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AAC’s Public Policy Director testifies against budget cuts that would hurt people living with HIV/AIDS

Posted Dec 07 2009 12:36pm
Monique Tula AACI recently had the privilege of testifying at the State House on behalf of the Coalition to END HIV. We were joining the Massachusetts Coalition for Addiction Services to ask the Office of Health and Human Services to preserve existing funding for key state initiatives that support people living with HIV/AIDS and others.

I wanted to share my testimony with the readers of AIDS Action’s blog. My prepared comments can be read below.

Thank you for reading and supporting our efforts,

Monique Tula
Director of Strategic Planning and Public Policy, AIDS Action Committee

EOHHS Public Hearing
December 3, 2009

Testimony on FY 2011 Budget
HIV/AIDS, Viral Hepatitis, Mental Health and
Addiction Prevention, Treatment and Recovery Services

Secretary Bigby and members of the committee, thank you for the opportunity to provide testimony on behalf of the Massachusetts Coalition to End HIV (C2EH).  The C2EH is a group of organizations who believe that sound public policy initiatives — in addition to adequate funding — are the keys to ending HIV/AIDS in the Commonwealth.  In order to advance the fight against HIV/AIDS in Massachusetts we must ensure that people living with HIV/AIDS and those at risk have access to the structural interventions and supportive services that will stabilize their lives, keep them healthy, and move them toward increased independence. 

We have joined with the Massachusetts Coalition for Addiction Services to speak with a unified voice to strengthen support for the preservation and expansion of funding for addiction prevention, treatment and recovery support services as a means of maintaining and increasing access to these services for people with living with and affected by HIV/AIDS, viral hepatitis, or grappling addictive disorders or mental health conditions. Because HIV infection, substance use, and mental health are significantly interconnected conditions, the C2EH is requesting that funding for the DPH/Bureau of Substance Abuse Services, the DPH/Bureau of Infectious Diseases, and MassHealth Behavioral Health line items be preserved and held harmless from cuts for several reasons:

Citizens of the Commonwealth with addictive disorders are some of the people at highest risk for HIV infection.  Nearly 50% of people who died from HIV/AIDS complications between 1999 and 2007 indicated injection drug use as their primary risk factor, either through their own use or that of their sexual partner.   Drug and/or alcohol abuse is the number three killer of people living with HIV/AIDS in MA.

The local environmental risk for substance abuse contributes to residents of the Commonwealth’s risk for addiction and consequently, to the risk for HIV and hepatitis.  Recent data indicates one out of every eight deaths in Boston was either drug-induced or drug-related.  Alarmingly, out of the 419 drug-related deaths in eastern Massachusetts in 2004, 127 were among young people between the ages of 18-34.  Boston continues to rank first in the United States for heroin mentions in drug-related deaths.

For those of us who provide HIV/AIDS services, by the time we see many of our clients for the first time, they are often homeless, or on the verge of losing their housing.  They may be co-infected with HIV and hepatitis C and not receiving treatment for either condition.  It is not unusual for some of our clients to turn to substance use as a way to mitigate the symptoms of mental illness.  Many of our clients have suffered from multiple childhood traumas, domestic violence, or sexual assault, and societal conditions such as racism, stigma, and poverty compound these challenging life histories.

Before coming to AIDS Action Committee, my work as the Director of HIV Prevention for a group of programs that included injection drug users and homeless youth made me critically aware of the high prevalence of trauma among these two groups and how such trauma histories can lead to self-sabotage.  And we know that the need to self-medicate anxiety and depression caused by a history of child abuse often leads to extremely risky behaviors.

Loss of funding for substance use or mental health services will not only result in the Commonwealth having more people with untreated addictions or mental illnesses to care for, but it will greatly increase the number of people living with HIV and or viral hepatitis to care for, an outcome we can ill afford see come to fruition.

Thank you once again for the opportunity to testify.  If you have any questions, please feel free to me at 617.450.1254 or

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