Testimony by AFC Executive Director Mark Ishaug to the Chicago City Council Budget Committee Regarding HIV Prevention Funding

November 5, 2003

Good morning. My name is Mark Ishaug and I am the executive director of the AIDS Foundation of Chicago.

I am here today to encourage members of City Council to swiftly approve the ordinance introduced today by 39 aldermen—led by Aldermen Thomas Tunney, Ed Smith, and Walter Burnett, Jr.—to secure an additional $1 million in city corporate funding for HIV prevention services in the City's 2004 budget.

Put simply, Chicago's HIV/AIDS crisis will continue to escalate and jeopardize the vitality of our city unless efforts are taken now to slow the spread of new infections.

One million Americans are living with HIV/AIDS-a quarter of whom do not know they are HIV-positive-and approximately 500,000 Americans have died from AIDS-related causes since 1981. An estimated 40,000 new infections occur in the U.S. each year—1,000 in the City of Chicago alone. According to the Centers for Disease Control and Prevention, half of all new HIV infections occur among people under age 25.

Despite remarkable treatment advances, there is still no cure for HIV/AIDS. Fortunately, HIV can be controlled for most people who learn of their HIV-status early in their disease progression and who have access to healthcare and prescription drugs. The disease remains deadly, however, claiming the lives of hundreds of Chicagoans each year. HIV treatments are difficult to take, causing discomforting—and in some cases, disfiguring-side effects. Because of drug resistance, the treatments are not always effective and a growing number of people have no treatment options left. The treatments are also expensive—averaging around $20,000 per year-and hard to obtain for many low- and moderate-income individuals.

With thousands of new infections each year and with treatments keeping people alive longer, there are more people living with HIV/AIDS in the U.S. than ever before. Increased survival for people with HIV/AIDS is unquestionably welcomed news. However, the large and growing population of people with HIV means that we have more people to care for and assist in obtaining costly medications. It also means that our prevention challenges are greater than ever before and that we have to work even harder to reduce new infections.

Until an HIV vaccine is developed-still at least a decade away-prevention education remains our most powerful weapon against this virus. The science proves that prevention works, and saves money. According to leading economists, $1 million invested in HIV prevention can save $2.7 million in averted healthcare costs.

We know that expanded access to sterile syringes prevents infections without increasing drug use.

We know that young people who receive comprehensive and age-appropriate health and sexuality education are more likely than their counterparts to delay having their first sexual experience and more likely to use condoms when they become sexually active.

We know that condoms, when used correctly and consistently, are close to 100% effective in preventing HIV infection.

We know that culturally and linguistically appropriate prevention education that is peer-based, sustained over time, and relevant to the target population reduces risk-taking behaviors.

We know that integrating HIV prevention into settings where people receive substance abuse treatment, mental health, HIV-specific care, and other community services is an effective model for reaching at-risk populations.

We also know public education campaigns and policy reforms that reduce AIDS-related stigma and discrimination boost HIV/AIDS awareness and acceptance of HIV testing programs.

And we know that all of this takes money. We should not be penny wise and pound-foolish.

Since 1997, City funding for HIV prevention has decreased 8%-from nearly $4 million to $3.6 million—while the City's reported number of AIDS cases has increased 32%—from 15,441 to 20,480. Chicago broke the 20,000 cases mark this year. Of the more than 20,000 Chicagoans who have been reported with AIDS, only 8,930 of them are still alive. More than 11,000 Chicagoan have died of AIDS since 1981.

The best way to conclude my remarks is simple to plagiarize the aldermen who authored the ordinance on HIV prevention funding, which perfectly describes the need for expanded HIV prevention services. The ordinance reads:

WHEREAS, the spread of HIV/AIDS has continued to be a scourge on all communities in the City of Chicago, and

WHEREAS, there are now an estimated 22,000 persons living with HIV in Chicago, and

WHEREAS, the number of reported AIDS cases in the City of Chicago has increased 32% in 5 years, and

WHEREAS, this disease disproportionately effects communities of color, with African Americans representing 36% of the City's total population, but 65% of newly diagnosed adult AIDS cases, and 61% of recently diagnosed HIV cases, and the incidence of AIDS among the Puerto Rican community is second only to that of the African American community (41 cases per 100,000 residents and 26 cases per 100,000 residents respectively), and

WHEREAS, HIV/AIDS is the leading cause of death for African Americans ages 25 to 44 in the U.S., and the third leading cause of death for Latino men in this age group, and

WHEREAS, annual AIDS deaths in Chicago, which were declining, have begun to rise again, increasing 13% in 2001, and

WHEREAS, a $1,000,000 increase in prevention funding has the potential to save $2.7 million in health care costs, plus avoid further devastation of families and community,

Now, therefore,

WE THE MAYOR AND THE CITY COUNCIL OF THE CITY OF CHICAGO HEREBY ORDAIN:

Section1. That the 2004 budget allocation for the Chicago Department of Public Health be increased by an amount of $1,000,000 for the purpose of expanding HIV/AIDS prevention programs in at-risk communities citywide.

Section 2. That this increase not be drawn from existing Department of Public Health funds, but from such other funds available to the City as shall be determined by the Budget Director.

Section 3. That this ordinance shall be in effect immediately upon its approval and passage.

Thank you all for your leadership and commitment to creating a healthier Chicago for all of us.

City funding campaign

Community Testimony to Budget Committee