Decision maker
The chosen decision maker is known as Mayor Muriel, and the main focus is on the different ways the Mayor can reduce the rate of HIV transmission between men having sex with other men in Washington. There is a higher rate of men having sex with other male gender, and that is increasing the rate at which HIV is being transmitted in different communities around the nation.
Priorities
Mayor Bowser has several priorities for D.C.’s improvement. Her primary focus is on homelessness, affordable housing, reducing gun violence, and improving the economy and health of D.C. residents (Pitasi, 2021). In fact, in observance of National Black HIV/AIDS Awareness Day on February 7, 20,24, the Mayor made the following comments: “On National Black HIV/AIDS Awareness Day, we are reaffirming our commitment to providing residents with the prevention resources and treatment options that they need to get the right care at the right time,” said Mayor Bowser. “We have so many free resources for the community, and we want people to know about them, use them, and feel comfortable reaching out for support.
Powers
The power of the Mayor is to pass or vote for the bill’s act that has been presented over by The DC council that will favor the HIV transmission exercise among men in the nationality. The Mayor either approves or vetoes bills passed by the D.C. Council, submits drafts of legislation to the Council, and can propose federal legislation or action directly to the president and Congress (Callander, 2023). Mayors can draft and enact executive orders relative to the departments and officials under their jurisdiction and reorganize any entities within the executive branch (except for formal disapproval by the Council).
Problem Identification
Problem Statement/ Question: What should Mayor Muriel Bowser do to reduce the rate of HIV transmission among black men who have sex with men in Washington, D.C.?
Currently, there are 12,408 current residents of the D.C. population living with HIV as of the 2021 study. Blacks and Latinos with HIV exceeded 1% of their respective populations, with Blacks disproportionately impacted at 2.8%. Despite some improvements and efforts to reduce HIV transmission, D.C. still has the highest HIV/AIDS rates in the U.S., with the higher rate form of transmission being men who have sex with men (Tilchin, 2022). There is a culture that the men have spread, and that is what has led to the increment in the rate of HIV transmission around D.C. Sex with others in some other countries has been prohibited and is not allowed, and thus why, the cases are always lower compared to D.C. Mayor Bowser has made several improvements to the HIV epidemic since being elected in office to include input in D.C.’s 90-90-90-50 plan to reduce HIV prevalence by 90%, which indicates she cares about this initiative. Although Mayor Bowser has the authority to address the president for policy recommendations, this issue should be resolved locally (Broady, 2020). The cases of HIV among men reduce the life span of the people as they are vulnerable to many diseases since they lack immunity. Some men who are in classes learning end up not being in a better position to study well because they are mentally disturbed.
The first main issue that accelerates the problem is peer pressure. Men have been affected by peer pressure, and thus why, the cases of sex between men have increased and are making the world not a better place for everyone. Whenever the cases of HIV infection are high, it means there is a generation being destroyed at some point in life.
Background The decision maker will focus on ensuring that mitigation and policies are beingare set aside to ensure that the HIV transmission has been sorted and everything is reduced at the best rate possible (Schumacher, 2022). HIV is one of the killer diseases around the globe, and therefore, measures should be set aside, and public demonstrations to stop sex between men to reduce the rate at which the disease is being spread to several people. The Mayor will be able to sort out the issue and discuss the possible elements to be observed.
Policy Options
Currently, in D.C., there is an HIV assistance program that can help cover individuals who are underinsured and uninsured living with HIV and AIDS called the DC AIDS Drug Assistance Program. However, this program still adds many barriers to care that my legislation proposals would cover. 1. D.C.’s current program only covers those who are already diagnosed with HIV/ AIDS and does nothing to allow better access to those who are at high risk due to their risky sexual behavior. 2. The HIV medication still requires a prescription, which adds another barrier to those who can’t see a provider. 3. There are strict eligibility requirements for the DC AIDS Drug Assistance Program, which many of the most at-risk populations will not meet the minimum criteria for (Milwid, 2022). This program is not doing enough to thoroughly address this public health issue’s barriers that the poorer or marginalized community faces when accessing HIV medications or preventable medications. Providing accessible and accessible HIV prevention medication without a prescription is a better way to encourage regular use.
Three options
Pass a law that would make HIV medication available without a prescription: Passing this law would allow the D.C. Mayor to remove the barrier of gay men seeing a medical provider for a prescription before engaging in risky behavior. Or if they have already engaged in risky behavior, they can quickly get the medication. In the state of California, Governor Gavin Newsom signed a similar bill called S.B. 339 that makes medication preventing HIV available to residents without a prescription. This would be a great local legislative model for D.C., potentially increasing access to preventative medicines.
Newsom signs bill making HIV prevention meds available without prescription (msn.com)
Pass a law that would allow pharmacists to screen someone who might be exposed to HIV and prescribe HIV medications: Passing this law would enable the D.C. Mayor to have more accessibility to HIV medication still but maintain regulator use and tracking by way of a pharmacist. Florida government passed a bill Florida that allowed pharmacists to screen someone who might have been exposed to HIV and offer prevention medication (Jeffries IV, 2021). This could be an excellent way for local government to increase the use of HIV medications and for doctors to regulate the use.
Recommendation of the best option
Option 1 is the best. Making medication available without a prescription is the best option to make the Mayor work on the issue of HIV transmission in gay men. Those who have engaged in risky behavior will get medication faster (Jennings, 2020). Making sure that medicine is available to different individuals will make sure that the rate of HIV transmission has been reduced, and that will e the best measure to curb the issue in Washington (Patel, 2021). The policies always ensure that everyone around the nation is protected and that health measures are considered for hood health. The mayor should ensure that the country has considered the first option: the turnout of events.
Bills expanding access to HIV prevention medication move forward in Florida legislature (msn.com)
Pass a law that would make both HIV-preventable and post-exposure medications covered 100% by insurance: Passing this law would remove some financial barriers for gay men who are already diagnosed with HIV and those at risk of accessing it regularly. Under this program, one barrier is that that this benefit would be limited to those withcurrently have insurance. However, Rhode Island’s Governor Dan McKee signed into law similar legislation that reduces the spread of HIV transmission by making HIV-prevention and post-exposure medications accessible and covered by insurance, including newer injectable formulations.
Governor McKee Signs Legislation Which Will Reduce the Spread of HIV Transmission | Governor’s Office, State of Rhode Island (ri.gov)
Table
| Options | Analysis |
| Option 1 | Normal cost of administrative staff to write up a proposed bill. T s option would be coscost-effective in the city because it would simove a legal barrier, thaallowinge medication to be available without a prescription. |
| Option 2 | NorAveragest of administrative staff to write up a proposed bill. This option would remove a legal barrier from pharmacists to prescribe the medications. T financial shift would likely switch from primary care providers to pharmacists. |
| Option 3 | Normal cost of administrative staff to write up a proposed bill. This will likely be the most expensive option dependent on the insurance company covering all the HIV medications and D.C. Government reimbursing them or the insurance companies would have to simply cover the cost. I would simply add the cost of those living with HIV and high risk population and multiply that the individual cost of HIV and preventable medications to estimate the average cost the insurance company or state may have to pay out of pocket. |
Conclusion
In conclusion, the rate of HIV transmission is high in Washington DC. The Mayor has several options that will be taken in order to make sure that the transmission has been reduced at a greater rate. Sex between men is one of the highest common cases happening in D.C. and has become a real threat to the nation and thus why good measures must be employed to curb the matter once and for all. Medication being made available in different areas is the best solution to ensure that HIV transmission has been lowered.
References
Pitasi, M. A. (2021). Vital signs: HIV infection, diagnosis, treatment, and prevention among gay, bisexual, and other men who have sex with men—United States, 2010–2019. MMWR. Morbidity and mortality weekly report, 70.
Jeffries IV, W. L., Flores, S. A., Rooks-Peck, C. R., Gelaude, D. J., Belcher, L., Ricks, P. M., & Millett, G. A. (2021). Experienced homophobia and HIV infection risk among U.S. gay, bisexual, and other men who have sex with men: a meta-analysis. LGBT health, 8(1), 1-10.
Schumacher, C. M., Thornton, N., Wagner, J., Tilchin, C., Ghanem, K. G., Hamill, M. M., … & Jennings, J. M. (2022). Sexually transmitted infection transmission dynamics during the coronavirus disease 2019 (COVID-19) pandemic among urban gay, bisexual, and other men who have sex with men. Clinical Infectious Diseases, 75(1), e1137-e1144.
Patel, P. G., Keen, P., McManus, H., Duck, T., Callander, D., Selvey, C., … & Clifton, B. (2021). Increased targeted HIV testing and reduced undiagnosed HIV infections among gay and bisexual men. HIV medicine, 22(7), 605-616.
Milwid, R. M., Xia, Y., Doyle, C. M., Cox, J., Lambert, G., Thomas, R., … & Maheu-Giroux, M. (2022). Past dynamics of HIV transmission among men who have sex with men in Montréal, Canada: a mathematical modeling study. BMC infectious diseases, 22(1), 233.
Broady, T. R., Bavinton, B. R., Mao, L., Prestage, G., & Holt, M. (2020). Australian gay and bisexual men who use condoms, PrEP or rarely practise HIV risk reduction with casual sex partners: an analysis of national, behavioural surveillance data, 2017–2018. AIDS and Behavior, 24(12), 3501-3510.
Callander, D., McManus, H., Gray, R. T., Grulich, A. E., Carr, A., Hoy, J., … & Guy, R. (2023). HIV treatment-as-prevention and its effect on incidence of HIV among cisgender gay, bisexual, and other men who have sex with men in Australia: a 10-year longitudinal cohort study. The Lancet HIV, 10(6), e385-e393.
Tilchin, C., Wagner, J., Schumacher, C. M., Ghanem, K. G., Hamill, M. M., Rompalo, A., … & Jennings, J. M. (2022). HIV transmission potential and sex partner concurrency: evidence for racial disparities in HIV risk among gay and bisexual men (MSM). AIDS and Behavior, 26(3), 709-718.
Jennings, J. M., Tilchin, C., Meza, B., Schumacher, C., Fields, E., Latkin, C., … & Ghanem, K. G. (2020). Overlapping transmission networks of early syphilis and/or newly HIV diagnosed gay, bisexual and other men who have sex with men (MSM): opportunities for optimizing public health interventions. AIDS and Behavior, 24, 2895-2905.
write