The following information was written by and is provided through a partnership with the Tennessee Department of Health:
On November 27, 2019, Tennessee Department of Health became one of the first state health departments in the Southern U.S. to join the “Undetectable Equals Untransmittable” (or “U=U”) campaign. The U=U campaign raises awareness about the fact that people living with HIV who stay on treatment and maintain an undetectable viral load cannot transmit the virus through sex and are much less likely to transmit it through needle-sharing.
For a person living with HIV, being undetectable means that the amount of HIV virus in their blood is so small that it is “undetectable” to HIV viral load tests. When this happens, the person is incapable of transmitting HIV via sex. This has enormous health benefits for the individual as well. Staying undetectable can help a person living with HIV avoid the health complications from the virus and live a longer, healthier life.
Getting to undetectable status is a health goal for people living with HIV. To achieve and maintain an undetectable viral load, people need consistent access to treatment without fear. The fear that stigma creates can build barriers between medical providers and their clients.
The Centers for Disease Control and Prevention define stigma as “discrimination against an identifiable group of people, a place, or a nation.” This identifiable group of people can be a group of people who all share the experience of living with a health condition. For people living with HIV, stigmatization is a shared fear and, unfortunately, one grounded in reality.
According to Needs Assessment 2020 Special Study conducted by the Tennessee Community HIV/AIDS Partnership, one out of every three people living with HIV in Tennessee lives with the fear that their HIV status may be discovered by someone living in their community (Tennessee Community HIV/AIDS Partnership. "Needs Assessment Special Study). One in five experienced stigma related to their HIV status while receiving medical services.
In deep dive interviews, people living with HIV in Tennessee reported choosing and staying with one provider and/or avoiding medical treatment altogether to avoid potential HIV stigma. Stories about stigma demonstrated that people living with HIV might be stigmatized because of their HIV status and because of their race, gender, and sexual orientation.
One important dimension of stigma is that it provokes a fear response where fear is not needed or helpful. Study respondents described fear from people who lived in their community and from medical professionals in situations where HIV transmission was not possible. This fear made them more likely to limit their own options for treatment and in some cases served as a barrier to treatment itself.
In 2021, we understand that treatment is a key cornerstone of prevention. Our state is healthier when everyone living with HIV has easy, uninterrupted access to treatment. Over the years, many barriers to such access have been dismantled in Tennessee; people living with HIV can get treatment even if they are uninsured and cannot afford it through the Ryan White HIV/AIDS Program. To help people get access to HIV treatment early and stay in care, services like transportation, housing, and psychosocial support are in place. Expert case managers are available to help people new to this network of support navigate to the services they need. But even with all of those resources, stigma can make a person living with HIV think twice about taking advantage of them.
Ensuring that all Tennesseans, not just people living with HIV, understand that HIV treatment substantially reduces the risk of transmission fights stigma. When people living with HIV take their medications as prescribed and maintain an undetectable viral load, their efforts benefit their personal health and protect their community.
All of us, whether we live with HIV or not, can play a role in dismantling stigma. If you or someone you love is living with HIV, here are some resources you can use to help a person achieve undetectable and untransmittable status:
- Get into care (if you aren’t in care already) by connecting with a Ryan White Medical Case Manager. A case manager can tell you whether or not you qualify for Ryan White services and can answer any questions you have about your diagnosis and your options. Click here to find a case manager near you.
- Get back into care after a lapse, a move, or any other type of care interruption with the help of an Early Intervention Services (EIS) specialist or a Re-engagement specialist. Click here to read more about EIS services in Tennessee or here to connect with a Re-engagement specialist.
- Identify and overcome your barriers to daily medication. Maintaining an undetectable viral load requires people living with HIV to stay on a daily medication regimen. If that is something you haven’t had to do before, it can be challenging. Identify what makes it hard to take your medication daily and share your concerns with your case manager and/or medical provider. Click here to learn more about all of the supportive services Ryan White offers to help people maintain stable access to care.
- Set up a system of social support. Living with HIV can be challenging, especially if you are living in fear that people will discover your health status. One way to fight this fear is by telling the people in your life about your health. Planning a disclosure can be difficult, but there are lots of professionals and peers in Tennessee that can help. Your Ryan White medical case manager can support you in planning a disclosure. For people new to living with HIV, Anti-Retroviral Treatment and Access to Services (ARTAS) linkage coordinators can help you get into care and plan a first disclosure. Healthy Relationships is a series of workshops for people new to living with HIV that uses a peer model to help people get comfortable and good at talking about their HIV status. Click here for more information about ARTAS and Healthy Relationships.
HIV stigma has its roots in a time when we didn’t know what HIV was, how it spread, or how to treat it. Stigma alienates people living with HIV and is often part of a person’s thought process when considering care. No one should be afraid to do something good for their health, especially when it will also benefit their community. We all have a role to play in eliminating HIV stigma in our communities. Spread the word about U=U, bring up HIV and educate your friends and family, and spread the word about all of the resources people living with HIV in Tennessee have to maintain their health.
As of May 18, Governor Lee has now signed all three of these anti-trans bills, in addition to his earlier signing of the anti-trans student athlete bill and the bill that allows parents to opt their children out of sexual orientation/gender identity curriculum in public schools.
HB1233 is an anti-transgender student bathroom bill that offers trans students separate and unequal accommodations in our public schools. Tennessee could be the only state this year to enact a bathroom bill this year. (signed into law)
HB1182 is the anti-transgender bathroom sign mandate bill that applies to businesses and organizations that have a trans-inclusive policy for multi-person restrooms. The bill requires them to put up a demeaning sign about biological sex. It could lead to increased policing of trans people in restrooms and aggression towards trans-inclusive businesses. (signed into law)
SB126 is a bill that puts into the Tennessee Code standards for gender-affirming care for trans youth. Why is that a bad idea? It is discriminatory because we don’t normally put standards of care into the law and if the standard of care changes based on research, we shouldn’t have to amend the law. It could also invite more restrictive amendments in future legislative sessions. (signed into law)
Contact Governor Lee today at 615-741-2001 and let him know your views on anti-transgender legislation.
Email Option: You can also send him an email through his contact form at https://www.tn.gov/governor/contact-us.html .
Make your voice heard on bills moving the week of May 3 as the Legislature prepares to adjourn.
*HB1027, the bill regulating gender-affirming care for transgender youth, is on the House floor Monday evening.
-Use this easy form to contact your member of the Tennessee House of Representatives. If you have already sent your message, share the link with friends.
-If you want to compose a personal email or voice mail for your state representative, but don't know who that is, be in touch at [email protected] any time before Monday at 10 a.m. Central Time. We will help you with your message and with the contact information. Put your street address and Zip code in the email.
-Calls to the Governor: Several bills are heading to the Governor or on his desk. Call Governor Lee at 615-741-2001, leave a message asking him to veto SB1229/HB529 (parent opt-out bill), SB1367/HB1223 (anti-trans student bathroom bill), and SB1224/HB1182 (anti-trans bathroom sign mandate bill).
-Letters to the Editor: If you want to write a letter to the editor of your local paper (especially outside Nashville), and you need some guidance, reach out any time at [email protected] and let us know the name of your newspaper. We could use some letters urging the Governor to veto these bills. This weekend is a great time to start.
Discriminatory bills continue to advance. Take action and fight back with the steps below.
*If you want to have a phone meeting with your state senator and/or your state representative the week of April 26, contact us at [email protected] and we will help you get it set up and prepare you with an issue brief.
April 26 or April 27
*HB1027, the bill regulating gender-affirming care for trans youth, is up for a vote in House Government Operations Committee. Note: The information on the bill's page on the Legislature's web site says that it is up for a vote on April 27, but the House Government Operations Committee meeting is listed for April 26. UPDATE: The Government Operations Committee did approve the bill on April 26 and it is headed to the House floor soon.
*SB1224, the anti-transgender sign mandate bill, will be on the Senate floor soon.
Note: There are additional bills that could be added to the calendar. If they are put on the calendar, we will add more campaigns.
More damaging bills are getting closer to passing. Take action on these bills moving the week of April 19.
Remember that the parent opt-out bill is heading to the Governor for his signature, so call him. Tell Governor Lee Veto SB1229/HB529 Parent Opt-out bill for LGBTQ curriculum at 615-741-2001.
Monday, April 19
*SB1367/HB1233, the anti-transgender student bathroom 2.0 bill, is up for floor votes in the Senate and House.
Tuesday, April 20 (possibly Wednesday, April 21)
*SB1224, the anti-transgender bathroom sign mandate, is back in Senate Judiciary Committee.
*HB1027, the caption bill amended to regulate gender-affirming care for trans youth, will be up for a vote in the House Government Operations Committee soon.
Note: If you clicked on this link from the Times News Editorial, go to the new campaigns for the week of April 19 at https://www.tnep.org/take_action_on_dangerous_bills_moving_the_week_of_april_19 . You can call Governor Lee and urge him to veto SB1229/HB529 by calling him at 615-741-2001 .
2021 has been the toughest legislative session in years. The week of April 12 is no departure as discriminatory bills continue their advance. Take action and fight back using the campaigns and events below.
If you are available to meet by phone or Zoom with your state senator and/or state representative in the next two weeks, be in touch at [email protected] and we will get you information to prepare you.
Monday, April 12
Tuesday, April 13
*SB1224, the anti-transgender bathroom sign mandate bill, is up in Senate Judiciary Committee.
*HB1233, anti-transgender student bathroom bill 2.0, is up in House Finance Committee. The Senate companion bill has been delayed on the Senate floor and has been reset for April 19.
Wednesday, April 14
*HB578 and HB1027, bills attacking gender-affirming care for trans youth, are up in the House Health Committee.
*HB529, the parent opt-out bill for sexual orientation/gender identity curriculum, is on the House floor.
More discriminatory bills are getting dangerously close to passing. Take action on these bills moving the week of April 5.
Monday, April 5
*SB1229, the sexual orientation/gender identity curriculum opt-out bill, and SB1367, the anti-transgender school bathroom bill 2.0, are on the Senate floor.
Tuesday, April 6
*HB1027, the caption bill regulating gender-affirming care for trans youth, is back in the House Health Subcommittee.
-Use the new email campaign under HB578 with Wednesday's action steps. It is a combined campaign that includes HB1027.
*SB1224, the anti-transgender bathroom sign mandate, is up in Senate Judiciary.
Wednesday, April 7
*HB578, the bill attacking gender-affirming care for trans youth, is up in the House Health Committee.
*HB800, the bill banning LGBTQ content in school textbooks and instructional materials, is up in House Education Instruction Committee.
-Use this easy email campaign for HB800 and the two bills below. It will go to members of Senate Education Committee and House Education Instruction Committee. Add your own written or video message.
*SB659/HB1535, a bill that would ban supplemental curriculum materials not approved by the state, is up in Senate Education and House Education Instruction Committees.
-See the email campaign above for HB800.
Thursday, April 8
*SB126, another anti-trans youth health care bill, is on the Senate floor.
Many dangerous bills are still moving through the Legislature during the week of March 29. Here are some ways you can take action.
Monday, March 29
*HB1182, the anti-transgender bathroom sign mandate, is on the House floor.
Tuesday, March 30
*HB800, the bill banning LGBTQ content in school textbooks and instructional materials, is up for a vote in the House Education Instruction Subcommittee.
*HB1027, the caption bill that could be amended to regulate gender-affirming care for trans youth, is up in the House Health Subcommittee.
Wednesday, March 31
*HB529, the sexual orientation/gender identity curriculum opt out bill, is up for a vote in the House Education Instruction Committee.
-See the email form under HB800 on March 30 for the email campaign on this bill. It is a combined campaign.
*SB126, the caption bill that could be amended to regulate gender-affirming care for trans youth, is up in the Senate Health and Welfare Committee.
-See above under March 30 for the email campaign that sends an email to the House and Senate committees on the bill.
A record for discriminatory bills moving the week of March 22! Here are ways you can take action.
*SB228/HB3, the anti-transgender student athlete bill, is up for a vote on the House floor.
*HB1027 is a caption bill that would likely carry language regulating gender-affirming care for transgender youth. It is on notice in the House Health Subcommittee.
*HB1182, the anti-transgender bathroom sign mandate, is BACK ON NOTICE after being taken off notice. It is up for a vote in the House State Government Committee.
-If you would like to leave messages for the members of the State Government Committee, find the script with phone numbers here.
*HB800 would ban LGBTQ content from the public school curriculum. HB529 would require schools to let parents opt their students out of sexual orientation/gender identity curricula in public schools. Both bills are up for consideration in the House Education Instruction Subcommittee.
-Use this easy form to send emails to the subcommittee. Feel free to add your own message in the blank space.
-Online Event: People's Preview of the State presented by Tennessee Advocates for Planned Parenthood. 6:00 p.m. Central Time.
*HB578, the bill attacking gender-affirming care is up for a vote in the House Criminal Justice Committee.
-If you would like to leave phone messages with the members of the committee, find the scripts and phone numbers here.
*SB126 is a caption bill that would likely carry language regulating gender-affirming care for transgender youth, is on notice in the Senate Health and Welfare Committee.
-The email campaign for this bill is combined with the March 23 campaign on the companion bill up in the House Health Subcommittee. See above.
*SB1229, the bill that would let parents opt their students out of sexual orientation/gender identity curricula in public schools, is up for a vote in the Senate Education Committee. SB1367, which is an anti-transgender student bathroom bill 2.0 is up in the same committee on the same date.
-Use this easy form to email the Senate Education Committee on both bills. Add your own message in the blank space.
-Online Event: TEP Knox, Anderson, and Blount Counties virtual meeting at 6:00 p.m. Eastern Time.
-Online Event: TEP Shelby County virtual meeting at 6:30 p.m. Central Time.
-Virtual Event: TEP Tri-Cities virtual meeting at 6:30 p.m. Eastern Time.
More anti-LGBTQ bills are moving the week of March 15. We urge you to take action by participating in the March 15 phone bank and using the email campaigns listed below. Be sure to use the blank space in each email campaign to add your own personalized short message.
Monday, March 15
*Zoom phonebanking event against the bills below at 6:30 p.m. Central Time: https://www.facebook.com/events/160316425916433/
Tuesday, March 16
*SB1124/HB1182, bathroom sign mandate, up in House State Government Committee. GOOD NEWS! The bill was taken OFF NOTICE on March 16.
Wednesday, March 17
*SB657/HB578, attacking gender-affirming care for trans youth, up in House Criminal Justice Subcommittee. The bill passed the subcommittee. There will be an amendment removing criminal penalties in the full committee, but no version of this bill is acceptable.
*SB193/HB372, diversity training opt out bill, in House Public Service Subcommittee. Taken off notice on March 17.
*SB1367/HB1233, Bathroom Bill 2.0, up in House Education Administration Committee
-If you want to leave phone messages for the members of the committee, find the scripts and phone numbers at this link.
Thursday, March 18
*SB228/HB3, anti-trans student athlete bill, on the House floor.
-Email campaign on the bill: https://ujoin.co/campaigns/1209/actions/public/1615478903?action_id=1251