Archives May 2020

People Worth Knowing: Katrina Harmon

Katrina Harmon, Executive Director
West Virginia Child Care Association

This week’s #PeopleWorthKnowing interview feature’s Katrina Harmon, Executive Director of the West Virginia Child Care Association (WVCCA).

Katrina Harmon was appointed Executive Director of the WVCCA in March 2017 after serving 2 years as Associate Director.

With years of experience in the non-profit sector, Katrina works with 15 member agencies to provide a voice for the most vulnerable children in West Virginia who have experienced abuse, neglect, emotional and behavioral challenges, substance abuse and/or delinquency.

WVCCA advocates for children and families by sharing member knowledge and resources, embracing partnerships and influencing public policy.

Prior to joining WVCCA, Katrina’s career roles included serving as a non-profit marketing consultant; nearly 10 years as Marketing Manager & Director at the state’s largest cultural arts facility and children’s museum; VP of Sales & Marketing for a construction firm specializing in community revitalization and development; and Account Executive for the Charleston, WV Convention & Visitors Bureau.

She received her Bachelor’s degree in Public Relations from West Virginia University and was one of the first graduates of WVU’s cutting-edge Integrated Marketing Communications Master’s degree program in 2005.

Katrina volunteers her time with the Winfield Baptist Church Awana program, and local United Way and 4-H youth programs. She enjoys practicing martial arts with her husband and son.

You can learn more about the West Virginia Child Care Association by visiting their website by clicking on their logo, below, or by Liking their Facebook page by clicking the icon below the logo.

Logo for the West Virginia Child Care Association

Photo of a gloved hand holding two purple vacutainer tubes filled with a blood sample

Infectious Disease Testing in Rural America

Marcus J. Hopkins
Policy Coordinator
Community Education Group

By: Marcus J. Hopkins

When I first tested HIV-positive, I was living in Atlanta, GA.  It was April 12th, 2005, and I was 23 and unready to face my diagnosis.  I ignored it, for two years, in part of that unpreparedness, and in part because, at the time, the treatment recommendation was to not initiate treatment until patients were diagnosed as having AIDS, the qualification for which is having one’s CD4 cell count drop below 200 cells per mm3

On October 17th, 2007, after being admitted to Broward General in Ft. Lauderdale, FL, I had them run my numbers, after ignoring them for over two years, and that CD4 count came back at 67.

It was official – I had AIDS.

Once I got a doctor and got prescribed my medications, I went to a Rite Aid with my supposedly full-coverage employer-provided insurance, only to be told that, after filling the scrip for one of my three medications, my insurance was maxed out, and I wouldn’t be able to get the drugs I desperately needed.  I’m not really a big “crier,” but at that time, I wept in a pharmacy.

Luckily, my then-partner lived with a man who would later form the ADAP Advocacy Association (aaa+) who told me about the Ryan White Act and how to get coverage for my medications.  After jumping through several hurdles, including gathering tax documents, paycheck stubs, a birth certificate, two forms of photo identification, and selling a kidney (that last one isn’t a thing), I was able to get an appointment and get approved for the AIDS Drug Assistance Program (ADAP).

I began taking meds on November 19th, 2007, and by Valentine’s Day, 2008, my viral load (the number of actively replicating HIV virus in my blood) was undetectable, where I have remained, with the exception of two months, for over 13 years.

During that time, I have moved from Florida to Tennessee, from Tennessee to California, and from California to West Virginia, and during those moves, I encountered a unique phenomenon: HIV testing has largely failed to reach rural America.

I know, right?  It’s 2020 – nearly forty years after the Centers for Disease Control and Prevention (CDC) published the first article directly related to what was then called GRID (Gay-Related Immune Deficiency) in the June 5th, 1981 Morbidity and Mortality Weekly Report (MMWR) – Pneumocystis Pneumonia – Los Angeles (CDC, 1981).  One would think that, after four decades, rural America would have its collective “stuff” together and be testing its population, right?

Unfortunately, no.

Both in Tennessee (specifically, Northeast Tennessee in the Appalachian Mountains), and in West Virginia, outside of the few metro areas, HIV testing has not been a priority.  For the very same reason that doctors in this part of the country told patients not to worry about getting vaccinated for Hepatitis B (HBV), people living in rural America – particularly in the geographically isolated Appalachian Mountain region – have been living under the shared illusion that their isolation has served as a good enough preventative measure against infectious diseases.  Worse, still, is that these Americans have been told that this is the case, not only by physicians who should know better, but by the people whom they elect into office.

This has been a common refrain about every epidemic in human history:

“This is a big city problem!  We don’t have to worry about heroin/meth/HBV/HCV/HIV/STDs/STIs/COVID-19, here!  Our folks are better than that!”

This prevailing theme has been proven false not just in the recent past, but over the course of millennia.  The people who believed that the rich, the politically empowered, and the men of the cloth (e.g. – priests) would never contract the plague in 14th Century Europe are the very same people who have claimed that those of us who live in rural America don’t have to worry about the ills of urban society, because our “goodness” protects us.

Perhaps, they should go and reread accounts from the 14th Century that depict entire monasteries filled with the bodies of the dead.  If that’s too far back for them to look, they might simply look at the recently discovered rural Plague Pit found in Lincolnshire, England on the site of a 14th Century monastery filled with 48 bodies, including more than two-dozen children (Sharman, 2020).

Dr. Hugh Willmott, one of the workers at the Thornton Abbey archaeology dig site in rural England said this:

“The finding of a previously unknown and completely unexpected mass burial dating to this period in a quiet corner of rural Lincolnshire is thus far unique, and sheds light into the real difficulties faced by a small community ill-prepared to face such a devastating threat.” (Sharman)

This assessment of past preparedness should serve as a dark portent of things to come, not only as they related to the burgeoning rates of new HIV diagnoses directly linked to Injection Drug Use (IDU), such as West Virginia has seen in the past three years), but as it relates to another, more pressing concern: COVID-19.

Having lived in West Virginia, again, for seven years, and carrying the banner that reads: “We must begin offering opt-out testing for Viral Hepatitis and HIV to every single person at every single medical appointment, regardless of specialty” (a long, unwieldy banner to carry, to be certain), I, along with others who work in the Infectious Disease space, have been sounding the alarm about COVID-19, as well.  Sadly – and yet, unsurprisingly – I have encountered much the same mindset about COVID-19 as I did when waving the HIV testing flag: “It can’t happen, here.”

Once COVID-19 really hits rural America – particularly the geographically isolated Appalachian Mountain region (I know…I keep hammering this description home) – rural America is not ready to respond.  We do not have in place the kind of rural public health infrastructure that is necessary to effectively respond to an outbreak in rural regions.

People who travel from rural areas to the suburbs or urban areas of their state for work will contract COVID-19.  They will carry that virus back to their loved ones, at home, as well as to every person they encounter, along the way.

Once they begin to shed virus, every single point of contact becomes a potential point of infection.

Once they begin to show symptoms, they will have to travel back into the suburban and urban medical facilities for diagnosis, treatment, and, potentially, intensive care, and each person they encounter along the way has the potential to contract the virus.

This has been the course of every viral pandemic outbreak in human history.  It isn’t just a random prediction; it’s a pattern that repeats itself, every single time.  Sadly, Americans don’t seem to learn these lessons for ourselves, until someone we personally know and love dies.

Photo of the state of West Virginia outline with counties shaded red where confirmed cases of COVID-19 have been identified.  Counties without diagnoses are colored in grey.
Only four counties in West Virginia have no confirmed COVID-19 diagnoses

WBOY 12 in Clarksburg, WV has a running tally on new cases and deaths in the state of West Virginia (here) that reported an increase of 42 cases in the state since May 23rd, 2020 at 5:00 PM.  To most people, “42 new cases” doesn’t sound like a lot, compared to the overall population of the state.

When you think about the fact that those 42 patients will likely come into contact with at least three people (potentially creating 126 new diagnoses), and those three people will likely come into contact with at least another three people (378 more diagnoses, on top of the original 168)…like a 1980s Fabergé Organics shampoo commercial, only without the benefit of “…super fresh-smelling hair”.

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

It was these thoughts I was thinking, this morning, as I ventured to a Walmart in Grafton, West Virginia, to pick up something my mother had ordered, and saw only store employees and a handful of shoppers wearing facemasks (myself, included).

There was no social distancing; no facemasks to be found.  As I waiting to pick up my mother’s item, I listened to the haunting strains of Naked Eyes’ “Always Something There to Remind Me” and thought to myself, “I wonder if these people will remember this day as the day they contracted COVID-19.

References

Centers for Disease Control and Prevention. (1981, June 05). Pneumocystis Pneumonia — Los Angeles. Morbidity and Mortality Weekly Report, 30(21), 1-3. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm

Sharman, J. (2020, February 19). Medieval Black Death burial site in Lincolnshire uproots previous theories about plague. London, United Kingdom: Independent Digital News & Media Limited: The Independent: News: Science: Archaeology. Retrieved from: https://www.independent.co.uk/news/science/archaeology/black-death-mass-grave-uk-lincolnshire-thornton-abbey-plague-a9344091.html

CEG is a national organization that offers local programs and policy solutions.

We serving diverse populations, prioritizing indigenous populations and populations in need

CEG’s work includes Direct Service programs, Policy work, and Capacity Building

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

National Viral Hepatitis Roundtable logo

People Worth Knowing: Jesse Milan, Jr.

This week’s #PeopleWorthKnowing video interview features Jesse Milan, Jr., President and CEO of AIDS United, a national organization focused on policy, grantmaking, and capacity building.

AIDS United has granted over $120 million over 30 years, and its Public Policy Council organizations and current grantees number over 300 in 40 states and territories. Mr. Milan is a lawyer whose career includes leading HIV programs and organizations at national, regional and global levels. He has chaired five non-profit boards including the Black AIDS Institute, was AIDS Director for Philadelphia, has chaired federal advisory committees, and serves currently on the Scientific Advisory Board for PEPFAR. He is a graduate of Princeton University and the NYU School of Law. Jesse has been living with HIV for over three decades.

You can find out more about AIDS United by clicking on the logo below.

Photo of TruEvolution, Inc. Founder and CEO, Gabriel Maldonado

People Worth Knowing: Gabriel Maldonado

Photo Credit: City of Riverside, CA – City Government Facebook Page

For the inaugural entry in our new video series, #PeopleWorthKnowing, we decided to feature Gabriel Maldonado, Founder and CEO at TruEvolution, Inc., in honor of CEG’s recent partnership with TruEvolution on a national sign-on letter to members of Congress, asking for a $5 billion federal grant appropriation dedicated to supporting, expanding, and mobilizing Rural Health Service Providers (#RHSPs) and the long neglected and underfunded public health infrastructures in rural America (read more), and a newer collaboration to form the Rural Health Service Providers Network (RHSPN).

As the Founder and CEO of TruEvolution, Gabriel Maldonado has led the organization’s efforts for the last eleven years to now include comprehensive HIV prevention and care services, a mental health clinic, and an emergency supportive housing program.

Logo of TruEvolution, Inc.

As a former member of the U.S. Presidential Advisory Council on HIV/AIDS under President Obama, Gabriel works to elevate the representation of minority community-based organizations in state and federal policy priorities. In addition to his work at TruEvolution, Gabriel continues his advocacy serving on regional boards, such as Borrego Community Health Foundation – the 2nd largest federally-qualified health center in the U.S. – and global organizations such as the AIDS Healthcare Foundation.

Bringing a passion for business and consultancy, Gabriel works to advise industry leaders as an advisory board member for Viiv Healthcare and Merck & Co.

Gabriel believes that the needs and priorities of marginalized populations should be heard in every room and at every table impacting those communities. What drives Gabriel’s passion is his experiences in witnessing the devastating impacts of the industrialization of poor urban communities. Raised in the City of Compton, Gabriel watched not only his health but the health of his family and neighborhood be affected by the corrosive effects of refineries, smog, logistics and chemical facilities.

Now as a person living with HIV, Gabriel is firmly-rooted in advancing the quality of life and human dignity of people of color in the LGBTQ experience.

#CEGInWV is proud to serve alongside #TruEvolution as we work to ensure that rural Americans across the nation have access to the services provided by #RHSPs.

You can visit TruEvolution’s website by clicking on the logo, below, and links to their various social media pages will be listed below.

So, I’ve Been Thinking: The Impact Of COVID-19 On Communities

CEG Founder & Executive Director, A. Toni Young

I’ve been thinking about the impact of COVID-19 on communities, on networks of people, on families and individuals. In addition to its direct toll on the health of older and medically vulnerable people, on the economy, and on people’s day-to-day lives, this pandemic has also highlighted a number of social ills. Essentially, it has aggravated “pre-existing conditions” in our society, like disparities in access to medical care and services, and lack of access in some communities to necessary resources.

Whether it’s access to Medically-Assisted Treatment (MAT) for persons with Substance Use Disorder (SUD), or syringes for trans folks on hormone therapy, during this pandemic, how do we have a productive conversation about those being essential needs and essential services? CEG is doing work in a very rural setting in West Virginia, and also in urban Washington, DC, but the challenges seem similar in both places. The biggest challenge before us is equity.

That’s the challenge going forward: equity in resource allocation, equity in service delivery, equity in information dissemination, equity in the availability of testing and treatment not just for COVID-19, but for ongoing health threats like HIV, Viral Hepatitis, and others. And the other thing this situation has highlighted for me is that none of us can go at this alone. No one individual — no one population — can attack this problem of access and equity on its own. If we want to get those services and resources to the people and communities that need them — whether that’s testing for COVID, or access to syringes, or just access to clean water because you don’t have running water in your home — we are going to have to work together in coalition.

For the rural segment of this initiative, Community Education Group is now working with TruEvolution in Riverside, California to ask Congress for a $5 billion federal grant allocation in the current or next iteration of the CARES Act to help vulnerable populations in rural communities across America. The goal is to help people access services, and to build the rural public health infrastructure needed to respond to COVID-19 and to future outbreaks and diseases. In conjunction with this effort, we are starting up the Rural Health Service Providers Network (RHSPN) to help direct funds and resources to where they are needed most.

We need to figure out a truly collaborative model for black communities, as well — one that accomplishes the same goals via community-specific strategies on issues such as PrEP education, HIV screening, access to care and treatment, follow-up, and workforce development. We need a Black strategy, but so often we get locked into a, “What about me? What about mine?” mindset, and we don’t get much traction, or maybe a few get it, but others are left behind. The bottom line, in both Rural America, and in Black America, is that we need to do this in a collaborative way, or it’s not going to get done.

That’s what I’ve been thinking…

Welcome To Community Perspectives

By: A. Toni Young


I’d like to welcome readers to the first entry in CEG’s new blog, Community Perspectives.  This post will serve as a brief introduction to the purpose of this blog, and a brief explanation of why I think it’s so important to hear from people we might not otherwise encounter.

The work that CEG has done in Washington, DC, West Virginia, Australia, Mexico, and beyond has consistently focused on the underserved and unheard.  When I first started, we were the National Women and HIV/Project.  In would become the Community Education Group, back in 1994, part of what called me to service was my dear friend Stephen M. Clement – the first, but not the last, of my dear friends to parish from “The Plague”.

On one of my last visits with Stephen, a gay, white, red-headed Texan, he looked me and said, “One day, HIV is going to look more like you than me.  More women, black and brown people.”

I was a bit shocked, but he went on to say, “I would be one of your only friends in a position to pay your medical bills if you got sick.”

Most women and people of color impacted by AIDS at this time – 1992 – had few resources, organizations, or a voice in policy.

CEG’s Background

Founded in 1993 as the National Women and HIV/AIDS Project (NWAP), Community Education Group’s (CEG) focus has always been on the Black community, particularly the risks and challenges faced by Black women.  NWAP’s immediate goal was eliminating the myth that HIV only affected homosexual white males.  Broadcasting the message that everyone was at risk, the new non-profit conducted face-to-face outreach and distributed culturally conscious pamphlets and posters to other organizations and the public, nationwide.

In 1999, NWAP became the Community Education Group (CEG), as I sought to expand the organization’s efforts to better address the challenges facing my Southeast DC community.  At this time, in addition to reaching out to heterosexual men and the recently incarcerated, CEG began to focus on creating strong, innovative community-based programming and providing training and technical assistance to fellow nonprofits.  With the knowledge that the HIV/AIDS epidemic could not be stopped by only talking to women, nor by only talking about HIV, CEG became the organization most capable of offering HIV testing to the DC neighborhoods hardest hit by the HIV epidemic, best able to develop and spread health messaging in our Black community, and a leader of collaborative and capacity building efforts.

            CEG’s Organizational Mission – CEG seeks to stop the spread of HIV and eliminate health disparities in high-risk communities by training community health workers, educating and testing hard to reach populations, and sharing our expertise with other organizations through national networks and local capacity-building efforts.

Over the years, I, along with various team members, put together a number of programs aimed directly at aiding underserved communities in the DC area.  We put out media campaigns; we engaged in direct service provision in DC neighborhoods where nobody else would go; we distributed condoms, conducted HIV tests, and linked people into care using our CHAMPs (Community HIV/AIDS Mobilization Prevention Services) model, using peer-based outreach and services.  For over twenty years, CEG’s work set standards for service provision in underserved communities, and of that work I was and am immensely proud.

When I moved to West Virginia, eight years ago, my plan was to retire.  I bought a cabin, moved in with my dogs and cat, and planned to stay involved in a remote capacity, at most.  But, like most of my life stories (of which there are many), things never quite turn out the way I initially expect.

What I found in West Virginia was yet another community of underserved, unheard voices facing an HIV epidemic and, again, nobody was talking about it.  While I knew, intellectually, that rural America had cases of HIV, what I didn’t know was how deep – how hidden – the problem was.

When we talk about HIV infection rates in the South, we think of jurisdictions like Georgia, Florida, Alabama, and Texas – areas where rates of new infections are still high, and black and brown people are paying the price.  What I found in West Virginia (and Kentucky…and Ohio…and Indiana) was that a culture of “not talking about it” had led to outbreaks of Viral Hepatitis, which we were catching, and also pockets of HIV.

Photo of an outline of the state of West Virginia made out of white powder, presumably heroin or cocaine, and a rolled up straw for snorting it

When the news of the outbreak in Scott County, Indiana made waves, back in 2015, I looked around West Virginia and saw the exact same circumstances, here, that made Scott County ripe for an epidemic: an area devastated by local industry job losses; high rates of physical and social isolation; high rates of Injection Drug Use and overdose deaths.  On top of all of those factors, West Virginia has almost no rural public health infrastructure in place to provide healthcare services to these people who were at high risk of an HIV outbreak.

And that’s what happened.  West Virginia saw a 13% increase in new HIV infections from 2017 to 2018, and a staggering 67.8% increase from 2018 to 2019.  In 2019, 61.6% of those newly identified cases listed Injection Drug Use as a primary risk factor for transmission (OEPS, 2020).

Unlike the outbreak in Scott County, Indiana, what didn’t happen was the kind of national and international press coverage that put Scott County on the map for HIV advocates.  Instead, little attention has been paid to West Virginians who are battling the same exigent circumstances as Scott County, but with added geographic and topographic barriers to care.

Once again, voices are not being heard.  Once again, meaningful change is not occurring, because those who have been failed by our healthcare system are being scapegoated and their voices ignored.

What’s more is that this problem isn’t specific to West Virginia – rural Americans across the United States are facing gaps in service, and despite all of the rhetoric about politicians listening to “Real Americans” when making decisions, those same politicians are happy to look the other way when it comes to adequately funding healthcare programs and infrastructure building that will serve these “Real Americans.”

This is why we have started Community Perspectives.  To give voice to people who might not otherwise be heard.  To introduce America to the people who are in the trenches our nation’s syndemic healthcare crises, whether that be Substance Use Disorder, Viral Hepatitis, Trans Health, HIV, or even access to basic utilities like running water.

Community Perspectives will feature pieces written by myself, our Policy Coordinator, Marcus J. Hopkins, and our Project Coordinator, Ty Williams.  In addition, we will be featuring voices from West Virginia and beyond, telling us their stories, and adding their Perspectives to our Community. Thank you, for continuing to be a part of Community Education Group’s community, and I hope you will follow this blog and share it with your friends, neighbors, family, and networks so that we can make these voices heard.

References

Office of Epidemiology and Prevention. (2020, May 01). HIV Diagnoses by County, West Virginia, 2018-2019 (As of May 1, 2020). Charleston, WV. West Virginia Department of Health & Human Resources: Bureau for Public Health: Office of Epidemiology & Prevention: HIV and AIDS. Retrieved from: https://oeps.wv.gov/hiv-aids/documents/data/WV_HIV_2018-2020.pdf

CEG is a national organization that offers local programs and policy solutions.

We serving diverse populations, prioritizing indigenous populations and populations in need

CEG’s work includes Direct Service programs, Policy work, and Capacity Building

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may begraphic due to the nature of the issues being addressed by the author.

Mountain Climber Summer

Community Education Group Premiering New “People Worth Knowing” Video Series

CEG’s new video series, People Worth Knowing, will launch on May 20th, 2020.

People Worth Knowing will feature three-to-five-minute interviews with people from West Virginia, across the nation, and around the world with a wide variety of backgrounds, lived experiences, and fields of work, including users unions, Rural Health Service Providers, child services, trans health, and many others.

People Worth Knowing will launch simultaneously across CEG’s new YouTube channel, our website, and our social media pages on Wednesday, May 20th, 2020, with new videos launching on Wednesdays.

Logos of Astho and the National Coalition of STD Directors

National Health Organizations Announce COVID-19 Contact Tracing Training

The Association of State and Territorial Health Officials (ASTHO) and National Coalition of STD Directors (NCSD) announced the launch of a free, on-demand training for entry-level COVID-19 contact tracers.

The course, Making Contact: A Training for COVID-19 Contact Tracers, will support ongoing public health agency efforts to prepare new contact tracers for their work of helping identify COVID-19 positive cases and those with whom they have been in close contact.

Contact Amanda Dennison (adennison@ncsddc.org) with any questions on the training.

Logo of the Milken Institute School of Public Health at George Washington University

Take The QUICk Survey – Quickly Understanding Impacts of COVID-19

The purpose of this study is to learn how the novel coronavirus (also known as SARS-CoV-2 and COVID-19) has impacted your life. Full information about this study is available in the informed consent document below.

At the end of the survey, you will be asked if you would like to be entered into a raffle for a $100 Amazon gift certificate using the email address you provide. If so, please indicate YES.