hiv/aids, bmsm and lgbtq advocacy in the south

69 Pages·2017·1.68 MB·English

by  Sonia Haerizadeh

HIV/AIDS, BMSM AND LGBTQ
ADVOCACY IN THE SOUTH

FINAL REPORT

AUGUST 2016
TABLE OF CONTENTS
Introduction ............................................................................................................................... 3
Florida ........................................................................................................................................ 4
HIV incidence ......................................................................................................................... 4
Access to care ........................................................................................................................ 5
Access to PrEP ........................................................................................................................ 7
Legal framework .................................................................................................................... 8
Prison system ....................................................................................................................... 10
Organizations ....................................................................................................................... 10
Georgia ..................................................................................................................................... 16
HIV incidence ....................................................................................................................... 16
Access to care ...................................................................................................................... 16
Access to PrEP ...................................................................................................................... 17
Legal framework .................................................................................................................. 17
Organizations ....................................................................................................................... 18
Louisiana .................................................................................................................................. 26
HIV incidence ....................................................................................................................... 26
Access to care ...................................................................................................................... 27
Access to PrEP ...................................................................................................................... 30
Legal framework .................................................................................................................. 30
Prison system ....................................................................................................................... 32
Organizations ....................................................................................................................... 33
Mississippi ................................................................................................................................ 39
HIV incidence ....................................................................................................................... 39
Access to care ...................................................................................................................... 39
Access to PrEP ...................................................................................................................... 42
Legal framework .................................................................................................................. 43
Prison system ....................................................................................................................... 44
Organizations ....................................................................................................................... 44
North Carolina ......................................................................................................................... 49
HIV incidence ....................................................................................................................... 49
Access to care ...................................................................................................................... 49
Access to PrEP ...................................................................................................................... 51
Legal framework .................................................................................................................. 52
Prison system ....................................................................................................................... 53
Organizations ....................................................................................................................... 53
Texas ........................................................................................................................................ 58
HIV incidence ....................................................................................................................... 58
Access to care ...................................................................................................................... 58
Access to PrEP ...................................................................................................................... 62
Legal framework .................................................................................................................. 63
Prison system ....................................................................................................................... 63
Organizations ....................................................................................................................... 64

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INTRODUCTION
The Southern United States is disproportionately impacted by HIV/AIDS, representing 45
percent of all new AIDS diagnoses.1 The South represents 37 percent of the US population but
49 percent of new HIV diagnoses.2
Racial and ethnic minorities have been disproportionately affected by HIV/AIDS since the
beginning of the epidemic, representing 68 percent of all new AIDS diagnoses in 2011, with new
infection rates highest among African-American adults and adolescents.3 These health
disparities are particularly prevalent in the Southern United States. Black Southerners account
for 20 percent of the population but over 60 percent of new HIV diagnoses in the South.4 Black
gay and bisexual men in the South have a 50 percent chance of acquiring HIV in their lifetimes5
and are more than five times more likely to acquire HIV than white gay or bisexual men.6
Nine states in the Deep South (AL, FL, GA, LA, MS, NC, SC, TN, TX) had especially high HIV
diagnosis rates and death rates due to HIV from 2008-2013.7 The Deep South states contained
40 percent of HIV diagnoses in 2013, while comprising only 28 percent of the US population.8 In
addition, eight of the 10 metropolitan areas that contain 500,000 residents or greater with the
highest HIV and AIDS diagnosis rates are located within the Deep South.9 The percentage of HIV
diagnoses among black men who have sex with men (MSM) increased from 25.9 percent in 2008
to nearly one-third (31.4 percent) in 2013 in the Deep South region, the largest increase of any
US region.10 Furthermore, more than one third (37 percent of Hispanic/Latinos) diagnosed with
HIV in the US live in the Deep South region.11
According to the CDC’s most recent national HIV Surveillance Report, the states with the highest
incidence of new HIV infection are: Louisiana, Florida, Georgia, Texas, South Carolina, Mississippi
and North Carolina. This report focuses on these six states and summarizes the current HIV
epidemic, access to care, legal framework, prison system as well as organizations and services
targeting minority and LGBTQ community health needs.
1 Centers for Disease Control and Prevention (CDC), HIV and AIDS in the United States by Geographic Distribution,
http://www.cdc.gov/hiv/resources/factsheets/geographic.htm.
2 HIV Plus, “1 in 2 Black Gay Men Will Have HIV by the Time They Are 35 & Other Shocking Stats,”
http://www.hivplusmag.com/stigma/2015/01/11/1-2-black-gay-men-will-have-hiv-time-they-are-35-other-shocking-
stats.
3 CDC, HIV Surveillance by Race/Ethnicity, http://www.cdc.gov/hiv/pdf/statistics_surveillance_raceEthnicity.pdf.
4 The Black AIDS Institute, Black Lives Matter: What’s Prep Got to Do with It?, The State of AIDS in Black America, An
Annual Report, 2016, p. 6.
5 The Black AIDS Institute, Black Lives Matter: What’s Prep Got to Do with It?, The State of AIDS in Black America, An
Annual Report, 2016, p. 6.
6 Lifetime Risk of HIV Diagnosis in the United States. 2016, Centers for Disease Control and Prevention: Atlanta.
7 CDC, HIV Surveillance Report 2013, Vol 25. 2015;
http://www.cdc.gov/hiv/library/reports/surveillance/2013/surveillance_re port_vol_25.html; Reif S, Safley D, Wilson
E, Whetten K. HIV/AIDS in the U.S. Deep South: Trends from 2008-2013. 2016; HIV/AIDS in the U.S. Deep South:
Trends from 2008-2013. http://southernaidsstrategy.org/research/.
8 CDC, HIV Surveillance Report 2013, Vol 25. 2015;
http://www.cdc.gov/hiv/library/reports/surveillance/2013/surveillance_re port_vol_25.html
9 CDC, HIV Surveillance Report 2013, Vol 25. 2015;
http://www.cdc.gov/hiv/library/reports/surveillance/2013/surveillance_report_vol_25.html.
10 Southern HIV/AIDS Strategy Initiative, Research and Reports, https://southernaidsstrategy.org/research/
11 Southern HIV/AIDS Strategy Initiative, Research and Reports, https://southernaidsstrategy.org/research/
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FLORIDA
HIV INCIDENCE
Florida has the highest rate of new HIV infections in the country (31.3 new cases per 100,000
people per year) and has the highest number of total persons living with HIV/AIDS, accounting
for 11% of all persons living with HIV/AIDS in the United States.12

Only 3% of new HIV infections occurred in rural areas in Florida.13 This is a lower percentage
than the nation as a whole (7.2%) and the South as a region (10.3%), and is likely reflective of
the magnitude of the epidemic in Florida’s urban centers rather than particularly low case rates
in rural areas. Miami (including Miami, Fort Lauderdale, and West Palm Beach), Jacksonville,
Orlando, and Tampa have AIDS diagnosis rates among the top 20 metropolitan statistical areas
(MSAs) in the United States.14 Broward, Miami-Dade, and Palm Beach Counties in South Florida
accounted for nearly half (46.4%) of the 3,461 new AIDS cases reported in the state in 2010.15

The social demographics of HIV/AIDS have changed over the past decade—the epidemic is
rapidly growing among communities of color, affecting both heterosexual women and men who
have sex with men. Reflecting this shift, northern Florida, a predominantly rural region with a
few large cities (Jacksonville, Gainesville, Tallahassee, Pensacola), is now experiencing a
significant upswing in HIV/AIDS cases. Indeed, Jacksonville now has the third highest AIDS
incidence rate in the country. Northern Florida’s African American, Latino, and migrant worker
communities are disproportionately affected by the HIV epidemic.

The incidence and prevalence of HIV/AIDS in Florida are not evenly distributed among different
racial, ethnic, and gender groups. As in much of the rest of the country, Florida’s African
American communities are disproportionately affected by HIV/AIDS. Non-Hispanic blacks
accounted for 54% of reported AIDS cases and 47% of HIV cases reported in Florida in 2010—
even though this group represents only 16% of the state’s overall population.16 Hispanics
represent 22% of Florida’s population and account for 16.81% of adult AIDS cases and 20.34% of
adult HIV cases. The rate of black males living with an HIV diagnosis is 4.8 times that of white
males. The rate of Hispanic/Latino males living with an HIV diagnosis is 1.8 times that of white
males.17

Seventy percent of people living with an HIV in Florida are men and 66% of HIV cases in men
were acquired through male-to-male sexual contact.18 In Jackson, it is reported that 4 of every
10 gay or bisexual man is HIV positive.

12 http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-us.pdf
13 https://southernaids.files.wordpress.com/2011/10/research-report-final-revised10-26-121.pdf
14 CDC, Surveillance Report, Volume 21 (August 2011), Table 24.
www.cdc.gov/hiv/surveillance/resources/reports/2009report/index.htm.
15 Florida DOH, Surveillance Report, No. 314 (January 2011), pp. 9-10, Table 1.
www.doh.state.fl.us/disease_ctrl/aids/trends/msr/2011/MSR0111.pdf.
16 Florida DOH, Surveillance Report, No. 314 (January 2011), pp. 25-26, Tables 3 and 4.
www.doh.state.fl.us/disease_ctrl/aids/trends/msr/2011/MSR0111.pdf.
17 Florida DOH, Surveillance Report, No. 317 (April 2011), pp. 17-18, Tables 5 and 6.
www.doh.state.fl.us/disease_ctrl/aids/trends/msr/2011/MSR0411.pdf; US Census Bureau, Florida – Quick Facts.
http://quickfacts.census.gov/qfd/states/12000.html.
18 http://aidsvu.org/state/florida/
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ACCESS TO CARE
FEDERAL FUNDING
Florida ranks 36th in federal funding for HIV/AIDS treatment and prevention receiving just $3,130
per person living with HIV.19 Ryan White grants offer the most funding to HIV/AIDS
treatment/prevention services in Florida. The majority of that money goes to prevention. An
estimated 53,337 Floridians received services through Ryan White in 2011, 63% of whom were
living at or below the poverty line.20

Florida’s AIDS Drug Assistance Program (ADAP) is administered by the Bureau of HIV/AIDS
(BOHA) within DOH.21 In order to participate in Florida’s ADAP, applicants must: be a Florida
resident; have a laboratory test documenting confirmed HIV infection; not be receiving services
or be eligible to participate in local, state, or federal programs that provide similar services; have
an income at or below 400% of the federal poverty level (FPL); submit a completed application;
and cooperate with staff during the eligibility process.22 Florida has the longest AIDS Drug
Assistance Program (ADAP) waiting list in the country.

Housing Opportunities for Persons with AIDS (HOPWA) is the US Department of Housing and
Urban Development’s program to provide housing assistance and related supportive services for
people living with HIV/AIDS. There are currently three competitive grant awards operating in
Florida, which fund model projects or programs that address the specific needs of persons living
with HIV/AIDS and their families in innovative ways. HOPWA funding for Florida programs totals
$42.6 million.23

The Centers for Disease Control and Prevention (CDC) provides additional federal funding to
local nonprofits and state governmental agencies for specific prevention initiatives including
counseling, testing programs, health education/risk reduction activities, and
surveillance/monitoring activities. Community-based organizations outside of the Jacksonville,
Miami, Orlando, and Tampa metropolitan areas were completely left out in recent HIV
prevention funding from the CDC.24 21% of people living with HIV in Florida live outside cities
eligible for funding. 22% of all new HIV diagnoses in Florida were from areas ineligible for
funding 25
STATE FUNDING
The AIDS Insurance Continuation Program (AICP) is a statewide program for individuals who,
because of their HIV/AIDS status, are unable to maintain private health insurance coverage. The

19 http://kff.org/hivaids/state-indicator/federal-grant-funding-per-person/
20 Health Resources Services Administration (HRSA), 2011 State Profiles, Ryan White HIV/AIDS Program, Client
Characteristics, http://hab.hrsa.gov/stateprofiles/Client-Characteristics.aspx. 2011 figures are the most recent
available.
21 Florida ADAP, ADAP: Contact Information. www.doh.state.fl.us/Disease_ctrl/aids/care/contact.html.
22 Eligibility and Documentation Requirements, Fla Admin Code Ann R. 64D-4.003 (2008); Florida ADAP, Eligibility
Requirements. www.doh.state.fl.us/Disease_ctrl/aids/care/Eligibility_Requirements.doc.
23 AIDS United, HIV/AIDS in Florida. www.aidsunited.org/uploads/docs/Florida_2010_FINAL.pdf.
24 (Grant No. PS15-1502)
25 MCALLASTER & FANG, SOUTHERN HIV/AIDS STRATEGY INITIATIVE, ONE SIZE DOES NOT FIT ALL: WHAT DOES HIGH
IMPACT PREVENTION FUNDING MEAN FOR COMMUNITY-BASED ORGANIZATIONS IN THE DEEP SOUTH? (2015),
https://southernaids.files.wordpress.com/2011/ 10/one-size -does-not-fit-all-updated-11-11-15.pdf.
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program makes direct payments (up to $750/month) to each client’s employer or insurance
company for the continuation of medical, dental, optical, and mental health coverage. The AICP
does not pay for disability or life insurance. The program also pays copayments and deductibles
depending on the availability of funds. Individuals can apply for the program through local
county health departments or through certain community-based organizations.

Approximately 17% of Florida’s population is uninsured, and almost 570,000 people fall in the
coverage gap. More than 70% of the people who fall into the coverage gap work part-time or
full-time for small employers who do not offer health insurance benefits.26 Medicaid enrollment
is highly restricted in Florida. Only low-income children, extremely low-income parents,
pregnant women, and disabled adults are eligible for Medicaid. As is true in all states that have
not expanded Medicaid, non-disabled adults without dependent children are ineligible for
Medicaid, regardless of their income.27
TESTING
The percentage of individuals age 18-64 who report ever being tested for HIV in Florida is 48.4%,
which is higher than the national average of 40.3%. This success is attributed to the state’s
aggressive testing campaign.28
BARRIERS
LACK OF MEDICAID EXPANSION
Florida’s Medicaid program, in terms of eligibility, scope of services, quality of care, and
reimbursement was ranked 48th worst in the nation. The state spends less than the national
average per Medicaid enrollee, pays providers less than the national average for primary care
and Medicaid physicians in Florida earn less than their counterparts nationwide.

Since Florida is not expanding Medicaid, an estimated 16,500 of the lowest-income people with
HIV will be left out of coverage available in other states.29 They will continue to rely solely on
Ryan White. Since Ryan White is legally required to be the “payer of last resort,” these people
did not have other access to these medical and support services. In addition, Florida does not
have a §1115 waiver in place to provide Medicaid coverage to nondisabled people living with
HIV/AIDS. Thus, an applicant must demonstrate disability before applying for Medicaid and
cannot use Medicaid to access therapies that might prevent disability.30
POVERTY
In 2015 Florida ranked 35th in the country for overall percentage of people living below the
federal poverty line (16.5%). Disparities in incomes across ethnic groups reflect trends in new
HIV infection rates—27% of African Americans and 21.7% of Latinos live below the poverty line.

26 See Rachel Garfield & Anthony Damico, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand
Medicaid, HENRY J. KAISER FAMILY FOUNDATION (Jan. 21, 2016), http://kff.org/health-reform/issue-brief/the-
coverage-gap- uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update/.
27 FLORIDA CHAIN, CLOSING THE COVERAGE GAP: INSURING LOW-INCOME FLORIDIANS IN 2016 1 (2016),
http://floridachain.org/wp-content/uploads/2016/01/2016-Close-The-Gap-Fact-Sheet.pdf.
28 KFF, Florida: HIV Testing. www.statehealthfacts.org/profileind.jsp?cat=11&sub=128&rgn=11&cmprgn=1.
29 Snider et al., Nearly 60,000 Uninsured And Low-Income People With HIV/AIDS Live In States That Are Not Expanding
Medicaid, Health Affairs, March 2014, http://content.healthaffairs.org/content/33/3/386.abstract.
30 Democratic Policy Committee, The Patient Protection and Affordable Care Act Detailed Summary.
http://dpc.senate.gov/healthreformbill/healthbill04.pdf.
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As in other southern states, inadequate transportation affects rural areas disproportionately. In
addition, in 2011, the Florida legislature enacted legislation that directs the Agency for Health
Care Administration (AHCA) to require copayments for transportation services—imposing yet
another barrier for those who need transportation.31
HOUSING
Florida ranks last in affordable housing.32
STIGMA
HIV-related stigma is partly due to the association of HIV/AIDS with behaviors considered
shameful or blameworthy, such as sexual promiscuity, male-to-male sex, and drug use. Florida’s
criminalization of behaviors associated with HIV exposure also contributes to stigma. Ironically,
because culpability under the criminal HIV-exposure statute is tied to knowing one’s serostatus,
the law presents a disincentive to testing—thereby contributing to late entry to care and, in all
likelihood, further transmission of the virus. Stigma is consistently identified as a barrier not only
to accessing treatment and care for people living with HIV and AIDS but to all services along the
prevention-treatment continuum. Consumers, case managers, healthcare providers, health
officials, and community organizers and advocates describe stigma as having a chilling effect on
the willingness of those living with or at risk of HIV/AIDS to access services. “Internalized stigma”
is a powerful and harmful deterrent in rural areas in particular, where the smallness of
communities and fear of others “knowing their business” or being recognized by family
members or acquaintances at offices or agencies that offer HIV testing or treatment services
makes people living with HIV/AIDS reluctant to access services near where they live.33

Stigma stands not only as a significant barrier for individuals to access services, but it can also
affect, to some extent, what services are available in a given community. At a time when public-
sector funding for HIV services is falling well short of need, lack of private-sector and faith-
community involvement due to entrenched stigma within communities can seriously handicap
agencies, clinics, and health departments that need not only financial support but also in-kind
support and partnerships to maximize their effectiveness in the community.
LACK OF PROVIDERS
Much of northern Florida’s area and populations are identified by the Health Resources and
Services Administration (HRSA) as health professional shortage areas (HPSAs). HRSA has also
identified Medically Underserved Populations (MUPs) or Areas (MUAs) across northern Florida.
The MUA designation is used to identify a whole county or a group of contiguous counties, a
group of county or civil divisions, or a group of urban census tracts in which residents have a
shortage of personal health services; MUPs identify groups of persons who face economic,
cultural, or linguistic barriers to healthcare.34
ACCESS TO PREP
All Medicaid programs in Florida are obligated to cover both PEP and PrEP and there are an
estimated 273 providers of Truvada (PrEP) accepting Medicare claims. Some have prior

31 Fla Stat §409.9801(2) (2011).
32 https://talkpoverty.org/state-year-report/florida-2015-report/.
33 http://southernaidscoalition.org/wp-content/uploads/2014/05/SHARP-Northern-Florida-Report_FINAL.pdf
34 HRSA, Shortage Designation: Health Professional Shortage Areas & Medically Underserved Areas/ Populations.
http://bhpr.hrsa.gov/shortage/.
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authorization restrictions which require confirmation of a negative HIV diagnosis. Florida has the
second highest number of patients using Truvada in the country, behind California with 74,022
claims.35 Organizations such as Latinos Salud and Broward House have readily embraced the
widespread use of PrEP, but are concerned that users may take the drug at the expense of
condom use. Thus there is need to effectively communicate with MSM communities about the
need to use of PrEP with condoms.
LEGAL FRAMEWORK
CRIMINALIZATION OF HIV
Under Florida state law, it is illegal for a person who is aware of his or her positive HIV status
and is aware that HIV is communicable by sexual intercourse to knowingly engage in sexual
intercourse with another person without first informing them of his or her HIV status and having
that person then consent to sexual intercourse.36 Violation of the statute constitutes a third-
degree felony and is punishable by not more than a $5,000 fine and not more than 5 years in
prison.37 Lastly, persons who commit the crimes of assault, sexual battery, incest, child abuse, or
aggravated battery can be charged with the additional crime of “criminal transmission of HIV”.38
It is important to note that these laws do not require that HIV be transmitted. Several arrests
and/or prosecutions have been made since May 2009 with one individual sentenced to fifteen
years for biting a police officer (without transmission).39 Criminalization, which is often
dependent on known HIV status, creates barriers to testing along with discouraging disclosure
and fostering stigma.
TESTING AND REPORTING
Florida law provides for confidential and anonymous HIV testing. The law requires informed
consent prior to testing, but consent need not be in writing so long as the medical record
reflects that the test has been explained and consent was obtained.40 STD reporting
requirements, including HIV/AIDS reporting, are described in the Florida Administrative Code.
Section 3 of Chapter 64D of the Code addresses reportable diseases and sets out detailed
requirements for medical providers and laboratories with respect to confidential, name-based
reporting of positive HIV test results. Practitioners must report an AIDS diagnosis within two
weeks, and laboratories must report a positive HIV test result within three days.41

Florida is 1 of 27 states that requires pretest counseling. Florida law requires those who perform
HIV tests in county health departments and other registered testing sites to make private
counseling available both before and after the test.42 Minors may receive confidential testing

35 http://www.miamiherald.com/news/local/community/gay-south-florida/palette-magazine/article59773281.html
36 Fla Stat §384.24(2) (2011).
37 Fla Stat §775.082 (2011); Fla Stat §775.083 (2011).
38 http://www.hivlawandpolicy.org/states/florida
39 Ending and Defending Against HIV Criminalization: A Manual for Advocates, Volume 1, State and Federal Laws and
Prosecutions, The Center for HIV Law and Policy, Fall 2010, available from:
http://www.hivlawandpolicy.org/resources/view/564.
40 Fla Stat §381.004(3)(a) (2011).
41 Fla Admin Code Ann R. 64D-3.029-3.030(3) (2010).
42Florida DOH, Model Protocol for HIV Counseling and Testing for County Health Departments and Registered Testing
Programs. www.doh.state.fl.us/disease_ctrl/aids/legal/ctforchd.htm.
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and treatment for sexually transmitted infections (STIs) and HIV, and providers may not reveal
that testing or treatment has occurred without the minor’s permission.43

Florida law does not require notification of a person’s known sexual contacts and intravenous
drug use contacts upon a positive HIV test result. Medical practitioners are protected against
civil and criminal liability, however, if they disclose confidential information to a sexual partner
or needle-sharing partner in a situation where: (1) a patient diagnosed with HIV has identified
such partners to the practitioner; (2) the patient refuses to notify the partner of the diagnosis
and to refrain from activity that is likely to transmit HIV; (3) the practitioner informs the patient
of his or her intent to inform the partner(s); an (4) the practitioner reasonably and in good faith
informs the partner(s) of the diagnosis out of a perceived civil duty or professional obligation. 44
PHYSICIAN EXTENDER LAW
Florida law allows physicians to delegate certain health tasks to licensed physician assistants
(PAs). Physician assistants can enhance access to care by allowing a doctor to see a larger
number of patients while best utilizing her medical expertise. A physician may supervise up to
four PAs and is ultimately responsible and liable for their performance, acts, and omissions. PAs
may assess patients and prescribe and dispense medications other than controlled substances,
anesthetics, and radiographic contrast materials.45
MINORS ACCESS TO HIV/STI TESTING
Florida allows minors to consent to HIV testing and treatment without parental consent. 46
SEX EDUCATION
Since 2007, Florida high school students are not required to complete any credits in sex
education in order to graduate.47 If a school district decides to offer sex education, it must teach
“abstinence from sexual activity outside of marriage as the expected standard for all school-age
students while teaching the benefits of monogamous heterosexual marriage.” It is also left up to
the district’s discretion to provide instruction on HIV/AIDS as part of its health education
curriculum.48

About seventy percent of public secondary schools grades 6-8 and 87.1% of grades 9-12 in
Florida have a required course that covers how to prevent HIV, other STDs and pregnancy. A
little over 60% of public secondary schools grade 6-9 and 83.9% of grades 9-12 have a required
course that covers how to access valid and reliable health information, products and services
related to HIV, other STDs and pregnancy.49

43 Physicians for Reproductive Choice and Health, Minors’ Access to Confidential Reproductive Healthcare in Florida.
www.law.miami.edu/pdf/Minors_Accessto_Confidential_Health_Care_in_Florida.pdf.
44Fla Stat §456.061(2) (2011).
45 Fla Stat §458.347 (2011)
46 Minors' Access to STI Services, State Policies in Brief, Guttmacher Institute, October 1, 2015.
47 Sexuality Information and Education Council of the United States, Sex Education in the Sunshine State: How
Abstinence-Only-Until-Marriage Programs Are Keeping Florida’s Youth in the Dark.
www.aclufl.org/issues/reproductive_rights/Sex%20Education%20in%20the%20Sunshine%20State.pdf.
48 Fla Stat §1003.46(1), (2)(a) (2011).
49 HIV, Other STD, and Pregnancy Prevention Education in Public Secondary Schools — 45 States, 2008 and 2010,
Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, April 2012.
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In 2009, there were 33 organizations in Florida that received federal funding to
provide abstinence-only-until-marriage programming. Of these, 16 were faith-based
organizations. In total, the state received over $13 million to support these programs, over twice
the amount it received for such programming in 2007. Notably, these programs are targeted
toward urban areas and minority communities.50
HARM REDUCTION
In Florida, it is illegal to deliver drug paraphernalia where one knows or has reason to know that
it will be used to introduce a controlled substance into the body.51 Consequently, the state
Department of Health does not operate a formal needle exchange program. However, a needle
exchange program exists in Miami.52
PRISON SYSTEM
Florida’s incarceration rate is well above the national average53 and there are an estimated
4,464 people living with HIV/AIDS in Department of Corrections (DOC) custody or otherwise
institutionalized.54 Approximately 100 HIV-positive inmates leave Florida’s prisons each month.
The DOC has implemented a prerelease program to counsel people living with HIV in prison
about post-release disease management. The Department’s Pre-Release Planning Program
(PRPP) provides planning services to inmates during the six months prior to their return to their
communities. In addition to educating inmates generally about HIV, the planners help connect
inmates with social service agencies and medical care providers in their communities. Inmates
are also given a 30-day supply of medicine upon release. The PRPP has been moderately
successful, with nearly 72% of inmates receiving PRPP services keeping their post-release
medical or social service appointments.55
ORGANIZATIONS
The AIDS Institute: Located in Tampa, the AIDS Institute, is a national bipartisan, nonprofit
organization that promotes action for social change through public policy, research, advocacy,
and education. It began as a grass roots community mobilization effort in 1985 and is Florida’s
first HIV/AIDS advocacy group. Over the years, The AIDS Institute has expanded its vision to
become a respected national leader dedicated to supporting and protecting health care access
for people living with HIV/AIDS, Hepatitis, and patients living with chronic diseases. They
achieve this mission through their National Policy Office in Washington, DC; Program and
Administrative offices in Tampa, FL, and Research and State Policy in Tallahassee, FL. TAI has a
strong working relationship with the Bureau of HIV/AIDS (BOHA) in the Florida Department of
Health. As issues arise in Florida, the group’s leadership works with BOHA to address them.

50 Sexuality Information and Education Council of the United States, Sex Education in the Sunshine State (2009).
www.siecus.org/_data/global/images/FL%20Report%20-%20Sex%20Education%20in%20
the%20Sunshine%20State.pdf.
51 Fla Stat §893.147(2) (2011)
52 Adams RW, Proven Effective, Needle Exchange Banned in Florida, The Ledger (January 16, 2010).
www.theledger.com/article/20100116/NEWS/1175030?p=1&tc=pg.
53 KFF, Florida: Incarceration Rate (per 100,000 residents).
www.statehealthfacts.org/profileind.jsp?ind=760&cat=1&rgn=11&cmprgn=1.
54 Florida DOH, Surveillance Report, No. 317 (April 2011).
www.doh.state.fl.us/disease_ctrl/aids/trends/msr/2011/MSR0411.pdf.
55 Florida DOH, Florida Corrections Programs. www.doh.state.fl.us/disease_ctrl/aids/corrections/corrindex.html.

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