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  1. World AIDS Day: December 1st

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    This is the final post from our fall intern Meghan Frisard, University of Maine student. 

    World AIDS Day happens annually on December 1st. It is an opportunity for people from around the world to show support for those living with HIV/AIDS and to raise money and awareness about this disease.  Since 1984 when the AIDS virus was first discovered, over 34 million people have died as a result. Despite progress in prevention, treatment, and destigmatization in recent years, thousands of people are diagnosed with HIV/AIDS every year.

    What is HIV/AIDS?

    HIV (human immunodeficiency virus) is a virus that attacks a certain type of white blood cells that are known as T Cells (CD4 Cells). T Cells are the cells in our bodies that allow us to fight off infection and have immunity to diseases that we have had in the past. The HIV virus uses the mechanisms in these T cells to replicate itself, killing the T Cell in the process. Fewer T Cells means that a person’s body is less able to fight off infection. HIV is spread from certain bodily fluids, such as blood, semen, and vaginal fluid. HIV can also be passed from mother to child.

    There are 3 stages of HIV Infection: Acute HIV infection, clinical latency, and AIDS. Acute HIV infection usually happens 2-4 weeks after a person is infected with the HIV virus and is characterized by terrible flu-like symptoms. Clinical latency is the period where a patient likely does not have any symptoms, but can still infect others. AIDS(acquired immunodeficiency syndrome)  is the final stage of HIV infection. When HIV has killed enough T Cells that a person’s ‘T Count’ is under 200 cells per cubic millimeter of blood, the patient is diagnosed with AIDS. When a person has progressed to AIDS, they often develop opportunistic infections, which are diseases caused by viruses or bacteria that are rare in people with healthy immune systems. Examples of opportunistic infections are pneumonia, tuberculosis, and Salmonella infection.

    Is there a cure for HIV/AIDS?

    There is no cure for HIV/AIDS. However, Antiretroviral Therapy (ART) can be used to treat HIV. ART is a combination of multiple medicines, called antiretrovirals, that are taken together. ART is recommended to be started as soon as possible post-diagnosis and has been shown to greatly reduce the rate of disease progression. Before the invention of ART treatment for HIV, the clinical latency period would last an average of 10 years, and an opportunistic infection would cause the death of an AIDS patient. Now however, advances in ART allow most HIV patients to remain in the clinical latency period for many more years without ever progressing to AIDS, and the life expectancy of an HIV positive person becomes the same as a non-infected person if ART is started early.

    In addition to ART, HIV-negative people can take Pre-exposure prophylaxis (PrEP) to reduce their risk of being infected with the virus. If taken daily, PrEP can reduce the risk of infection from having sex by more than 90%, and more than 70% from sharing needles. Anyone who may be at risk for infection is recommended to take PrEP; this includes anyone in a partnership with an HIV-positive person, anyone who may have sex with someone who is at a higher risk for infection (men who have sex with men, or IV drug users), and/or anyone who has used IV drugs or been in treatment for IV drug use in the last 6 months. PrEP is covered by many insurance plans, and can only be prescribed by a healthcare provider.

    Mabel Wadsworth Center provides confidential and private HIV rapid testing. The Health Equity Alliance (HEAL) does a lot of work within the state of Maine regarding HIV and AIDS. HEAL is also holding a World AIDS Day event on December 1st in Pickering Square. Details are here.

     

    Sources:

    https://www.worldaidsday.org/about

    https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids

    https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/26/86/what-is-an-opportunistic-infection-

    https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/hiv-treatment-overview

    https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis

  2. Transgender Day of Remembrance

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    At Mabel Wadsworth Center, our interns are responsible for updating the bulletin board in our waiting room once a month. Past topics have included healthy relationships, safer sex, abortion stories and more. In case you haven’t had the chance to visit us during November, you can read about our bulletin board here.  This post is by our fall intern, Meghan Frisard, a student at the University of Maine.

    *CW: murder, transphobia

    The week of November 14th-20th is  Transgender Awareness Week, which serves to help increase visibility of transgender people and inspire action against transphobia and bias. November 20th is the annual Transgender Day of Remembrance (TDoR), a day that honors and remembers the transgender people who lost their lives in acts of anti-transgender violence. The event began in 1999 in San Francisco to remember the life of Rita Hester, a transwoman who was murdered in Boston in 1998. Rita Hester was not, and still is not, a household name, but she was murdered just a month after Matthew Shepard was murdered by homophobic assailants in Laramie, Wyoming. Matthew Shepard, however, often is a household name and the reporting on his murder was widespread and accurate. Many members of the transgender community, in Boston and nationwide, felt that Rita’s death was not publicized in the same way as many murders of cisgender people are and that the reason for this difference was due to transphobia. More about Rita Hester’s murder can be found here.

    Of all trans people murdered in America every year, a disproportionate amount of the victims are trans women of color, just as Rita Hester was. The Transgender Day of Remembrance serves to keep us conscious of how transphobic violence is still happening in America, and how many Americans and institutions are unfazed by such violence. Transgender murder victims are often misgendered by the police and media outlets, which makes any accurate data collection of transgender murders challenging. Join us in Bangor to commemorate Transgender Day of Remembrance at UMA-Bangor (the college campus near the airport), information can be found here.

    Still unsure what transgender means? Sex, gender, and sexuality are not the same thing. Transgender (or “trans” for short) is an umbrella term that generally encompasses anyone whose gender identity does not correspond with the sex they were assigned at birth.  This graphic of a “genderbread person” helps break down these complicated concepts. For more information about transgender people and their experiences, check out this local source: Maine Transnet.

    At Mabel Wadsworth Center, we provide hormone therapy for transgender clients and make every effort to ensure our trans clients feel safe. Hormone therapy is an option for transgender people to help them to feel more at ease in their body by taking higher doses of sex hormones (testosterone and estrogen) than what the body naturally produces. Not all trans people choose to take hormones, just as not all trans people choose to have gender-affirming surgery. Providing culturally competent healthcare to the trans community is essential to their health and safety. We are grateful to the Maine Women’s Fund for their generous support in helping us to better serve folks in this community.

  3. Get Out The Vote: Yes on Question 2

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    At Mabel Wadsworth Center, our interns are responsible for updating the bulletin board in our waiting room once a month. Past topics have included healthy relationships, safer sex, abortion stories and more. In case you didn’t have the chance to visit us during the month of October, we’ve decided to put the bulletin board online as well. Enjoy this post by our fall intern, Meghan Frisard, a student at the University of Maine.

    Question 2, an effort to expand MaineCare (Medicaid) to 80,000 people will be on the ballot in the Maine election on November 7th, 2017. Mabel Wadsworth Center is a part of Mainers for Healthcare and endorses ‘YES’ on question 2.

    What is Question 2?

    A ‘yes’ vote is a vote to expand MaineCare. What does it mean to expand MaineCare?  The rule for who is and is not covered under Medicaid depends on each state. 31 other states have already expanded their Medicaid programs. Currently, there are thousands of Mainers who do not qualify for MaineCare and cannot afford quality private health insurance. As a result, they may end up delaying care and then ending up needing care from hospital emergency departments, making the entire health system less efficient and more expensive for all of us. If Question 2, passes Mainecare will expand coverage and increase access to preventative care. Improving access to preventative care and other services will also allow rural hospitals to stay open and thus create more jobs in these rural parts of the state, where jobs are needed.

    If you want to learn more, you can see the impact question 2 will have on our entire state or by county. MaineCare expansion is especially important to women, the LGBTQ community, people of color, and those experiencing sexual assault or domestic violence. All of these vulnerable populations are more likely to be living in poverty and therefore in need of healthcare. This program would also support our hospitals, community health centers and other providers like Mabel Wadsworth Center. We know firsthand how devastating a lack of healthcare can be on our clients.

     

    When, Where, and How can I vote on Question 2?

    Election day is Tuesday, November 7th, 2017. Your polling location depends on where you live. You can use this portal to see what your polling location is and what its hours are on Election Day.

     

    How do I register to vote?

    You can register by mail up to 21 days before the election, and any day leading up to Election Day in person. You can register in person at your town/city office or at any Department or Registry of Motor Vehicles branch. In Maine, you can also register at the polling station on Election Day – be sure to bring proof of residency in the town/city that you are registering in. Proof of residency includes a ME driver’s license with a current address, a utility bill, etc.

     

    I work on Tuesdays or have other obligations. Can I still vote?

    Yes! You can either get an absentee ballot or vote early. Absentee ballots for this election must be received no later than 8 pm on Election Day (November 7th). You can request your absentee ballot here: http://www.maine.gov/cgi-bin/online/AbsenteeBallot/index.pl. You can also vote in person by absentee at your town clerk’s office as soon as the absentee ballots are available, which is at least 30 days before the election.

     

    Why should I vote in this election? No representatives or legislators are getting elected.

    Every election is important, and something is always at stake. Your vote in this November election could decide whether or not someone gets the healthcare that they need. You can vote by absentee ballot early, so you don’t have to miss work, school, or family time to vote. In the presidential election last fall, 72.8% of Mainers voted, making us the state with the second highest voter turnout in the country. Let’s keep that momentum up and VOTE!

     

  4. Health Insurance 101

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    At Mabel Wadsworth Center, our interns are responsible for updating the bulletin board in our waiting room once a month. Past topics have included healthy relationships, safer sex, abortion stories and more. In case you didn’t have the chance to visit us during the month of September, we’ve decided to put the bulletin board online as well. Enjoy this post by our fall intern, Meghan Frisard, a student at the University of Maine.

    Health insurance is a super complicated topic, but something that every American needs to know about. There are a lot of sources of misinformation out there, and we are here to break down the key features of health insurance, and what Mainers need to know to make sure that their healthcare needs are covered!

    Let’s start with the basics. What is health insurance?

    Health insurance is a system that individuals pay into that helps them pay for medical expenses. It is similar to car insurance, something people are often more familiar with that’s a little less complicated; you pay a monthly car insurance bill even if you are a safe driver and have never been in an accident, and your car insurance company will then pay to fix your car if you get in an accident or crack your windshield. Similarly, you pay into your health insurance even when you are healthy, and then your insurance company covers your health services as you need them.The biggest difference is that car insurance companies do not pay for preventative maintenance, while most health insurance companies do!  They often cover preventative services (regular check-ups, pap smears, etc) because catching a problem early will almost always lead to a better outcome for you and less expenses for them, as opposed to having to cover long hospital stays or surgeries.

    What is a premium? copay? A deductible? Coinsurance?

    A premium is what you pay for insurance every month.

    A deductible is what you pay for health services before your insurance kicks in and pays for services until you hit your maximum out of pocket amount.

    A copay is a fixed amount that you pay for certain services, such as prescription drugs or doctors visits, until you hit your maximum out of pocket amount.

    Coinsurance is a certain percentage of covered services that you will pay until you hit your maximum out of pocket amount.

    Your maximum out of pocket amount is the maximum amount of money that you would pay for services in a year. Copays, coinsurance, and money paid towards your deductible all count towards this amount. Your monthly premiums, however, do not count towards this amount.

    A lower premium will result in a lesser monthly bill, but low premiums often are paired with high deductibles, which means you will be paying more for services. Lower premiums also often have higher maximum out of pocket amounts.

    If you have listened to, watched, or read any news media over the past 7 years, you have probably heard about The Affordable Care Act, also known as Obamacare. What is Obamacare?

    The Affordable Care Act (ACA) is a major piece of legislation passed in 2010. Some of the key features of the ACA are:

    • required insurance companies to cover essential health benefits which include: preventive care, hospitalization, maternity and newborn care, emergency-room care, and broader prescription drug coverage.
    • Required all Americans to have health insurance or face a tax penalty, and offered subsidies and expanded Medicaid for low-income Americans, to offset the costs of being required to have health insurance.
    • Allowed young people to stay on their parent’s insurance until they are 26.
    • Prevented insurance companies from denying coverage based on preexisting conditions (such as diabetes, cancer, childbirth, or other common but expensive conditions)
    • Required insurance companies to charge women the same rates as men.
    • Prevented insurance companies from charging older consumers drastically more than younger consumers. Insurers cannot charge older consumers more than 3x the rate of younger consumers, but before the ACA older consumers were being charged as much as 10x more than younger consumers.
    • Required employers to offer adequate insurance to employees, and offered options for employees who could not afford the insurance offered by their employers

    If you’re already covered by insurance purchased from healthcare.gov as part of the ACA (Obamacare), you need to reapply each year, or you will lose coverage. Open enrollment for ACA Marketplace insurance begins November 1st, 2017 – December 15th, 2017.

    Do you have (or want) private insurance from the ACA Marketplace, an employer, or elsewhere? What is the best option? What is an HMO? A PPO? EPO? POS?

    All of these are different types of health insurance plans that offer you more or less flexibility in choosing the healthcare providers that you see. The terms “in-network” and “out-of-network” refer to the so-called network of providers that your insurance company has agreed to work with for your plan. If you choose a plan that only allows in-network providers, make sure that your provider is part of the network before you go in for a visit because otherwise your services may not be covered and you could get a large bill! This infographic from TakeCommandHealth shows the differences between different insurance plans, but make sure to read your own policy closely to see what services are covered.

    Some people in Maine have health insurance through MaineCare but may not know what it is. What is MaineCare?  Medicaid? Medicare?

    Medicaid is government-funded health insurance for people who fit certain categories and are eligible based on income. In Maine, Medicaid is called MaineCare. What your MaineCare plan covers depends on age, family size, health care needs, and other variables. In terms of sexual and reproductive health, MaineCare covers ultrasounds, pap smears, mammograms (which you can get a referral for from Mabel’s), pregnancy, and birth control. MaineCare does not cover abortion services, but Mabel’s can help you find other ways to pay if you need an abortion and are covered by MaineCare. Check out this infographic from Maine Equal Justice Partners to see if you qualify for MaineCare. If you still have questions, you can call the Consumers for Affordable Health Care Help Line: 1-800-956-7476.

    Medicare is a federally funded health insurance program for people who are 65 or older. Medicare has 4 parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans), and Part D (Prescription Drug Coverage).

    Part A covers inpatient hospital care, and most people who are 65 or older get Part A for premium-free when they turn 65, but still are responsible for copayments, coinsurance, and deductibles.

    Part B covers doctors visits, outpatient hospital services, and other medical visits. All people who are eligible get Part B and pay a deductible and a monthly premium.

    Part C covers everything that A and B cover and most Part C plans also include prescription drug coverage (part D).

    Part D covers the cost of prescription drugs. There are many Medicare Part D plans and each has a different amount and type of drugs that they cover, so make sure to look carefully at the medications you take to ensure that you select a plan that covers them.

    If you have questions about Medicare, you can call the Eastern Area Agency on Aging: 1-800-432-7812.

  5. We support nurse practitioners and increased access to abortion care!

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    The Center strongly supports the ACLU’s lawsuit to challenge a medically unnecessary abortion restriction that burdens Maine women, especially young women, women of color, and women with low income. The current law singles out abortion as the only health care service advanced practice registered nurses (APRNs) are banned from providing, despite their rigorous post-graduate training and extensive clinical experience providing a broad range of comparable services. It prevents many qualified, trained APRNs from providing abortion, leading to a shortage of medical providers of abortion care in our communities.

     

    As Maine’s first publicly available abortion provider, and only provider of the procedure north of Augusta, we know how challenging it can be for women in rural communities to access safe, quality abortion care. If this lawsuit is successful, Mabel Wadsworth Center will be able to greatly expand the availability of abortion care in northern and eastern Maine.

     

    We also know that abortion can be provided safely and effectively by APRNs, including nurse practitioners. Numerous medical authorities ranging from the American College of Obstetricians and Gynecologists, to the American Public Health Association, to the World Health Organization have all concluded that laws prohibiting APRNs from providing first-trimester abortion services are medically unfounded.

     

    Mabel’s was founded by and has always been led by and staffed by nurse practitioners. We firmly believe in nurse practitioners’ ability to provide quality, client-centered healthcare. Co-founder Terry Marley DeRosier, certified women’s health nurse practitioner, is celebrating her 20th year of service at Mabel’s this month, and has provided exceptional healthcare in Bangor for more than three decades! Our other provider Lindsey Piper, CWHNP, has more than 15 years of experience in women’s health. She practiced abortion care while working in other states and pursued a nursing career so she could provide abortion care. Both are qualified clinicians that always put the needs of their clients front and center. They are also passionate about ensuring our clients are able to receive abortion care, prenatal care, and other sexual and reproductive health services.

    Please join us in celebrating the critical role of nurse practitioners and this proactive case to end a stigmatizing and unnecessary restriction on abortion access in Maine, and potentially open the door for other states to follow.