While both candidates for president have made statements that they want to combat HIV/AIDS, a comparison of the voting records, public statements and other actions shows Sen. John McCain, (R-AZ) and Sen. Barack Obama (D-IL) have differing agendas when it comes to HIV/AIDS testing, prevention, treatment, healthcare access and more. has very few specifics to address the crisis and has a history of supporting legislation that damages and impedes the process of addressing the HIV epidemic in America.

In the days leading up to the election, voters will be asked to make tough decisions on who will be the next American leader to face the world. In the presence of a global HIV/AIDS crisis, voters should choose wisely based on each candidate’s positions, records and statements. We hope this guide will help you in your decision-making.

National strategy on HIV/AIDS in America
Currently the U.S. requires that all foreign countries receiving HIV funding provide a comprehensive HIV/AIDS strategy that outlines specific outcome-based measures for the success or failure of funded programming and prevention of transmission of HIV in the grant country. However, the U.S. itself, 27 years after the cases of this epidemic were identified, still does not have a national strategy on HIV/AIDS in America.

McCain has never addressed the issue of whether or not he would support a comprehensive HIV/AIDS strategy for America.

Obama has stated that in the first year of his administration he will develop a comprehensive HIV/AIDS strategy for America that will specifically encompass every department of the federal government.

Needle exchange programs
In 1989, marking the “war on drugs,” the Congress and President George H.W. Bush created a law preventing the funding of needle exchange programs. However, studies have shown time and again that providing clean needles does not increase drug abuse, and more importantly they prevent the transmission of HIV, Hepatitis B and C, and other diseases among intravenous drug users. Some of the studies even indicated that needle exchange programs funnel drug users into treatment and out of the addiction cycle.

Congress has authorized the president to lift the needle exchange ban if the Department of Health and Human Services certifies that needle exchange programs do not contribute to drug abuse. The DHHS made that certification in 1998, but no president has used his congressionally authorized power to lift the ban.

McCain has never stated whether or not he would use the congressional power afforded presidents in 1998 to lift the ban on needle exchange programs to address the spread of HIV/AIDS in the intravenous drug using population in America.

Obama has stated he would lift the ban on needle exchange programs, and he has made it part of his HIV/AIDS platform on his website.

HIV testing
One of the most crucial impacts on prevention of HIV transmission is the simple act of widespread testing for the virus. The Centers for Disease Control has recommended routine testing as part of an annual physical, but as with millions of Americans without basic health insurance, very few are getting even this basic treatment. As a result, testing has fallen to community organizations who provide anonymous or confidential testing. Any comprehensive HIV/AIDS strategy must address the issue of access to testing within impacted communities.

McCain has made no public statements about testing.

In a show of support for the idea of HIV/AIDS testing, Obama and his wife, Michelle, have both taken HIV tests publicly in 2006 in a trip to sub-Sahara Africa and have called on others to follow suit.

Access to treatment
In addition to testing, it is imperative from a public health perspective to make sure that those persons testing positive for HIV have access to adequate medical care, including access to anti-retroviral medications, which have made HIV a manageable, chronic disease in the United States, rather than the death sentence it used to be. However, many HIV-positive Americans die without access to these necessary medications because of wait lists for AIDS drug assistance programs, which are funded only a certain amount to provide HIV medications to patients.

McCain voted against a federal program titled Early Treatment with HIV Act. ETHA would expand Medicaid coverage to low-income persons who are living with HIV but have not been diagnosed with AIDS. McCain was a co-sponsor of the original Ryan White CARE Act, which authorized funding to states to assist in treating HIV. McCain did not sponsor the 2000 Ryan White CARE Act reauthorization.

In 2003 McCain voted against increasing funding to the Global Fund to Fight HIV/AIDS, Malaria and Tuberculosis by $940 million. He also voted against increasing treatment worldwide by $800 million that same year.

Obama has co-sponsored ETHA as well as Ryan White CARE Act legislation. He also has outlined a concise plan, within his larger health plan, to assure access to health care for those infected with HIV.

Confronting stigma
In all the issues surrounding HIV/AIDS, nothing is as painful and important as the need to address as the stigma of being HIV-positive. Many people would rather never get tested than to hear the words “You are HIV-positive” from a medical care provider. The reasons for this are overwhelming. They run the gamut of issues from family prejudices on sexuality to taboos about sexuality in American culture, fear of disease and death, and simple ignorance about how HIV is spread.

While McCain has made comments about how terrible the epidemic is, he has also taken serious actions as a senator to support legislation that adds to the stigma of being HIV-positive in America.

Among the things McCain has supported is a 1993 ban preventing HIV-positive individuals from coming to the U.S. as tourists, students or on other visas. He also voted in 1991 to involuntarily test all patients going in for surgery and to imprison any health care worker who is HIV-positive and participates in surgery.

In a debate at Howard University, Obama said, “One of the things we’ve got to overcome is a stigma that still exists in our communities. We don’t talk about this. We don’t talk about it in the schools. Sometimes we don’t talk about it in the churches. It has been an aspect of sometimes a homophobia, that we don’t address this issue as clearly as it needs to be.”

Obama also supports the lifting of the ban on immigration and other visas to persons with HIV, a ban passed in 1987 with the assistance of McCain.

Science or dogma to drive HIV prevention programs?
Since George W. Bush became president, the U.S. has been aggressively supporting abstinence-only education programs. Those programs have been shown to fail, but it has not stopped the president and his supporters from pushing this broken agenda on this country and the world. The recently passed President’s Emergency Plan For AIDS Relief included a provision that demanded that 33 percent of all HIV prevention programs presented in other countries and funded under PEPFAR be abstinence-only programs.

Comprehensive prevention programs include development of new modes of prevention as well as education programs targeting groups most at risk for HIV infection with effective programs.

Obama is the Democratic sponsor of the Microbicide Development Act, which would fund a program at the National Institutes of Health to develop a topical anti-HIV agent to use in conjunction with other activities to prevent the spread of HIV. Obama also supports the JUSTICE Act, which would assist in the prevention of HIV transmission in U.S. prisons by allowing the distribution of condoms to prisoners. Current law makes possession of condoms in federal prison a crime. Obama also supports the end of abstinence-only-until-marriage prevention programs and replacing them with programs based on proven comprehensive reproductive health education.

Obama is also a co-sponsor of the Prevention First Act, which would provide young Americans with information about abstinence, contraception and condom use to reduce unintended pregnancies, disease transmission and abortions. The bill would also lift the 33-percent abstinence-only education component of PEPFAR. Obama has said the government should “rewrite much of the bill to allow best practices — not ideology — to drive funding for HIV/AIDS programs.”

Obama also is opposed to federal funding of abstinence-only programs.

Todd A. Heywood is the capitol correspondent for Between the Lines, the statewide LGBT newspaper of Michigan, as well as a Fellow for the Center for Independent Media. His work can be found regularly on www.Pridesource.com and www.MichiganMessenger.com. This article originally appeared on The Michigan Messenger and is reprinted with permission.