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Thursday, July 2, 2009

priorities



for the last 3 years, i have been graced with the opportunity to volunteer for the denver mayor's office of hiv resources planning council (mohr) with the last 2 acting as a co-chair. the purpose of the council is to guide with respect to which categories of service to fund for coming year.

we have entered into the prime season for our work. as the leadership of that body, we are now organizing the data to present, collecting community opinion and feedback, and preparing to present all this to the council at large (about 30 people) at an all day retreat we call "priorities".

in this process, i have learned so very much about the needs of persons living with hiv well beyond the scope of my own experience. i have also been made aware of the costs of doing business as a provider, and seen the magic that happens when people's hearts and minds become passionate about the work they do and the people they serve.

please don't be misled. additionally, i have seen how becoming too directed in one's service can easily turn good intentions into what could be labeled misdirection and manipulation in search of obtaining the almighty dollar. although i like to have faith in people as much as possible, i am not completely naive. but this is the exception and not the rule, and i refuse to become bitter because a snake or two can be found in the garden.

the council is comprised of about 1/3 treatment providers, 1/3 plwh, and 1/3 interested citizens at large. the real intention is to keep a "checks and balances" in place for the dissemination of the ryan white funds for the city. this is part of the federal legislation and is required in every major funding area of the country.

the effects of hiv and the communities involved have shifted over the years. medications have taken the infection of the virus from being almost certainly fatal to completely manageable in most cases. but the specific communities that are largely affected have become more in number and the poverty factor continues to become increasingly influential. this causes successful treatment to become more challenging and much less of a "slam dunk".
this is one concrete reason that priorities remains vital. from the outside, treatment would seem such a non-issue. "why don't we just give them medicine and be done with it"? one might ask... but upon closer inspection, one sees that if a person has no home, or a concrete substance use issue, or a mental health issue, or cannot pay their bills, then the likelihood of treatment adherence, which is vital for successful application, is doubtful. quite the opposite, starting a person on medication in this lifestyle environment creates further issues down the road as they can become resistant to meds.

thought and discussion is required in the dissemination of treatment dollars. all of the components mentioned are necessary in successful application. and listening to those who aren't always at the table is mandated for a holistic approach.

it's draining emotionally. it can be distracting to our regular schedules, but it improves and saves lives without fanfare on an annual basis. i welcome priorities.

today's sound choice is michael jackson with "they don't really care about us"






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