USCA: We’ve Come a Long Way

September 24, 2015

Cindra Feuer is an AVAC staff member.

This was my eighth time to the USCA conference. It’s impressive to watch the evolution of people’s knowledge and understanding of biomedical prevention. In fact, “biomedical” has become a household word, tossed around casually at plenaries and in sessions. In the early days, while PrEP was still in clinical trials, no one was really interested in attending our PrEP sessions, usually relegated to 8:30 on a Saturday or Sunday morning. People would say, “talk to us when PrEP is here.” My colleague Kevin took to donning a sandwich board to advertise our sessions. Our PrEP talks have graduated from sideline roundtables to primary real estate — this year, the first workshop session after the first day plenary.

My fondness for this conference grows yearly. Participants are primarily frontline service providers from ASOs, which by now are mostly staffed by people living with HIV or those in proximity. Needless to say, it is a community of about 4,000 black and brown gay men, women of color and transgender people. There are also Department of Health and CDC folks and a smattering of PhRMA. The constellation makes for a serious yet fun and non-judgmental way of sharing experiences. The mission lately is how to best move people through the treatment cascade and deliver PrEP. Most who need PrEP are not aware of it but worse is the lack of knowledge on the part of providers. Culturally competent care is a tiresome gap.

I learned that funding for PrEP could be available to most people in the country, even the undocumented. There are at least five different mechanisms covering some combination of costs for drugs, doctor’s visits and lab tests. However, wending through these systems is terribly complicated, requires a professional health navigator and underscores the need for better healthcare systems in the US. Access is especially difficult in the 19 states the have not signed on to Medicaid expansion because their representatives’ resentment for Obama outweighs their need to serve their constituents.

We’ve come a long way from the activism of “drugs into bodies”. There was a staged protest for trans’ rights. USCA is all about “edutainment”. Folks like Laverne Cox now participate, sharing the spotlight with other motivational speakers. There were hired professionals who interpretive danced through the leaky treatment cascade, “filling the gaps”. This particular lunch show was sponsored by Gilead. I suppose this is why their dance did not address the distance between cost to manufacture Gilead’s life-extending HCV drug — Sovaldi — and the gouged prices they sell it for. Times have indeed changed but, at last, biomedical HIV-prevention is becoming inculcated at the forefront of the US HIV response.