record numbers, and it won’t be for Hillary Clinton, it will be for Donald Trump.”

“This is simple—what Trump is saying is dangerous,” said Robby Mook, Clinton’s campaign manager, in a statement responding to the Republican nominee’s suggestion. “A person seeking to be the President of the United States should not suggest violence in any way.”

Gun safety advocates and liberal groups swiftly denounced Trump’s comments as violent and inappropriate for a presidential candidate.

“This is just the latest example of Trump inciting violence at his rallies—and one that belies his fundamental misunderstanding of the Second Amendment, which should be an affront to the vast majority of responsible gun owners in America,” Erika Soto Lamb, chief communications officer of Everytown for Gun Safety, said in a Tuesday statement. “He’s unfit to be president.”

Michael Keegan, president of People for the American Way, also said in a Tuesday press release, “There has been no shortage of inexcusable rhetoric from Trump, but suggesting gun violence is truly abhorrent. There is no place in our public discourse for this kind of statement, especially from someone seeking the nation’s highest office.”

Trump’s comments engaged in something called “stochastic terrorism,” according to David Cohen, an associate professor at the Drexel University Thomas R. Kline School of Law, in a Tuesday article for Rolling Stone.

“Stochastic terrorism, as described by a blogger who summarized the concept several years back, means using language and other forms of communication ‘to incite random actors to carry out violent or terrorist acts that are statistically predictable but individually unpredictable,’” said Cohen. “Stated differently: Trump puts out the dog whistle knowing that some dog will hear it, even though he doesn’t know which dog.”

“Those of us who work against anti-abortion violence unfortunately know all about this,” Cohen continued, pointing to an article from Valerie Tarico in which she describes a similar pattern of violent rhetoric leading up to the murders that took place at a Colorado Springs Planned Parenthood.

What Else We’re Reading

Though Trump has previously claimed he offered on-site child-care services for his employees, there is no record of such a program, the Associated Press reports.

History News Network attempted to track down how many historians support Trump. They only found five (besides Newt Gingrich).

In an article questioning whether Trump will energize the Latino voting bloc, Sergio Bustos and Nicholas Riccardi reported for the Associated Press: “Many Hispanic families have an immense personal stake in what happens on Election Day, but despite population numbers that should mean political power, Hispanics often can’t vote, aren’t registered to vote, or simply choose to sit out.”

A pair of physicians made the case for why Gov. Mike Pence “is radically anti-public health,” citing the Republican vice presidential candidate’s “policies on tobacco, women’s health and LGBTQ rights” in a blog for the Huffington Post.

Ivanka Trump has tried to act as a champion for woman-friendly workplace policies, but “the company that designs her clothing line, including the $157 sheath she wore during her [Republican National Convention] speech, does not offer workers a single day of paid maternity leave,” reported the Washington Post.

The chair of the American Nazi Party claimed a Trump presidency would be “a real opportunity” for white nationalists.

NPR analyzed how Clinton and Trump might take on the issue of campus sexual assault.

Rewire’s own editor in chief, Jodi Jacobson, explained in a Thursday commentary how Trump’s comments are just the latest example of Republicans’ use of violent rhetoric and intimidation in order to gain power.

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