The number of Californians living with HIV/AIDS continues to grow by 6,500 to 9,000 individuals each year. The failure of the Bush administration and Congress to increase funding for prevention and care programs to keep pace with this growth has required that California's governor and legislature take actions that contribute to ending the epidemic. To assess their willingness to lead on pressing HIV/AIDS issues, advocacy groups recently conducted a survey of all candidates for governor and lieutenant governor on the November 2006 ballot.
Of the leading candidates for both offices, only Insurance Commissioner John Garamendi, the Democratic nominee for lieutenant governor, responded to the advocates' survey. Garamendi's positions on key issues were consistent with those of advocates. Among other positions, he supports increased funding of the AIDS Drug Assistance Program, which provides free HIV medications to low-income Californians; state funding for sterile syringes to prevent HIV transmission among injection drug users; and the availability of condoms in state prisons to limit HIV transmission both there and in the larger community.
Although state Senator Tom McClintock, the Republican nominee for lieutenant governor, did not respond to the survey, his record in the state Senate places him in strong opposition to advocates' positions on virtually all of the key issues in the epidemic.
State Treasurer Phil Angelides, the Democratic nominee for governor, also failed to respond to the survey.
Governor Arnold Schwarzenegger is running for re-election as the Republican nominee. He also failed to respond to the survey. However, his existing record can be evaluated. Although not perfect, the San Francisco AIDS Foundation considers the governor's record on HIV/AIDS issues to be commendable. He has supported every request made by advocates to increase state spending on HIV/AIDS programs, and approved new laws to strengthen HIV prevention and protect federal HIV/AIDS funding. His key representatives on health issues have been highly accessible and responsive on HIV/AIDS issues. The leadership of the State Office of AIDS also continues to be strong under the administration's guidance.
In his first draft budget in 2004, the governor proposed to flat-fund ADAP and close enrollment. Responding to vigorous protests, he signed a budget that increased the program's funding by $27 million. In two additional budgets, the governor has increased ADAP funding by a total of $63 million without pressure from advocates. The total budget for ADAP is now $299 million, of which $108 million comes from state funds.
The governor has provided resources to cover expenses required of HIV-positive individuals enrolled in the Medicare Prescription Drug Plan. He has approved an increase of $5.6 million in HIV/AIDS prevention spending two years in a row, as well as an allocation of $10 million for methamphetamine prevention programs, including programs targeting gay men.
The Schwarzenegger administration urged the legislature to replace the state's code-based HIV reporting system with a system requiring that HIV-positive individuals be reported by name to their county and the state. After securing a set of protections for HIV-positive people, SFAF agreed with this change because it is needed to protect tens of millions of dollars in federal HIV/AIDS funding in coming years.
Schwarzenegger signed legislation permitting certain pharmacies to sell sterile syringes to adults without a prescription to help reduce HIV transmission among IDUs. He liberalized state law establishing the manner in which counties must authorize syringe exchange programs, which advocates believe will lead to an expansion of these life-saving services. He has, however, stalled legislation that would permit cash-strapped needle exchange programs to use state funds to purchase sterile syringes.
Finally, citing state law prohibiting sex in prisons, the governor vetoed a bill to permit the distribution of condoms to California inmates. This was disappointing given the significant role HIV transmission in prisons plays in the growing epidemic. Advocates look to the next governor to permit condom distribution to inmates, despite state law prohibiting sex in prison, in the greater interest of the public health.
SFAF is disappointed by the lack of response from candidates for key state offices. We urge community members who support sound public policy on HIV/AIDS to join us in our efforts to ensure that the epidemic remains a priority for elected officials. Please visit us at www.sfaf.org/policy to learn more about the issues discussed here and to join our HIV Advocacy Network.
Dana Van Gorder is the director of state and local affairs for the San Francisco AIDS Foundation.