USPSTF turmoil, moms.gov propaganda, and modernizing Indiana's HIV laws

Hoosier Health Matters
Season 2, Episode 15
Date: 5/22/2026
Title:  USPSTF turmoil, moms.gov propaganda, and modernizing Indiana's HIV laws

0:00- Intro

1:33- Physician in charge of the Hantavirus oubreak has no public health experience but does have a podcast called "The Erection Connection"

2:30- United States Preventative Services Task Force quietly being dismantled

4:13- Marty Makary resigns as head of FDA- we now have no CDC director, no FDA director, no surgeon general

5:42- Nicole Saphier, nominee for Surgeon General, is a grifter

7:10- NIH doesn't have enough grant managers to pay out all the grants that have been awarded

8:34- Federal government had been holding up immigration visas for doctors but it looks like they are going back on that

9:38- Updates in abortion

12:08- Moms.gov is a really shitty website

14:36- New FSSA plan to attempt to reign in Indian Healthcare costs is a novel attempt to acheive this

18:30- Thoughts about legalizing marijuana in Indiana may be changing

19:57- Interview with Carrie Foote about the HIV Modernization Movement to update laws to decriminalize being HIV positive

35:00- Join Good Trouble for its annual meeting (on Zoom) on June 8!

35:53- Wrap up

This episode was edited by Elijah Bosslet.

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Transcript

Good Trouble Indiana (00:00)
No one is going to want to have a baby because JD Vance says people should have more babies. That makes me not want to have more babies.

Tracey (00:06)
Yeah, yeah.

Good Trouble Indiana (00:09)
In fact, I'm never going to have sex again.

Tracey (00:09)
No.

Just think about him and it'll ruin the moment.

Good Trouble Indiana (00:20)
Hello, and welcome to Hoosier Health Matters for Friday, May 22nd, 2026, brought to you by the Good Trouble Coalition. I'm Gabriel Baselett, pulmonary critical care physician and and founding president of Good Trouble. I'm joined as always by Tracy Wilkinson, pediatrician, health services researcher and Good Trouble board member to talk about all things public health in Indiana. Hi Tracy.

Tracey (00:40)
Hey, Gabe, how excited are you about the Indy 500 this weekend?

Good Trouble Indiana (00:44)
very excited actually. And from what I read, they dropped the blackout.

Tracey (00:49)
Yes, this is the second year in a row that they have sold out of tickets.

Good Trouble Indiana (00:53)
So that's great. People will be able to watch it, which I find really exciting because I really have gotten into motorsports the last few years.

And it always frustrated me that the Indy car race wasn't on TV. So it's great that it's on TV.

Tracey (01:07)
Yeah.

no, and we went to the race one time and I was like, OK, this is cool, but I'm probably not going to be one of those people that comes every year.

Good Trouble Indiana (01:09)
Do you watch it? Cause you're not like a big motor sports person.

Tracey (01:19)
I just, find it really overwhelming and I can't imagine taking the kids to the actual race,

Well, today we are excited to have a guest, but before we get to our interview, we want to talk about the news. Okay. So I wanted to flag a story about the hantavirus outbreak because this is kind of dominating the news as we're following this outbreak that started on a cruise ship

But we wanted to let you know that the physician who has been put in charge of this outbreak in the United States has no public health experience, but does have a YouTube show called The Erection Connection.

Good Trouble Indiana (01:53)
Brian Christine, I have no idea how this guy got this position.

Tracey (01:57)
Gabe, you're frozen.

Good Trouble Indiana (01:59)
He's a urologist and actually specializes in penile implant surgery. and he's the guy who was standing at the podium talking about the hantavirus outbreak. It's mind boggling.

Tracey (02:09)
Yeah, well, I also saw that the CDC actually fired all of its cruise ship inspectors before the hantavirus outbreak. So guess we just won't have that kind of oversight either.

Good Trouble Indiana (02:19)
it's hard to sort of say this happened because of this and put cause on it. But when you, when you decimate all of the public health infrastructure, stuff like this is going to happen.

Tracey (02:29)
I also wanted to talk about what's happening with the US Preventative Services Task Force. Similar to what happened to ACIP, which is our vaccine committee, released a new notice kind of requesting

people to self nominate or nominate individuals. And there's been like a notable shift in the description of who they're looking for from members of the USPSTF.

Good Trouble Indiana (02:51)
Yeah, this is a, this is quiet decimation of very important things. So most people don't know what the USPSTF is. It's the United States preventative services task force. It determines What screening services people should get. So if you get a colon, I'm, I've had a colonoscopy. I've actually had two. know you've had one Tracy.

That's recommended by the U.S. Preventative Services Task Force. This is a group that quietly analyzes data and makes recommendations to what screening services should be covered. This is a group that is highly respected.

It's mostly made up of primary care physicians because they're the ones who are doing most of this work. and basically they're reformulating this trying to fix something that is not only is it not broken, but it's probably the gold standard for how this should be done. it's a huge problem. they're, calling for nominees. They're, they're saying specifically that, they want to, make it.

more specialists, which is, in my opinion, probably going to make this like a committee where people advocate for their own things within their own specialty, whereas primary care looks at everything.

Tracey (03:45)
Hmm.

Good Trouble Indiana (03:55)
I mean, when you are the executive in charge of HHS, you can, you can formulate committees however you want to. So this is well within a RFK juniors

this is just as with everything else in HHS. is not moving us in a good direction.

it's just idiotic.

Tracey (04:12)
Speaking of idiots, wanted to report that Marty McCary from the FDA after there were rumors that Trump was going to fire him. I wanted to flag that part of the controversy Marty McCary is also because the anti-abortion

lobby was pissed at him that this review on the safety

of Mifepristone

was taking so long. And I wanted to tell everybody that the new interim chief had a call with the anti-abortion lobbyists and reassured them, like, you know, the day after he was put into the position that the Mifepristone safety review is his top priority.

Good Trouble Indiana (04:48)
Marty McCary was not, someone who most public health people would have chosen by any means for this position to begin with at the FDA. they've basically cleaned house at the FDA. So Marty McCary is gone. Tracy Beth Hogue is gone, who was a bad actor in COVID.

⁓ and Vinay Prasad, who we've talked about on this podcast is gone. All these are gone within the last month or so. the Washington post had a story that talked about how a lot of people think that Marty McCary was gone because he was holding up the approval of us, flavored vape products, which, the, the Washington post did a really good podcast, about this story.

that I listened to last week. And these were authorized this week, which is not great. But he was really trying to adhere to science and the fact that these are probably not great to release into the public. And that's why all of this tension aside from the Mipha Pristone stuff.

Tracey (05:41)
Yep. And then probably to nobody's surprise, we learned that the nominee for Surgeon General, Nicole Safier, also owns her own supplement company. I feel like everybody has their own supplement company. It's called

her nomination, more stuff has come out as to her stance on things. And it's quite clear she's pretty anti-vaccine, anti-abortion, and

probably doesn't believe in a lot of the public health stuff that we do.

Good Trouble Indiana (06:06)
A hundred percent. If you remember, we talked two weeks ago that, people think she may be a good, you know, nominee. Nope. Not a good nominee from a public health perspective. So I went to drop our acts. You can buy two physician formulated herbal supplements. One is called focus. One is called calm. They are two ounce bottles for $30 a piece.

and I looked back through history, she would be the first nominee for Surgeon General to be grifter and a shyster. nutraceuticals, as she likes to call these, not FDA approved. There is no data behind their use. In fact, these

really great way to create very expensive urine period. So yeah, this is not a great nominee. I will say that we are now at the point where we don't have an FDA chief. We don't have surgeon general. We don't have a CDC director.

Tracey (06:48)
Yeah. Yeah.

Yeah.

Mm-hmm.

Good Trouble Indiana (07:02)
really the most qualified physician in the white house is Dr. Oz.

Tracey (07:07)
Please don't say that out

Good Trouble Indiana (07:08)
I

Tracey (07:09)
So let's talk a little bit about some research that's come out. Gabe, I want you to talk about the study in nature about the NIH grant managers.

Good Trouble Indiana (07:17)
Yeah. So nature did has looked at sort of the grant managers at the NIH and found, there are so many grant manager positions unfilled they have asked like early career researchers to serve as volunteer grant managers, which is bonkers.

the national Institute of mental health, which is one of the NIH is institutes, projected in March that it would only be able to issue about 5 % of its new awards just because they have no one to process the grants that have been scored and gotten fundable scores, which is absolutely bonkers.

This is the quiet decimation of American scientific superiority, period, full stop. It's crazy.

Tracey (08:00)
Mm-hmm.

was a study that analyzed all of the grants that were canceled by the Trump administration in 2025. And surprising probably to nobody, they disproportionately impacted investigators that self-reported as

minoritized individuals or sexual minorities. And so this, potentially ending their research careers when they lost their grant.

Good Trouble Indiana (08:23)
Huge problem. I mean, you and I have anecdotally heard this among the people that we work with and among friends of ours, frankly, who do this

Tracey (08:26)
Yeah.

Yeah. And then I just wanted to say that there has been a lift of a hold on immigration visas for physicians that are coming into the United States. While this has been lifted, it does not necessarily mean that individuals are going to be granted green cards in time to...

for example, start residency in a few weeks or start the jobs that they have been contractually obligated to start.

Good Trouble Indiana (09:00)
So I was a fellowship program director for 15 years, which meant I ran a large program that had 21 or 22 trainees at any one time. And I can tell you that bottlenecking the visa, the physician foreign visa program is a huge problem. About 30 % of training physicians in the United States are from other countries.

and to bottleneck. This will cause major problem for hospitals. So I'm glad that they pulled this, but to even put it in place in the first place belies, an ignorance about the way the U S health system works.

Tracey (09:34)
OK, I wanted to quickly talk updates in abortion cases. Let's start with Indiana. There are two challenges right now to the Indiana abortion ban. One is our religious freedom challenge, which is continuing through the courts and is going to be heard by the Indiana Supreme Court this summer. But the second challenge we learned last week had a final kind of decision, which was really a challenge on the kind of

wording of our abortion ban on the exception for the life of the mother and really pushing this idea of life and health being broader than what is written in the law. And we learned that the Indiana Supreme Court declined to take that up, which means the lower court ruling stands and ⁓ the abortion ban is unchanged.

Good Trouble Indiana (10:18)
I don't think this ruling surprised anyone. I think that most people think that the religious freedom case is probably a stronger case, but still disappointing.

Tracey (10:26)
Yeah, really disappointing. And then as we talked about in our episode two weeks ago, there has been a lot happening at the Supreme Court of the United States regarding ⁓ medication abortion, which is Miffl-Pristone. Last week, in kind of like a dramatic moment on Thursday, a little bit after 5 o'clock, the Supreme Court announced that it was going to keep its permanent stay on the Fifth Circuit Court of Appeals ruling.

Which just means, Gabe, that the case is going back to the Fifth Circuit Court of Appeals. This case eventually will come back to the Supreme Court of the United But a lot of people think that this is just a way to kind of kick the can down the road for after midterms and while the FDA continues their safety review. Air quotes on safety review.

I also wanted to flag a study in JAMA that looked nationwide at the management of miscarriages.

and found that in states with abortion bans, there was more expectant management of miscarriages compared to states without bans that were able to use medications and procedures to complete a miscarriage. And so this is really important, Gabe, because when they talk about abortion bans, they often say this is only about abortion, but this really has data showing that it's impacting

the broader reproductive healthcare field and impacting the care people have when they miscarry.

Good Trouble Indiana (11:46)
Okay. I think that's an important point.

what this study shows is that, there's spillover from abortion care to management of miscarriages, which is not abortion care and that abortion bans are leading to poor care, less evidence-based care for patients who have had miscarriages.

Tracey (12:01)
Yep, exactly. And last, I want to talk about an amazingly horrible website that is now part of the internet. It's called moms.gov. And they debuted this website with all this excitement about all these resources that were available for women. And if you look a little closer, you'll notice that there's just a lot of stuff missing.

So they don't mention anything about pregnancy planning, contraception, or any child care, or anything about vaccines, or paid family leave, or anything like that. And instead, it's really a platform for a lot of the pro-natalist agenda that's in the government right now.

Good Trouble Indiana (12:48)
It's actually worse than that Tracy, because they do actually mention contraception in the form of fertility awareness based methods of contraception. That's all they mentioned. ⁓ Yeah, which is really quite bonkers because this is the worst.

Tracey (12:50)
Yeah

Yeah.

Yes, my bad.

Good Trouble Indiana (13:05)
form of contraception that you can choose. website does feature Trump accounts and Trump Rx ⁓ very big at the at the top. This is a very bad, very poorly done, very not scientific based website at all.

Tracey (13:08)
ahead.

Mm-hmm. Yep.

No, and you know what's scary is that they also direct users to an option line, a pregnancy option line, which is actually run by Heartbeat International, is one of the largest crisis pregnancy center organizations in the country. And they've already had data breaches of their data because they're not a health care organization and they have no requirements to keep their data safe or HIPAA compliant. So it's scary.

Good Trouble Indiana (13:47)
Can I bring up one other thing that sort of is in this orbit that we haven't talked about on the podcast? Because there's been a lot in the news recently about like talking about falling birth rates and the fact that we need people to have more babies. this moms.gov kind of just lives in that space. And it's just, you know, if you want people to have more babies, then

Tracey (13:50)
Mm-hmm.

Mm-hmm.

Good Trouble Indiana (14:09)
What the government's job there is, is to create an environment in which people are stable, secure, from a financial perspective, from a health perspective. And people are then going to just are going to want to have babies because life is good. No one is going to want to have a baby because JD Vance says people should have more babies. That makes me not want to have more babies.

Tracey (14:25)
I know.

Yeah, yeah.

OK, I also want to quickly talk about a few things in Indiana. I'm going to look to you, Gabe, because you had an amazing op-ed about Medicaid costs. there is a new plan that was just introduced

⁓ by FSSA, Indiana Medicaid to lower costs. And I'm wondering if you can explain it to us.

Good Trouble Indiana (14:51)
Yes, it's very complicated, but I'm going to try and I'm going to try to boil it down as much as I can. I'm going to be honest with you. This is a, this is novel. We're the first state to do this. We had to get a permission from the federal government to do it. they gave us that permission. They're trying to use two facts in order to change medical economics in the state of Indiana. Fact. Number one is that we have some of the highest.

healthcare costs among our hospital systems of any state in the country. And in fact, number two is we have some of the lowest Medicaid reimbursement rates by the state of any state in the country. And so what they're basically saying is, it's this very complicated, I'm gonna make it very, I'm gonna reduce it down Tracy. So people are gonna be like, oh, it's not what it is. And that's fine. I'm trying to make it easy for people to understand.

Tracey (15:35)
Okay.

Good Trouble Indiana (15:39)
they are tying Medicaid reimbursement rates to commercial insurance charges for services. So they're trying to use Medicaid.

to lower charges for people not on Medicaid, which is actually kind of smart. I'm going to be totally honest. Like this, when I read about this and dived in, dove into this, this made sense to me. So if your average charge is a certain percentage above Medicare charges, you're going to get a lower reimbursement rate for your Medicaid patients, which is a large percentage of a lot of hospital systems. There, this does several,

Tracey (16:12)
Yeah.

Good Trouble Indiana (16:14)
actually very good things. Number one, it treats rural and critical access hospitals different. So those hospitals are automatically going to get a bump in their Medicaid reimbursement rate to 158 % of what they currently get. So, and what I read was that will basically go from these hospitals losing money on all of this care to these hospitals breaking even on this care. Fine.

Tracey (16:28)
Which is good.

Good Trouble Indiana (16:38)
Then tier two is hospitals who behave well. So they keep their private charges reasonable. These hospitals will get, will move to 155 % of their current Medicaid reimbursement. Okay. And that's, remember the private, these are private charges. They're, they're basing the Medicaid reimbursement on private charges. And then the third is like a penalty box where you're, you're still charging commercial insurance is too high.

So rather than giving you 155 % of your Medicaid reimbursement, we're to give you 120 % of Medicaid reimbursement. And a lot of this money is coming from the federal government. So not only that, and I didn't get into this, but there's a matching program with fees. And so they're going to actually raise more money through that and get more federal money in. So it's actually a really interesting way to do this that I think

from my reading of this probably protects safety net hospitals, rural hospitals, et cetera. And I'm, it may be helpful. Now, I think the risk here, there's always risk with changes like this. The risk here is that sort of major hospital systems will start to cut services and stuff. ⁓ I think that's a definite risk because I think this puts, you know, this is going to require that they either reduce their

Tracey (17:49)
Mm-hmm.

Good Trouble Indiana (17:56)
commercial medical fees or that they get lower Medicaid reimbursement, which is a really interesting thing. So I don't know. It's somewhat interesting. Do you find it interesting? I don't know. It's very pretty wonky.

Tracey (18:04)
Yeah, just, well, I read

that four out of five of the largest healthcare systems already meet this. And so I wasn't quite sure I understood how this was impacting them, but maybe it's more of a rural hospital like support, focus and yeah.

Good Trouble Indiana (18:20)
I think, I think a lot of people,

this is new. This just came out last week. I think a lot of people are still trying to get their brains around this. And so we'll probably talk about this more.

Tracey (18:25)
Yeah.

Mm-hmm.

I also wanted to flag that it seems like both the governor and maybe some senators if the Indiana State House are interested in talking about legalizing medical marijuana. We are one of the only states that does not have legal medical marijuana. So I just wanted to flag some stories that I started reading that there seems to be some sign of minds around this concept.

Good Trouble Indiana (18:53)
I'm not, I think this doesn't surprise me. And part of the reason why is because all the States that surround us, have some sort of legalized marijuana and all of those States, are getting tax revenue from that. so I can remember driving to Colorado several years ago and being like, damn, their roads are really nice. And someone being like, yeah, that's all the marijuana money. Like that marijuana money has really improved our road system.

Tracey (19:10)
Mm-hmm.

Yeah.

Yeah.

Good Trouble Indiana (19:16)
So,

you know, this is a financial, we're basically losing out to our surrounding states on these taxes. And I do think this will change in the next year or two. The question will be how, you know, in what fashion does it change? Do we do just medical marijuana? Do we do recreational? I think a lot of physicians and physicians groups are kind of torn on this.

Tracey (19:33)
Mm-hmm.

Good Trouble Indiana (19:38)
in some ways, you know, I think some people do see benefits to medical marijuana. Others I think see just problems. from my perspective, I think marijuana is probably safer than some of the drugs that we have that are legal, like alcohol and tobacco. but who knows?

Tracey (19:54)
Yeah. And that's all I got for the news.

Good Trouble Indiana (19:57)
Today on Hoosier Health Matters, we're talking about a gap in Indiana law that most people don't even realize exists. Back in the 1980s and 90s, at the height of

epidemic, Indiana, like many states, passed laws that criminalized certain behaviors for people living with HIV.

These laws were created during a very different medical era before effective HIV treatment and modern transmission science. Today, we talk about HIV law modernization. Simply put, this is the movement to bring those decades old laws into the 21st century so they actually reflect modern medical looks like is Carrie Foote, a professor at IU Indy diagnosed with HIV in 1988.

and a leading advocate with the HIV modernization movement in Indiana. Kerry, thanks lot for being here.

Dr. Carrie Foote (20:41)
Thank you, very happy to be here.

Tracey (20:43)
So Kerry, to start, let's get everyone on the same page. When you walk into the state house and talk about HIV modernization, what's the core problem that you're trying to solve? And can you give our listeners an example of how Indiana's law conflicts with modern HIV science?

Dr. Carrie Foote (20:58)
Yeah, absolutely. So it's pretty straightforward. These laws were enacted decades ago. Actually, the first one was enacted the year I was diagnosed in 1988. And that was a time of great fear, a lot of stigma. There were no treatments. I was told essentially that I wasn't going to live. I only had a few years. Fast forward to today and the medical science around treatment and prevention has jumped leaps and bounds. But these laws that were enacted decades ago

based on a totally different understanding of HIV has completely changed and they just simply haven't caught up with modern science. So there's essentially two groups of laws that we're trying to modernize and one of them falls into a group that criminalizes people for allegedly not disclosing their HIV status prior to an act that could transmit HIV and the other sets of laws.

are laws that are associated with battery by bodily fluid that have increased punishment if you're living with HIV as well as viral hepatitis. So an example of what does this look like in practice?

is often people are getting into a verbal altercation and they spit on another person. Not a very nice thing to do. That's a crime in Indiana. I'm going to assume you don't have HIV. For you, it's a minor crime, a misdemeanor penalty. But for me, because I live with HIV, I spit on you in an aggressive manner,

I'm going to get a worse penalty, a felony enhancement, even though we know today spit doesn't transmit HIV. So essentially we're punishing people solely because they live with a health condition.

Good Trouble Indiana (22:35)
So Carrie, you

mentioned two laws that need updated and you described the second one. The second one was the bodily fluids one. Can you give us an example of the first one?

Dr. Carrie Foote (22:46)
Yeah, so under the alleged one with the HIV non-disclosure law, that one, it's widely variable where people are accused for not disclosing their HIV status. And the key thing here is knowledge of their HIV status is a key element of the crime. And then they have to engage in an act that can transmit HIV. And then they basically can be prosecuted under these laws.

And what we see there is in practice in some of the actual cases is often people are being accused for non-disclosure when they said they did disclose their status. Sometimes it's not safe for people to disclose their HIV status that they risk actual harm in disclosing because of the stigma that still exists around HIV. And then the other challenge is people don't understand how that HIV is not easily transmitted.

Everyone thinks that any sexual act with somebody living with HIV is automatically going to transmit HIV. But actually, HIV is not easily transmittable. It's only transmittable through very certain acts. But when people get arrested,

both people involved, the accuser, the police officers, the lawyers, they don't understand the medical science around HIV.

And we don't find any other disease where people are being criminalized because they don't disclose. So for example, someone living with herpes,

where there's no cure for herpes. It's a chronic condition just like HIV. And that can have serious health consequences, don't require people to disclose their herpes status, This is something, you know, while it might be best ethical practices to close, we don't require the criminal law to come in and have forced mandated disclosure.

because that can have incredible harms. It can create mistrust with medical providers, and we need trust. We want people to be open to talk to their providers about issues around HIV, challenges with disclosure, talk about their sexual partners. But if we have a law that potentially criminalizes them for

they might be afraid that you might call the police on them. And that's a bad thing for medical And then a lot of times it's very difficult to actually prove in a court of law, did somebody disclose? Because it's done in private quarters. There is no witness. is no, unless you have like a text message.

or you brought them to your doctor's appointment and there was a witness talking about your HIV. So it's just very difficult. So what we're trying to do is modernize that law, not to be based on HIV nondisclosure, but to be based on actual intent to harm another human being and then to engage in a behavior that could transmit HIV. And then you didn't tell that individual that you didn't. That's kind of where we're going with that particular law.

With the battery one, we just want to remove the enhancement or at a minimum bring it up to science to require substantial risk of transmission. So things like spitting wouldn't carry extra penalties for an individual.

Tracey (25:56)
Carrie, can you give our listeners a concept of how many people are prosecuted with these laws in our state?

Dr. Carrie Foote (26:03)
so in our most kind of recent data, which was actually a little bit disturbing for the battery law, which is one where we are clearly prosecuting people every single case. And there were 41 cases.

So under that one, the disturbing trend is actually the cases are increasing in recent years. And that was like, wait a minute, this is going really away from current modern science. So that one has become a priority for us because cases are actually increasing. For the HIV non-disclosure law, we've seen cases decrease

And on average in recent years, it's about two cases a year of people being charged and prosecuted for that law. Now importantly, the harm goes beyond the actual contact with the justice system. Because these laws exist, there's public health policy.

linked to the laws to inform us about the laws, which is a good thing, right? We need to know that these laws exist so we understand them But by telling us about them, we're directly stigmatizing people,

And I can't think of anything more stigmatizing to tell somebody that you are potentially dangerous, right? We think of criminals and crimes against people as a danger, and we are not a danger. My HIV status is not a danger. It's a health condition like anybody else, and nobody should be treated differently under a criminal law because of a health condition.

Good Trouble Indiana (27:27)
Carrie, you've mentioned you equals you and I wonder if you could explain that for our listeners, cause I suspect a lot of people don't understand what that means.

Dr. Carrie Foote (27:34)
Absolutely, and it's so critical. It's also hard not to tear up because I was diagnosed in a time where we didn't know about U equals U. The science wasn't there yet. The treatment wasn't there. And for many years, I lived in fear of passing on HIV to my sexual partners. You none of us want to pass on HIV Fast forward to today.

We've had successful treatments that have kept me alive and well and, you know, millions of other people living with HIV around the world since around 1998.

So what the treatment's doing is it's lowering, it's containing, it's stopping the replication of that virus in my body. It can't cure it.

but it brings it so low in my body in the fluids that can transmit HIV, blood, seminal fluid, cervical fluid, breast milk, to where when the doctors draw my blood, they can't find that. We call that undetectable. Your viral load is undetectable. What we now know with incredible research and study after study is that when a person living with HIV

has a sustained undetectable viral load, which is longer than six months, and they're taking their medication, basically they cannot transmit HIV sexually. Just remarkable. You cannot transmit. So we simply call that U equals U. And it basically, how it shows up in the HIV criminal laws is that it kind of, people are thinking HIV is easily transmittable.

Good Trouble Indiana (29:02)
Okay.

Dr. Carrie Foote (29:07)
It was already not an easy virus to transmit, but we can't even pass on HIV sexually as long as we're engaged in care.

And we need the lawmakers help because these outdated criminal laws that don't reflect all these advances in modern science, they add to stigma. And stigma is a barrier to testing and to engagement and care. And we want people to know their status and remove anything that creates a barrier to doing that.

So, you know, the undetectable science is absolutely critical. Not a lot of people still know about it, right? Because science doesn't have a publicist, right? And that's where we come in as advocates to share this great science with community, with our lawmakers.

because often their understanding is back in the 80s because they're not getting this information.

Tracey (29:57)
So are there other states that have passed modernization laws?

Dr. Carrie Foote (30:01)
Yes, so there's this has been a movement.

So right now there's about, I believe, 13 or 14 states that have either fully repealed their HIV criminal laws or have modernized them.

Good Trouble Indiana (30:12)
Kerry, you know, I think we've seen over the past 10 years that the HIV modernization movement has really gained a lot of support among places like the Indian State Medical Association, the Indiana Prosecuting Attorneys Council. Talk a little bit about building that coalition and what you see as the final hurdles to getting these modernization laws in place.

Dr. Carrie Foote (30:35)
Sure. So we were formed, and this is incredible because it's actually our 10 year anniversary that we're kind of celebrating this year. We were formed by about eight people back in 2016, almost all of us living with HIV.

who learned about the issue, saw the harms firsthand and said, we have to do something. Fast forward to today, we're nearing close to 3000 people who follow us across the state. We have a network that consists

all kinds of different folks who we've grown into this network. And then like you mentioned, state organizations that actually have lobbying power at the state house, meaning they represent large groups of people who are impacted by these laws. So the Indiana State Medical Association, they put out an actual resolution in their policy guide supporting modernization.

The biggest one, Indiana Department of Health fully supports modernization. If folks look at their policy priorities, we have to modernize these laws if we want to end the epidemic. And then the Indiana Public Defenders Council, and then most recently, the Indiana Prosecuting Attorneys Association.

Where our barrier is, is we're still facing HIV stigma and misunderstanding and lack of information among individual lawmakers. And it's hard also to sometimes get their time to educate and understand the issue,

Another challenge that we have is just the nature of the Indiana State lawmaking process. It goes so fast. They're a part-time legislator, two and a half to three months out of the year. They can only hear a certain number of bills, hundreds are filed. And

we're also a smaller issue in their mind compared to other things like housing, poverty, food insecurity, right? But we're an important issue and we're one that's solvable, very solvable. Some of these others are much more difficult. So that can be a challenge to just the nature of the lawmaking process. But over time, we've built incredible support and how we've done it, I believe is being persistent.

Good Trouble Indiana (32:38)
you

Dr. Carrie Foote (32:46)
We come back every year to the state house, talk to lawmakers, introduce a bill every year.

The science is on our side. There is no counter movement to what we're doing. There's only individual kind of beliefs, misunderstandings and that sort of thing.

Tracey (32:58)
Thank you.

Dr. Carrie Foote (33:04)
So we are definitely slowly getting there and we've seen like in the House chamber that we've passed bills, very good bills. So now it's kind of the Senate that we're working on and we're determined that we're making incredible progress.

I cannot emphasize how important it is to bring in the lived experience of the people who are most impacted. So those of us living with HIV, what does this look like on the ground? What does it look like to live with HIV today?

we have incredible bipartisan support in the state house. And we always see that this is a really, it's a public health issue. It impacts everyone. We're gonna improve public health in Indiana by modernizing these laws. And we need your help, the lawmakers. You can be key to this effort to helping us end the epidemic by modernizing the laws.

Tracey (33:53)
So Carrie, if a listener wants to get involved and support this work in modernizing Indiana's HIV criminal laws, what's the most effective way for them to get involved?

Dr. Carrie Foote (34:02)
So first I would say join us. You know, we have a slogan, change the law and the stigma. And it's very easy to join us. You can go on our website, the HIV Modernization Movement dot com. You'll see a join us button. You click on that. When you click on that, it'll do two things. It'll get you on a petition that we use when we advocate at the state house that just calls on our lawmakers to modernize our laws.

And that's how we kind of show we are indeed statewide. Also puts you on our email listserv. So you'll get updates on everything that we're doing, particularly during bill session when we have a bill, you will know what bill it is. And then you can talk to your lawmakers, just talk to them about HIV, educate yourself, tell them about U equals U, tell them about all the great prevention efforts, know, start with the basics, HIV 101, and then, you know, talk to them about the laws and tell them you're a constituent.

Tracey (34:53)
Carrie, thanks so much for joining us on Hoosier Health Matters to talk about this important topic.

Dr. Carrie Foote (34:57)
All right, thank you so much for being here.

Good Trouble Indiana (35:00)
now's the time of the podcast where we talk about things people can do or a good vibe What are you gonna do?

Tracey (35:05)
I'm going to do a good vibe. I consider Memorial Day like the official start of summer, so I hope everybody enjoys it and enjoys my favorite temperatures arriving.

Good Trouble Indiana (35:16)
I'm going to do a thing. the good trouble, coalitions annual meeting is June 8th at seven 30 on zoom. you can find the link to register for that on our website. This is where we talk about all the things we've done this year, all the things we're going to do this coming year. it's not, it's usually like 45 minutes or an hour. It's very brief.

Again, June 8th at 7.30 PM. I would ask people to go on the website and register and join us. You can see us live and well, not in person, but live and virtually.

Tracey (35:44)
Yeah, and then watch your email. We're working on a social event as well in June where you can see us in person. So if you enjoyed this episode, please subscribe, rate, and review us wherever you get your podcasts. Also email us with your thoughts and issues you think we should be covering at GoodTrouble at GoodTroubleIndiana.org. If you aren't already a GTC member, please become one by visiting our website. It's free and easy, and we promise to not overwhelm you with emails. Also consider becoming a donor. Even $20 a month helps us support and grow this work.

You can find links to join and or donate in the show notes. You can also follow us on social media, Blue Sky Facebook and Instagram. Please look for our next episode two weeks from today on June 5th, where we will continue to discuss health policy happenings at the State House and all other things public health. Thanks again for joining us. Until next time, be safe.

Good Trouble Indiana (36:31)
And be kind.