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A Texas border town, HIV, and national
health policy
This is a story about maps. Let’s imagine for a moment that HIV is a colored dye that has been injected into the map of the United States. The dye shades the routes the virus travels. The veins of the map that would begin to fill with color would not only be the highways and byways, but the uneven roads of language, sexuality, religion, gender, race, and money. The jagged and scenic routes of culture. As the colored dye steadily coursed its way through the human and institutional map of this country, lines would become bolder, more defined, and some new ones would appear. Where there was once no connecting path, we could begin to clearly see the pronounced roadways of HIV that feed into our cities and towns, illustrating the truths of health. It is easy to follow these newly marked routes if you are a reader of maps. It could very well be that HIV is nothing less than a map maker, charting the unruly anthropology of the constructs of health in modern America. Today I want to take you on a journey. And like most journeys, when it’s over and you arrive back home, something in you will have changed; something will be different. On today’s journey we will make use of maps that are geographical and conceptual, and we will be doing a bit of map making ourselves. We will connect the dots, like the rutted lines that join the scatter of distant cities on a road map. We will pencil in the lines between the notions of “place,” “health,” and “policy.” Our first destination is Texas, a prominent state without a doubt. Links are
also part of today’s journey. If you print the article, remember
to visit the links when you go back on line. Below you will find
a map of the U.S., so that you can have the image fresh in your
mind. As you look at this map, remember that we are also looking
at the geographic region of national health policy. Pass your
gaze over the borders of this nation – north and south, then blur
your focus and look at the image again. You should be seeing a
single, rather asymmetrical land mass. The borders seem arbitrary.
And what about the health map. Do those lines blur as well? The purpose of this narrative is not to give you an HIV surveillance update on the state of Texas, nor to offer a full report on current health issues. It is simply to help formulate the idea that developing solid federal health policy on HIV rests on knowing the facts and seeing the lives of people in different regions of the country. To help build a workable, intelligent national health policy to respond to the epidemic of HIV, a viral infection that is penetrating every corner of the United States of America, we must first know how the people living under the roof of this nation are affected by that virus. Since HIV moves into a person whose life is already in progress, it would do us well to understand how people were living before that virus showed up. Not knowing these realities is one of the principal obstacles for serious policy advocates. Educating the policy makers and health program funders about how HIV affects this nation is what AIDS Action has taken on as its mission since it’s creation in 1984. Today, in 2003, AIDS Action is challenged to uphold this vital mission: that of knowing the epidemic in order to educate and advocate. Last
week, Dr. Marsha Martin, executive director of AIDS Action, and
I went to Texas to see where another part of this epidemic lives,
to know what HIV feels like in the South, in a rural community
that sits on the border of Mexico. The team at AIDS Action has
just recently completed its first national policy agenda since
Dr. Martin’s year tenure as the Executive Director. The document
is an educational and advocacy tool that outlines eight broad
subjects that frame the discourse around the HIV public health
agenda. They include Ryan White Care Act Reauthorization, Access
to care, Access to HIV medications, Improved surveillance systems,
Improved testing and counseling, Prevention, Faith based communities,
and Research. To be capable advocates, the team could easily read
up on the facts, consult with board members, memorize the issues
to then lobby Congress or the Administration. However, the most
effective advocacy comes from believing in and understanding your
words. When one can really see people’s health conditions, terms
like “vulnerable community,” “barriers to care,” “health disparities,”
and “effective prevention strategies” take on new meaning, and
advocacy work takes on new strength. | next > |
