As the state Legislature puts this year’s budget together, it should categorically reject Gov. David Ige’s proposed 64% cut to HIV-related services. These cuts will put the health of thousands of Hawaii’s most vulnerable residents in jeopardy. If enacted, this cut would devastate HIV treatment and prevention efforts and health care services for the state’s most vulnerable and marginalized communities.
As medical director of the Hawaii Health and Harm Reduction Center (HHHRC), I am concerned about what this budget cut would mean for our organization and others like HHHRC across the state. Thousands of Hawaii residents rely on community-based organizations to help with testing, linkage to HIV and hepatitis C treatment, and other services. We provide counseling by mental health psychiatrists who specifically work with patients who are using substances. We also provide detox services to more than half the patients who come through our center, and frequently connect our clients to critical mental health services.
It is vitally important that AIDS services providers and community health organizations have the resources needed to serve the most vulnerable in our society. For people living with HIV, this may mean getting medication refilled and delivered to their home; many require case managers and peer navigators to deliver them food. For some, this is of the utmost importance, as certain medications require the consumption of at least 800 calories per day.
A 64% cut in funding for HIV treatment, prevention and ancillary services would mean a reduction in case management and peer navigation services, and it would effectively eliminate our ability to physically go into communities to identify individuals who may require rapid HIV and hepatitis C testing in the field. We have provided these services throughout the course of the COVID-19 pandemic.
Syringe access has helped keep rates of HIV low in Hawaii for three decades. This cut will not only have a dangerous impact on residents who are HIV positive. It will have long-lasting negative public health implications across our state by limiting regular access to sterile syringes in rural parts of the state.
The recent cessation of syringe exchange services in Kanawha, W. Va., saw an immediate uptick in HIV rates. Hawaii should not make the same mistake.
Drastically reducing the ability of organizations like HHHRC to meet community needs would add additional stresses and anxieties to individuals who already are living on the margins of and feel isolated within their own communities.
Legislators have an opportunity to protect underserved populations by rejecting this proposed budget cut. Notably, no official has publicly defended this unprecedented cut to HIV services in a state that so desperately needs them.
Leaving those living with HIV or at risk of contracting HIV with fewer care services as we move through the COVID-19 pandemic is foolhardy and contrary to the spirit of aloha so often invoked by our elected leaders.
Dr. Christina Wang is medical director of the Hawaii Health and Harm Reduction Center, which works against HIV, hepatitis, homelessness, substance use, mental illness and poverty.
