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Legislators hope for early start on HIV-specific bills

by Joe Gamm | December 4, 2018 at 5:51 a.m. | Updated December 4, 2018 at 12:58 p.m.
Missouri HIV Justice Coalition member Brennan Keiser, background, listens as Rep. Holly Rehder, R-Sikeston, answers questions from the media Monday during a press conference in the House of Representatives Lounge.

Supporters of legislation aimed at updating Missouri's "outdated and medically inaccurate" HIV-specific laws are confident the upcoming General Assembly will take up and pass their bills.

Rep. Holly Rehder, R-Sikeston, and others pre-filed a package of three "harm-reduction bills" to improve safety for the state.

Rehder and a coalition of activists announced the filings at a news conference late Monday morning in the Missouri House of Representatives Lounge. It was the first day of filing for the 2019 session, which is to begin Jan. 9.

Rehder said she has worked on a prescription drug monitoring program (PDMP) bill for many years, on syringe access for several years - it passed the House last year, but not the Senate - and a communicable diseases bill, which she first filed last year.

"Our hearing came very late last year, so we have great hopes of getting further this year," Rehder said.

She said the PDMP bill is gaining support in the House and also in the Senate.

Intravenous drug users who accept syringes are six times more likely to get into treatment and shift into healthy lifestyles than users who don't, she said.

Throughout the state, syringes still may be considered drug paraphernalia, if law enforcement agencies wished to press the issue, Rehder said.

"But, they don't because those who use them are six times more likely to get into treatment," she added. "And it also reduces the spread of HIV and Hepatitis C."

HIV - the human immunodeficiency virus - causes infection, and over time, acquired immunodeficiency syndrome (AIDS). AIDS results in the progressive failure of the immune system, allowing life-threatening infections and cancers to thrive. Without treatment, average survival time after infection with HIV is estimated to be nine to 11 years, depending on a number of factors, including the HIV subtype.

Hepatitis C is caused by a virus and primarily affects the liver. The virus persists in the liver in about 80 percent of people initially infected. Over years, it can lead to liver disease or cirrhosis.

Both infections are primarily spread by blood-to-blood contact associated with intravenous drug use. Both infections may be spread through sexual intercourse, although the risk with Hepatitis C isn't as great as that with HIV. Both may be spread from an infected mother to her baby.

"It's very important that we arm our local health departments with the tools they need, so when they have that moment in time - I pray they don't, but if they do - they have the resources they need," Rehder said.

As for communicable diseases, there have been many advances in research since some of Missouri's laws went into effect, she said.

"Our laws, as they currently stand, serve as a disincentive to know your status. Missouri has 13 counties in the CDC hot list of 220 counties determined to be experiencing, or at risk of significant increases in Hepatitis C or HIV outbreak due to (intravenous) drug use," Rehder said.

Thirty to 40 percent of people who are HIV-positive don't know their status. That leads to 90 percent of the transfer of the virus.

Not getting treatment is detrimental to public health, she said, and added the House Health and Mental Health Committee agreed last year that, although neither Rehder's bills nor Rep. Tracy McCreery's similar bills passed, they should be refiled this year.

They pre-filed their bills Monday. House Bill 166, sponsored by McCreery, D-Olivette, changes the laws regarding unlawful actions by persons knowingly infected with communicable diseases. House Bill 167, which changes the laws regarding unlawful actions by persons knowingly infected with communicable diseases, and House Bill 168, which exempts health care entities registered with the Department of Health and Senior Services that distribute hypodermic needles or syringes from the crime of unlawful delivery of drug paraphernalia, were both sponsored by Rehder.

Punishment does not improve public health outcomes, Emily O'Laughlin said.

"Legislation filed today will be a step forward toward empowering individuals to know their status, and will update our statutes to be medically based and accurate," said O'Laughlin, legislative assistant to McCreery. "Modernizing our HIV-specific laws is the right thing to do."

LaTrischa Miles, treatment adherence supervisor for Kansas City Care Health Center, read a statement about needle-exchange programs from the center's wellness officer.

"This evidence-based, harm-reduction program is crucial to preventing the spread of HIV, Hepatitis C and other infections transmitted through used needles," Dennis Dunmyer said. "It will lead to safer communities and can serve as a gateway to important health services."


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