WhiteHouse.gov Blog Feed: Office of National AIDS Policy

May 19th is National Asian & Pacific Islander HIV/AIDS Awareness Day

Dr. Howard K. Koh — Fri, 17 May 2013 22:28:14 +0000

As we celebrate Asian Americans and Pacific Islanders (AAPI) Heritage Month and the many accomplishments of AAPIs, we also want to recognize that these communities still face many barriers to health and health care, including HIV/AIDS. To recognize these challenges, May 19^thhas been designated as the National Asian & Pacific Islander HIV/AIDS Awareness Day. The theme for this year’s observance is: “Saving face can’t make you safe. Talk about HIV—for me, for you, for everyone.”

According to the Banyan Tree Project which founded the observance:

“Saving face” is a common cultural concept in A&PI communities, where individuals seek to protect the family from perceived public shame or disgrace. In practice, “saving face” contributes to silence about sex, HIV, and safe sex practices. Saving face and stigma also lead to higher rates of HIV infection and a lack of knowledge about one’s HIV status.

In addition to cultural challenges, many AAPIs in the United States experience economic and language barriers that contribute to discrimination and make HIV prevention, care, and treatment efforts even more challenging.

We are working to address some of the factors that contribute to a culture of silence and to health disparities in AAPI communities. And we are using new tools and technologies to help reach those at greatest risk for, or living with, HIV/AIDS.

The U.S. Department of Health and Human Services continues to look for ways to bridge the difficulties that some AAPI individuals and communities have in accessing medical care. To that end, we recently issued enhanced National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards), which guide health professionals and organizations in delivering culturally respectful and linguistically responsive care.

The enhanced CLAS Standards recognize that health is influenced by many factors, and the standards now include race, ethnicity, language, spirituality, sexual orientation, and gender identity, among others, in the definition of “culture.” Culturally and linguistically competent health care providers can play a major role in helping AAPIs (and other racial/ethnic minorities) to understand the impact of HIV in their communities and to take appropriate actions to protect themselves and their partners from HIV infection.

One of the first steps is to take an HIV test. You can find HIV testing services near you by using the AIDS.gov HIV Testing and Care Services Locator.

Another step is to receive treatment for HIV disease, because people who are taking HIV medications are much less likely to pass the virus on to their partners. Known as “treatment as prevention,” it is a key element in stopping the spread of HIV. To ensure that treatment is available to everyone who needs it, we are also working to expand healthcare availability and options to AAPI populations. The Affordable Care Act [PDF] will help to get people at risk for, or living with, HIV/AIDS the preventive services and treatment they need and reduce health disparities in AAPI communities.

For example, the Affordable Care Act has expanded coverage of free preventive care (including HIV screening and STD prevention counseling for adults at higher risk) to an estimated 3.8 million AAPIs with private insurance. These services will help those who are living with HIV (or an STD that can increase their risk for getting HIV) but don’t know it yet to learn their status and receive treatment if appropriate. And because of the health care law, millions of Americans will have the opportunity to get affordable, quality health coverage—including people living with HIV/AIDS, who have traditionally had great difficulty in obtaining health insurance.

Beginning October 1, 2013, Americans will be able to shop for coverage that best fits their needs and budget in the new Health Insurance Marketplace. Coverage will begin as early as January 1, 2014. Sign up now for information at https://signup.healthcare.gov.

Finally, the Department continues to broaden the use of technology and social media to reach populations at greatest risk for HIV. Studies show that English-speaking AAPIs have the highest rate of cell phone usage of any racial/ethnic group, and they are more likely to have wireless access than other groups. Under the guidance of the Digital Government Strategy, we are making it easier for everyone to find information on HIV prevention, testing, and treatment when they want it and on any device they choose. Given AAPI communities’ heavy use of mobile technologies, these efforts will provide particular benefits.

As we celebrate the diversity and contributions of AAPIs this month, I encourage you to talk to your family members, friends, and colleagues about HIV and to share information with them about available resources. A great conversation-starter is the Banyan Tree Project’s Taking Root: Our Stories, Our Community video series, which chronicles the experiences of AAPI people who are living with HIV.

HIV Vaccine Awareness Day Bulletin

AIDS.gov — Fri, 17 May 2013 22:22:27 +0000

Editor's Note: This is a cross post from the aids.gov blog. You can find the original post here.

The implementation of scientifically proven HIV prevention strategies is helping to reduce the number of new infections — the annual HIV infection rate globally fell by 22 percent from 2001 to 2011 — but a great deal more must be done. Significant scale-up of proven HIV prevention strategies coupled with the discovery of new HIV treatment and prevention interventions are needed to achieve an end to the global HIV/AIDS pandemic. A safe, effective and durable HIV vaccine is an essential cornerstone to the long-term strategy to achieve this goal.

Developing a safe and effective HIV vaccine has been a long and difficult process largely because HIV has proven to be an especially tough target. Recent developments with the HVTN 505 clinical trial and analyses from the HVTN 503 “Phambili” vaccine study have been disappointing, but they also provided clear answers about investigational vaccine strategies that, ultimately, were not effective. Still, the new directions for HIV vaccines that have been recently initiated define our future path and will be pursued.

Among many projects, scientists continue to explore findings from the RV 144 HIV vaccine study in Thailand, which, in 2009, provided proof-of-concept that an HIV vaccine can afford a modest level of protection. Ongoing research related to the Thai trial is providing important information about human immune responses and other factors that may explain why the investigational vaccine protected some trial volunteers from HIV infection but not others. Such data will help advance researchers’ understanding of HIV’s structure and vulnerabilities and help guide the development of future HIV vaccine candidates. Large-scale investigational vaccine clinical trials designed to build on the RV 144 results and create a more robust and durable level of protection are expected to begin in two-to-three years in South Africa.

In basic research, scientists are making important discoveries about broadly neutralizing antibodies capable of disabling a wide range of HIV strains when tested in the laboratory setting. For example, NIAID scientists recently charted the co-evolution of HIV and a strong antibody response in an HIV-infected study participant, who is one of the 20 percent of HIV-infected individuals who naturally develops broadly neutralizing antibodies to the virus after several years of infection. Their findings could help identify which proteins to use in an investigational vaccine to induce broadly neutralizing antibodies more quickly. In another advance, a team of NIH scientists recently developed a new tool to identify broadly neutralizing antibodies from blood samples, which could help speed HIV vaccine research.

Other interesting basic research findings have included the identification of a new HIV-suppressing protein, called CXCL4, in the blood of HIV-infected individuals. NIAID scientists found that CXCL4 binds to HIV in such a way that the virus cannot attach or enter a human cell, leading to the conclusion that it may serve to regulate viral replication in an infected individual and, therefore, control the pace at which HIV disease progresses. Additionally, NIAID researchers found that even though HIV diversifies widely in infected individuals over time, the virus strains that are passed on through heterosexual transmission often resemble the strain that originally infected the transmitting partner. Learning more about the characteristics of these dominant strains could help inform HIV vaccine design.

Recent NIAID investments in basic research toward innovative HIV vaccine discovery researchand vaccine immunology and immunogen discovery should also prove fruitful in the coming years for HIV vaccine research.

On this HIV Vaccine Awareness Day, NIAID thanks the thousands of men and women who have selflessly volunteered for clinical studies and the scientists and clinicians working to find an effective HIV vaccine. NIAID shares your commitment and will continue the important research needed to make a protective HIV vaccine a reality.

Editor’s note: Please see our National HIV Vaccine Awareness Day video with Dr. Carl Dieffenbach from NIAID, NIH.

May 18th HIV Vaccine Awareness Day (HVAD): A Conversation with Dr. Carl Dieffenbach

Miguel Gomez — Fri, 17 May 2013 19:05:31 +0000

Editor's Note: This is a cross post from the aids.gov blog. You can find the original post here.

May 18th is HIV Vaccine Awareness Day (HVAD), led by the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health. We spoke to Dr. Carl Dieffenbach at NIH, who had this to say about HIV Vaccine Awareness Day:

“[On Vaccine Awareness Day] we can take a moment to acknowledge the study participants who have given their time, their energy, . . . to the study of HIV vaccines.”

Watch the HIV Vaccine Awareness Day video to hear the rest of his comments and visit the HIV Vaccine Awareness Day website for resources to help community members support the day. To learn more about HIV/AIDS and the Federal response, including information on federally funded research, visit AIDS.gov.

Miguel Gomez is Director of AIDS.gov, and Senior Communications Advisor, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

Courage, Strength, Resilience: Women Fight AIDS

Valerie Jarrett — Thu, 18 Apr 2013 13:57:00 +0000

On Monday, I attended the launch of EMPOWERED, Alicia Keys’ new campaign with Greater than AIDS to reach and inform women about HIV/AIDS, at an event hosted by the Kaiser Family Foundation. This is the second event that Alicia Keys and I have attended at Kaiser within the last year, both focused on ending AIDS.

The women were thrilled to meet Alicia Keys, and Alicia, who was deeply moved by their stories, committed to add her powerful international voice to helping to end the epidemic here in the U.S. Alicia and I intended to lift up the women. But really, it was their strength, courage, resilience, good spirit, and humor that lifted us up.

The HIV crisis touches every corner of the globe. And it’s personally touched so many of us, including here at home. We all have tragic stories about how HIV/AIDS has affected our family and friends, and these stories propel us all to continue to fight to end this disease.

Monday's event addressed one of the tragic realities of HIV in our country. The HIV epidemic continues in the United States, with about 50,000 new HIV infections each year. And while about one-quarter of new HIV infections are among women, three-quarters of new infections among women occur among black and Latina women.

The rate of new HIV infections among African-American women is 20 times higher compared with white women; among Latinas, the rate is 4 times higher.

There is no doubt: the statistics are sobering. Every part of society has a role to play in ending AIDS. On our end, President Obama has recognized the need for immediate action. Here are just a few of the steps we’ve already taken to defeat AIDS:

First, President Obama released the nation’s first comprehensive National HIV/AIDS Strategy, a blueprint for how to make greater progress in the fight against HIV/AIDS, through reducing health disparities and improving health and wellness for everyone living with HIV.

To this end, the President’s 2014 budget, which he released last week, includes over $23 billion to address HIV/AIDS in the United States, including an additional $10 million from 2012 for the Centers for Disease Control to provide critical prevention interventions. The budget also includes an additional $20 million for the Ryan White Program, named after a young man who fought discrimination and for his right to go to school, to increase access to life-extending care and treatment.

For women specifically, thousands of women at risk for and living with HIV will benefit from the Affordable Care Act. Thanks to this law, millions of women now have access to preventative services, including HIV testing, without cost sharing.

And starting next year, insurance companies are prohibited from charging women higher insurance premiums than men, or denying insurance for pre-existing conditions, including HIV infection.

We are also addressing the fact that women who live with HIV are at greater risk of experiencing domestic violence or assault. We need holistic solutions. That’s why President Obama established a working group focusing on the intersection of HIV/AIDS, Violence against Women and Girls, and gender-related health disparities.

Recently released national data included some good news– HIV infections among women dropped by 21% between 2008 and 2010, and we are hopeful that this trend continues. However, stigma and misconceptions continue to be significant drivers of HIV, keeping many from talking openly, using protection, getting tested, and starting and staying on treatment.

At a government level, we continue to address HIV-related stigma as well, which we know is a tremendous barrier to women seeking care. For example, we are aggressively pursuing cases of alleged discrimination through the Department of Justice and the Department of Labor.

In addition to the progress that the Obama Administration is making on a policy level, Monday's EMPOWERMENT launch by Alicia attests to the fact that all of us have the responsibility and ability to help end the disease. And that’s why Alicia’s campaign is so exciting.

She knows that we can reach the end of HIV/AIDS—but a key part of getting there is recognizing the power women have to turn the epidemic around. It’s no accident that during this year’s State of the Union, in the same sentence in which the President spoke of reaching an AIDS-free generation, he spoke of empowering women. We can turn the corner on the AIDS epidemic, but we will only succeed if we embrace that power.

Please learn more about EMPOWERMENT here.

FY 2014 Budget reflects the Administration’s Commitment to Implementing the National HIV/AIDS Strategy

Dr. Grant Colfax — Wed, 17 Apr 2013 21:30:25 +0000

Last week, the President sent Congress his budget for fiscal year 2014. The 2014 Budget highlights this Administration’s ongoing commitment to implementing the National HIV/AIDS Strategy. The Budget also aligns with the President’s commitment to achieving the goals of the Strategy by investing in evidence-based interventions, focusing efforts in populations most affected by HIV, and supporting vital research. The Budget is a comprehensive plan that reduces the deficit and puts the Nation on a sound fiscal course. By making strategic and science-based investments in Federal efforts to address the HIV epidemic, it will help the Nation meet the goals of the Strategy.

For details on the President’s budget and HIV/AIDS, please visit the Office of Management and Budget's website.

Grant Colfax, MD is the Director of the Office of National AIDS Policy.

National Youth HIV + AIDS Awareness Day

AIDS.gov — Thu, 11 Apr 2013 19:52:24 +0000

Ed. Note: This is a cross post from AIDS.gov. You can find the original post here.

At AIDS 2012, the international AIDS conference, youth advocates announced the inauguration of National Youth HIV + AIDS Awareness Day (NYHAAD) to be marked on April 10, 2013.

In establishing this observance, A dvocates for Youth and the eleven other founding partners are recognizing the key role of youth in our collective response to HIV. The organizers note that “the creation of National Youth HIV & AIDS Awareness Day is a step toward addressing the needs of young people in the fight against HIV and AIDS.”

On this day, AIDS.gov calls attention to previously published resources that can help inform discussion and action. These are:

Vital Signs Report: HIV Infection, Testing, and Risk Behaviors Among Youths — United States

On November 27, 2012, the Centers for Disease Control and Prevention (CDC) released data to highlight the impact of HIV among youth in the United States. Young people between the ages of 13 and 24 represent more than a quarter of new HIV infections each year (26 percent) and most of these youth living with HIV (60 percent) are unaware they are infected, according to the Vital Signs report. The most-affected young people are young gay and bisexual men and African-Americans, the report says. Among the recommendations in the report is that “all youth should know how HIV is transmitted and prevented, understand what puts them at risk for HIV, and be tested if they are at risk.”

The National HIV/AIDS Strategy

This is the nation's first-ever comprehensive coordinated HIV/AIDS roadmap with clear and measurable targets to be achieved by 2015. The Strategy notes that “To better educate the American people about HIV/AIDS, the following is needed: [3.2] Promote age-appropriate HIV and STI prevention education for all Americans: Too many Americans do not have the basic facts about HIV and other sexually transmitted infections. Sustained and reinforcing education is needed to effectively encourage people across the age span to take steps to reduce their risk for infection.”

How are you addressing the impact of HIV on youth? What would you like to say to the young people in your lives about youth and HIV? For more information on HIV and youth, visit this CDC page. For more information on NYHAAD click here.

Implementing the National HIV/AIDS Strategy Across the United States

Dr. Grant Colfax — Fri, 29 Mar 2013 16:23:52 +0000

Successful implementation of the National HIV/AIDS Strategy (the Strategy) requires ongoing collaboration among Federal, state, and local governments and key non-governmental stakeholders. As part of our ongoing efforts to support Strategy implementation, ONAP is convening community discussions across the United States. Discussions are focusing on the following key areas:

State and local efforts to concentrate resources in communities where HIV is most common and to scale-up evidence-based interventions
Interventions to improve outcomes along the “care cascade” (i.e. moving people from an HIV diagnosis to care, treatment, and viral suppression)
The importance of the Affordable Care Act implementation for HIV care and prevention

To date we have visited three cities: Miami, Florida (December 18, 2012); Los Angeles, California (February 14, 2013); and Chapel Hill, North Carolina (February 21, 2013). At each meeting, state and local public health officials, representatives from community-based organizations, advocates, and other key stakeholders convene. ONAP and other Federal partners provide information about the current state of the epidemic nationally and ongoing Federal efforts to implement the Strategy. Key stakeholders provide their perspectives on implementation efforts at the State, local, and community levels. ONAP staff also visit local clinics, community-based organizations, and academic centers to hear what these organizations are doing prevent and treat HIV. The goal is to share information, identify strategic priorities, and determine next steps for moving forward.

The partnership between the Federal government and our colleagues across the nation is bringing positive results. A common theme at each of these meetings has been a strong commitment to aligning local and State efforts with the Strategy and an excitement that, with recent breakthroughs in understanding and treating HIV, we are at a “tipping point,” where our collective efforts will turn the epidemic around. What also stands out is the dedication of public health officials, researchers, clinicians, community service providers, and volunteers working diligently to implement the Strategy. It is inspiring to see the depth of commitment to the goals of the Strategy and the ways in which people are bringing their passion and creativity—backed by evidence and data—to bear on their local epidemics.

A focus of these meetings has been on improving outcomes along the HIV care cascade . This is a priority because nearly one-fifth of persons living with HIV in the United States are unaware of their infection, while only one-quarter have a suppressed viral load. State and local jurisdictions are asking themselves: “What do we need to do, as a system, to reach out in culturally competent and accessible ways to bring people into care and treatment?” This theme came up repeatedly during our meetings and local efforts are increasingly focused on addressing this question.

It is also clear that the Affordable Care Act is and will continue to helping State and local efforts to improve outcomes along the HIV care cascade. Currently, as a result of the healthcare law, there are 71 million Americans receiving expanded preventive services coverage without cost-sharing. In 2014, about thirty million Americans will become eligible for affordable coverage options, including tens of thousands of people living with HIV. And, insurance companies will not be able to deny coverage for pre-existing conditions, including an HIV diagnosis.

Discussions have also identified areas with ongoing challenges, including: the need to reach out more effectively to vulnerable populations, including gay and transgender youth, young women of color, and homeless persons; the imperative of addressing HIV-related stigma and discrimination as key parts of our work; and the ongoing challenges of collecting accurate, timely data and using it efficiently to inform decision making. ONAP and our Federal agency colleagues remain committed to helping address these and other challenges as part of Strategy implementation.

In the two and a half years since the Strategy was released, we have made remarkable progress at the Federal, State, and local levels. We look forward to the ongoing conversation and continuing our work implementing the Strategy.

Grant Colfax, MD is Director of the Office of National AIDS Policy

Progress to Date: President’s Working Group on the Intersection of HIV/AIDS, Violence against Women and Girls, and Gender-Related Health Disparities

Lynn Rosenthal and Dr. Grant Colfax — Sun, 10 Mar 2013 17:00:24 +0000

Violence is common in the lives of women and girls living with, and at risk for, HIV/AIDS, and the Obama Administration is working to address these intersecting issues. In March 2012, the President issued a Presidential Memorandum creating the “Intersection of HIV/AIDS, Violence against Women and Girls, and Gender-Related Health Disparities Working Group”.

Sunday marks Women and Girls HIV/AIDS Awareness Day, and we are providing an update on the Working Group’s progress. As co-chairs, we are personally committed to this work, having first-hand community and clinical experience in seeing and treating the devastating effects violence has on the lives of women and their families.

The Presidential Memorandum directed select Federal agencies to improve data collection, research, and intervention strategies related to the intersection of these issues and to improve cooperation between agencies and with external partners.

During the past year, the Working Group looked at interagency coordination and the development of actionable, evidence-based recommendations. To assess current Federal efforts, members developed an inventory of programs for each agency that works in the intersection of HIV/AIDS, violence against women and girls, and health disparities.

Identifying and analyzing research was also a priority and led to two research review sessions with members of the Working Group, academic and public health experts, and other key stakeholders. In addition, the Working Group hosted two community webinars and had an online submission process to obtain individual stories, experiences, and public comments.

Both the webinars and the online submissions focused on answering questions that the Working Group was especially interested in understanding – specifically: To what extent is violence driving HIV infections and poor health outcomes among women living with HIV? What are barriers to reaching women and girls affected by HIV and violence? What further research is needed about how, where, and why violence and HIV intersect? What are model programs and promising practices for addressing the intersection of HIV/AIDS and violence against women and girls? How do we best treat HIV, address violence, and empower women who have experienced violence and other trauma? What are the best ways forward to prevent violence and HIV infection among women and girls?

After collecting information and data from a variety of additional sources, the Working Group has now concentrated its efforts on several well-defined focus areas. The Working Group will explore how, within existing resources, to best address the intersection of HIV/AIDS, violence against women and girls, and gender-related health disparities by focusing on specific areas, including:

Increasing outreach and education
Integrating HIV testing and screening for violence in medical and other settings
Improving care and treatment for women living with HIV who have experienced violence
Identifying next steps for research
Identifying interventions to evaluate or amplify
Supporting steps to increase economic stability for vulnerable women and girls
Increasing training/capacity building/technical assistance for providers

As co-chairs of the Working Group, we are committed to achieving the goals of the National HIV/AIDS Strategy and to taking the steps necessary to prevent and address violence among women and girls. The recent enactment of the reauthorization of the Violence Against Women Act (VAWA) reinforces the Administration’s commitment to this issue, establishing a foundation for sustainable action.

We are proud of our progress to date—but we also know that we have more to do. We are grateful to our partners across the Federal government and those in the field who are working to protect women and girls at risk for violence and HIV. Together, we are committed to making a difference to women and girls, to their families, and to communities across the nation.

You can learn more about National Women and Girls HIV/AIDS Awareness Day here.

Lynn Rosenthal is the White House Advisor on Violence Against Women and Dr. Grant Colfax is Director of the Office of National AIDS Policy

Prevention and Treatment of HIV Infection in Infants Born to Infected Mothers: Need for a Fresh Look

Carl W. Dieffenbach, Ph.D., Anthony S. Fauci, M.D. — Fri, 08 Mar 2013 19:43:33 +0000

On Monday, March 4, 2013, at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Dr. Deborah Persaud of the Johns Hopkins University presented an intriguing case study of a child who by all measures seems to be cured of HIV infection. This single case has sparked significant conversation, debate, and optimism. There are important questions that have naturally arisen from this case and we hope to examine some of the aspects of the research agenda that now need to be pursued. While this is an exciting case, we want to stress that it remains very important for people living with HIV/AIDS to continue their medications and to see their healthcare providers on a regular basis.

Certain of the facts are clear. An infant was born at a hospital in Mississippi to a woman unaware she was infected with HIV until she was already in labor. Having been born somewhat prematurely, the child was transferred to the University of Mississippi Medical Center, where the baby came under the experienced and skilled care of pediatrician Dr. Hannah Gay. Knowing that the mother was not previously treated for HIV infection (which put the infant at a high risk of becoming infected), Dr. Gay proceeded under the assumption that the infant had become infected. She started the infant on a three-drug cocktail of antiretroviral medications for HIV treatment, as opposed to the standard two-drug regimen for prophylaxis (prevention) of infection. Blood samples from the infant were repeatedly drawn, and lab results confirmed that the baby indeed had a detectable level of virus. Over the course of several weeks of treatment with antiretroviral drugs, the amount of virus in the child’s blood declined to undetectable levels. The child was discharged from the hospital on antiretroviral therapy that continued for up to 18 months, at which point the mother and child interrupted their medical care. Fast forward several months: the child reappeared in care after a significant lapse in antiretroviral therapy. Surprisingly, the child had no detectable circulating virus, no detectable anti-HIV antibodies, and was clinically healthy. Dr. Gay then reached out to Dr. Persaud and Dr. Katherine Luzuriaga of the University of Massachusetts to perform laboratory studies to help understand what had happened with this toddler.

Several aspects of how this case was dealt with stand out. First, the potential importance of this case was recognized immediately and some of the best laboratories in the world were brought in to help validate the laboratory data. Investigators with long-standing working relationships, some established a decade or more ago, collaborated on state-of-the-art analyses of specimens. The results from all the laboratory studies confirmed that there was no ongoing HIV replication in this child; all that apparently remained was miniscule snippets of viral material.

This case study has touched off vigorous discussions, with both agreements and disagreements about key questions -- a healthy and important part of the scientific process. For example, questions have arisen whether the child was ever truly infected in the first place, or was the virus detected in the blood stream of the infant soon after birth actually virus that was passed from the mother during pregnancy or during birth? Was the observed result due to the early treatment within 30 hours of birth, or was there something important about the intensity of the antiretroviral treatment or even some characteristic of the infant’s immature immune system?

It is essential that critically important questions are raised and ultimately addressed. This is a report of a single case, and as scientists, our goal is to confirm or refute research findings, and through this process, we also seek to fill in the missing details. There are several immediately obvious lines of research that will be pursued. First, we will work to better understand the relationship and/or difference between the virus passed to an infant from the mother and the virus produced by an infant’s infected cells during the early hours and days following exposure. Second, assuming that the immediate treatment of infants at high risk for infection could result in a possible “cure” of a truly infected infant, the risk-to-benefit ratio of starting very early 3-drug treatment (rather than 2-drug prophylaxis) for babies born under such conditions is now altered and must be discussed and possibly reconsidered. In addition, studies need to be designed and implemented to investigate the questions of timing and duration of pediatric antiretroviral treatment. In this regard, we need to examine existing cohorts of children who years ago were truly infected (or were assumed to be infected) and were treated not within hours of detection of virus but within weeks to months to determine if such cases had similar outcomes to the Mississippi child and can shed light on the timing and intensity of starting therapy. To this end, the team led by Drs. Persaud and Luzuriaga presented information at CROI on five additional children who had been perinatally infected and started antiretroviral therapy at a median of 2 months after birth. Encouragingly, in these children long-term control of HIV replication following early antiretroviral treatment has resulted in extremely low levels of virus and diminished anti-HIV immune responses.

Of course, as part of the National HIV/AIDS Strategy, as we move forward with our research agenda we must engage in serious discussions on the criteria, risks and ethics involved in all our studies, including the idea of stopping antiretroviral therapy in individuals who may be “cured. As physicians and scientists, we must first do no harm as we seek ways to improve the health of the nation and world through biomedical research.

Anthony S. Fauci, M.D. is the Director, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health.

Carl W. Dieffenbach, Ph.D., is the Director of the Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH).

The Role of Science in Helping Achieve the Vision of the National HIV/AIDS Strategy

Ronald Valdiserri — Wed, 06 Mar 2013 15:45:20 +0000

Ed. note: This is cross-posted from blog.aids.gov

While at the 2013 Conference on Retroviruses and Opportunistic Infections (CROI) this week, I was pleased to sit down with Dr. Grant Colfax, Director of the White House Office of National HIV/AIDS Policy. We discussed the role science plays in helping us achieve the vision of the National HIV/AIDS Strategy as well as some of the important findings being announced at CROI 2013 including a focus on the treatment cascade and research on next generation treatments and prevention methods. Watch our conversation below.

To read abstracts from presentations or view presentations on the topics they discussed, visit the conference website.

Ronald Valdiserri, M.D., M.P.H., is Deputy Assistant Secretary for Health, Infectious Diseases, and Director of the Office of HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services.

Addressing HIV in the Black Community

Valerie Jarrett — Fri, 08 Feb 2013 20:45:17 +0000

Ed. note: This was cross-posted from The Root.

Yesterday, on Black HIV/AIDS Awareness Day, I had the pleasure of meeting with leaders who are doing outstanding work to prevent new HIV infections and improve health outcomes for African-Americans. We shared stories and discussed the importance of engaging everyone in these efforts, including faith leaders, educators, athletes, entertainers, artists, scientists, healthcare providers as well as friends, families, and neighbors.

This approach also reflects the National HIV/AIDS Strategy, which calls for a collective response to the ongoing domestic epidemic, and sets specific goals with regard to addressing HIV-related disparities among African-Americans.

Our conversation was both sobering and inspiring. Sobering because of the challenges that remain in addressing the epidemic, including confronting the myths about HIV transmission and the virus itself. Inspiring because during our dialogue it became clear that these leaders are committed to breaking down barriers that impede our progress in preventing and treating HIV/AIDS.

Data highlight the urgency of this work. According to the Centers for Disease Control and Prevention, 1.1 million people in the United States are living with HIV/AIDS and nearly 50,000 people become infected with HIV each year. In 2010, African-Americans accounted for only 14% of the U.S. population, but 44% of new HIV infections. The majority (70%) of new HIV infections among African-Americans occur among black men, and are concentrated among gay men. In fact, young black gay and bisexual men who are the only group in the black community where new HIV infections are increasing. Black women represent 30% of new infections among African-Americans. Transgender black women are also at risk for HIV with as many as one in three in some studies diagnosed with HIV. And only 21% of black Americans have a suppressed viral load, the key health marker for HIV treatment.

Conclusive research shows that African-Americans do not engage in riskier HIV behaviors than other Americans. So why are HIV rates so high in our communities? One main reason is the lack of access to healthcare. As many as 22% of African-Americans with HIV do not know that they have the virus. Of new infections among youth, 60% are among black youth, and over half of all HIV positive youth were unaware of their infection.

Despite the sobering statistics, the group was optimistic about meeting the goals of the National HIV/AIDS Strategy. Significant advances have been made in HIV prevention and treatment – getting tested is easier than ever before, and medications have extended the lives of tens of thousands of people living with HIV. In addition, the Affordable Care Act is dramatically expanding coverage of HIV prevention services and medical care for African-Americans – in 2014, seven million uninsured African-Americans, including thousands living with HIV, will have access to healthcare coverage. Already, the Affordable Care Act has extended coverage to thousands of young adults, and has increased access to HIV testing for millions of women without cost sharing. And because of the law, insurers can also no longer turn someone away just because he or she is lesbian, gay, bisexual, or transgender.

We also discussed the ongoing importance of continuing the Ryan White Program, which provides vital care and treatment for people living with HIV who would not otherwise have access to comprehensive care.

Participants also pointed out that we must address more upstream issues, including increasing education and economic opportunity for all Americans, to turn the tide permanently against HIV.

They stressed the importance of addressing homophobia, empowerment of women and girls, and HIV-related discrimination in the broader context of our everyday lives.

We still have much work to do. Too many people have been affected and we must continue to drive our efforts forward to build healthier communities and reduce HIV-related disparities. As the day’s theme, “I Am My Brother/Sister’s Keeper,” attests, it will take the nation’s collective efforts, including on-the-ground grassroots advocacy, to reach an AIDS-free generation for all Americans. After our inspiring discussion yesterday, I am more hopeful than ever that we can reach that goal.

To read the Twitter chat Russell Simmons and I had yesterday on HIV/AIDS, please visit here. For more information, please visit aids.gov.

We Want to Hear from You

Dr. Grant Colfax and Lynn Rosenthal — Wed, 19 Dec 2012 20:49:15 +0000

As we commemorated World AIDS Day earlier this month, the importance of addressing the needs of women and girls as part of the National HIV/AIDS Strategy was clear. While we have made tremendous progress in learning how to prevent and treat HIV, including among women and girls, much work remains. Of the approximately 1.1 million people living with HIV/AIDS in the United States, about 290,000 are women and women account for 23 percent of new HIV infections.

This Administration has made combating the HIV/AIDS epidemic a priority. For women, that includes addressing gender-based violence and gender related health disparities. This violence can increase the risks women and girls face of acquiring HIV while decreasing their ability to seek prevention, treatment, and health services.

As directed by the National HIV/AIDS Strategy, federal agencies are collaborating and coordinating in an unprecedented manner to decrease new HIV/AIDS infections, improve HIV-related outcomes, and reduce HIV-related disparities. To continue this collaborative approach, President Obama issued a Presidential Memorandum in March 2012, establishing an interagency working group on the intersection of HIV/AIDS, violence against women and girls, and gender-related health disparities.

The working group includes representatives from the Departments of Justice, Interior, Health and Human Services, Education, Homeland Security, Veterans Affairs, Housing and Urban Development, and the Office of Management and Budget. We are also tapping into the wealth of expertise and experience of members of the Presidential Advisory Council on HIV/AIDS as well as our global Federal partners from the Department of State, the United States Agency for International Development, and the Gender Technical Working Group from the President’s Emergency Plan for AIDS Relief (PEPFAR).

The interagency group is charged with developing recommendations that focus on increasing public awareness of the intersection of HIV/AIDS, violence against women and girls, and gender related health disparities; sharing best practices and gender specific strategies aimed at addressing women’s risks and vulnerability to HIV/AIDS and violence; and prioritizing the needs of women of color who make up the majority of women living with and at risk of HIV infection in the United States.

Since June 2012, working group members have met regularly to pursue this mission of interagency coordination and the development of recommendations. We believe that it is critical to obtain input from as many stakeholders as possible regarding the issues the working group is addressing. So we want to hear from you.

From December 20, 2012 to January 20, 2013 you will be able to submit your individual stories, experiences, and comments to the working group by completing this online form. While we welcome any comments salient to the issue, we also ask that you consider the following questions:

1) How can we best address both violence and HIV among women and girls?
2) What are model programs and promising practices in addressing the intersection of HIV/AIDS and violence against women and girls?
3) What are barriers to reaching women and girls affected by HIV and violence?
4) What are the most effective strategies to reach women and girls who are living with violence and with HIV?

We would appreciate if you could keep you submission to under 500 words.

We are extremely grateful for your input. Your experiences and recommendations will inform our work, and we will be sure to keep you informed as we move forward.

Dr. Grant Colfax is Director of the Office of National AIDS Policy and Lynn Rosenthal is the White House Advisor on Violence Against Women.

Moving Towards an AIDS-free Generation

Gayle Smith and Dr. Grant Colfax — Wed, 28 Nov 2012 21:48:49 +0000

A red ribbon is displayed on the North Portico of the White House, Nov. 30, 2010, in advance of World AIDS Day. (Official White House Photo by Lawrence Jackson) (Official White House Photo)

What a year it has been! One year ago on World AIDS Day, President Obama announced ambitious new targets in the global fight against HIV/AIDS, and on the domestic front focused investment to support the first comprehensive National HIV/AIDS Strategy to fight the epidemic here at home. In the President’s speech that day he said: “we are going to win this fight. But the fight is not over…” As we celebrate World AIDS Day 2012, it is worth taking a moment to look back at what’s been achieved and what remains to be done to meet the goal of an AIDS-free generation.

We’re pleased to announce that the President’s commitments have translated into meaningful action over the last year and that we’re making measurable, real progress. We’ll talk about that progress in detail this week, when the White House will host an event for World AIDS Day on November 29 from 1pm-3pm, which you can watch at www.whitehouse.gov/live. We’ll discuss the results we have achieved over the last year – including towards meeting the targets set by the President one year ago, and the next steps we will be taking to turn the tide on this epidemic. Please join us!

This summer, we were reminded that HIV impacts all of us, no matter who we are or where we live. The International AIDS Conference returned to the United States for the first time in 22 years, thanks to President Obama concluding a successful bipartisan effort to end the entry ban on persons living with HIV. The Conference was an unqualified success, with new and exciting treatment and prevention research announced and representation of persons living with HIV from all regions of the world. President Obama welcomed delegates to the conference and hosted HIV-positive conference delegates and others for a White House reception. Six senior White House staff recorded powerful and personal videos on how the HIV/AIDS epidemic has impacted their lives.

The complete AIDS Memorial Quilt was also back in Washington D.C. for the first time in 16 years, and we were privileged to host panels of the Quilt in the White House.

This year the U.S. also led with our partners a successful series of reforms at the Global Fund to Fight AIDS, TB and Malaria to make the Fund more nimble and increase its impact, and we are pleased to offer our warmest congratulations to Ambassador Mark Dybul, who was named the new Executive Director of the Fund this month and who led PEPFAR from 2006-2009. We’re delighted that he’ll be at the helm of this critical multilateral partner as we seek an AIDS-free generation, and thank him for demonstrating through his work and commitment that the fight against HIV/AIDS is a bipartisan fight.

Domestically, we are making incredible strides. Ongoing implementation of the Affordable Care Act means tens of thousands of persons living with HIV will gain health coverage and access to life-extending treatment. Starting in 2014, people will not be able to be denied insurance for pre-existing conditions, including HIV. Already the Act has increased access to HIV testing and other prevention services for millions of Americans, many persons living with HIV have insurance through state-established pre-existing condition plans and AIDS drug assistance program (ADAP) contributions help people move through the Medicare part D “donut hole” more quickly. Thanks to ongoing Federal investments, the number of Americans living with HIV on the ADAP waiting lists has dropped over 95% in a little over a year. With Federal efforts increasingly focused on linking and retaining people in care and treatment, new grants have been awarded to expand this work, particularly among black and Latino communities, where HIV disparities are the greatest.

World AIDS Day is a time when we remember the friends and loved ones lost to this terrible disease. More needs to be accomplished in the domestic and global fight against HIV. But by following the science, making smarter investments, and supporting a sustained, collective response, we are making tangible progress. This week, let’s celebrate that progress, and to recommit to moving forward together.

Observing National Latino HIV/AIDS Awareness Day

James Albino — Mon, 15 Oct 2012 23:50:31 +0000

Today, we observe the 10th anniversary of National Latino AIDS Awareness Day. It is a day where we recognize how far we’ve come, but also how much more work there is to do fighting HIV/AIDS in the Latino community. In commemoration of today, Mayra Alvarez, Director of Public Health Policy in the Office of Health Reform at the U.S. Department of Health and Human Services, posted a blog discussing the sobering HIV/AIDS statistics and this Administration’s commitment to fighting HIV/AIDS in the Latino community.

To read Mayra’s post, please visit aids.gov.

James Albino is the Senior Program Manager in the Office of National AIDS Policy.

Helping Understand and Treat HIV Through Community-Based Leadership

Dr. Grant Colfax — Thu, 27 Sep 2012 19:10:58 +0000

The lesbian, gay, bisexual and transgender (LGBT) community have helped bring about much of the tremendous progress in understanding and treating HIV, ranging from increasing HIV awareness, to fighting HIV-related discrimination, to volunteering for cutting-edge research. This legacy of community-based leadership is one to note on this 5^th Annual National Gay Men’s HIV/Awareness Day.

In 2010, President Obama released the nation’s first comprehensive National HIV/AIDS Strategy, which called for aligning resources where HIV is most concentrated, and implementing evidence-based, high-impact interventions to reduce new HIV infections, improving HIV-related health outcomes, and reducing HIV-related disparities. The Strategy has focused Federal, State, and local efforts on a combination prevention approach for gay men and other populations at high risk, including increasing HIV testing and HIV treatment, because studies demonstrate that increasing diagnosis rates and reducing viral loads will significantly reduce new HIV infections in disproportionately affected communities.

The National HIV/AIDS Strategy also calls for addressing stigma and discrimination as part of a comprehensive response to the HIV epidemic. In keeping with the goals of the Strategy, the Department of Justice has taken steps to enforce civil rights laws that protect the rights of persons living with HIV/AIDS, and has launched a website dedicated to fighting discrimination against people living with HIV/AIDS.

In addition to the Strategy, the Affordable Care Act will ensure more Americans have access to affordable, high-quality health insurance and make it illegal for insurance companies to discriminate against anyone with a pre-existing condition like HIV. These changes will help gay men and other disproportionately affected populations get the coverage they need to receive comprehensive care.

This is a transformative time with regards to addressing HIV among gay men: we have made tremendous progress in aligning resources with the epidemic, increasing access to care, and addressing additional factors that contribute to HIV risk.

To fully realize the potential of these accomplishments, and to continue to fight the HIV epidemic, it will take shared commitment and leadership among Federal, State and local governments, community members, LGBT leadership organizations, and other private and public organizations. Today is a day where we recognize how far we’ve come since the early days of the epidemic while also acknowledging that there is more work to do. Through this collective effort, we will realize the goal of an AIDS-free generation.

Dr. Grant Colfax is Director of the Office of National AIDS Policy

National HIV/AIDS and Aging Awareness Day: Recognizing the Challenges of Growing Older with HIV/AIDS

Dr. Grant Colfax — Tue, 18 Sep 2012 18:29:51 +0000

Today marks the fifth observance of National HIV/AIDS and Aging Awareness Day. It is a day where we recognize that while the progress made in reducing HIV mortality and morbidity is remarkable, people aging with HIV face multiple, unique challenges. By 2015 over half of all people living with HIV in the US will be over age 50. A major reason for the ‘greying’ of HIV in the US is due to the tremendous success of medications that have dramatically increased the lifespans of people living with HIV.

About 10% of new HIV infections in the United States occur among persons over 50. HIV prevention among older adults is complicated because clinicians are less likely to consider the possibility of HIV infection in this population. Part of the reason for this is that the overwhelming majority of new HIV infections in the US occur among younger populations. However, decreased testing rates mean that older adults are more likely than younger adults to be diagnosed later in their disease progression (i.e. more likely to be diagnosed with AIDS less than a year after diagnosis).

Racial and ethnic disparities observed in the US HIV epidemic overall are reflected among older persons living with HIV. The rates of HIV/AIDS among people over 50 are 12 times higher for African-Americans and 5 times higher for Latinos compared with whites, which has implications for life expectancy as well as HIV transmission because black and Latino populations generally are less likely to have access to clinical care.

While more people aging with HIV are living healthier, more productive lives than ever before, growing older with HIV may present multiple medical challenges. Because the immune systems of people living with HIV are constantly fighting infection, they are more prone to ongoing inflammation which is associated with co-morbid conditions associated with aging such as diabetes, heart disease, hypertension, and cancer. Liver disease, often the result of co-infection with hepatitis C, is prevalent. Decreased bone density is also common, potential due to combination of the normal aging process, medication side effects, and the direct effects of the virus itself

Over the past several years, the US government has drawn attention to the issue of HIV and aging. In 2010, President Obama released the first comprehensive National HIV/AIDS Strategy for the United States. HIV and aging was among the issues outlined in the Strategy. The Department of Health and Human Services (HHS) Administration on Aging (AoA), the US Department of Veterans Affairs (VA) as well as the National Institutes of Health (NIH) have also moved the HIV and aging agenda forward.

In the past year, HHS AoA held a webinar on (The Graying of HIV/AIDS) to provide information on seniors living with HIV and seniors at risk for HIV. HHS AoA also produced and released a toolkitto inform older adults about HIV risks and to encourage older adults to know their HIV status. The VA continues to be at the forefront of HIV and research through ongoing implementation of the Veterans Aging Cohort Study (VACS). VACS, a study that includes HIV-positive as well as HIV-negative veterans, follows participants over time and evaluates the health of veterans. Much of what we have learned about HIV and aging has arisen from VACS analyses.

HIV and aging has also been a major focus at National Institutes of Health (NIH). Over the past year, the NIH has released several research funding announcements specific to HIV and aging and in July NIH released HIV and aging was one of the topic areas during the International HIV/AIDS Conference. In addition, the NIH Office of AIDS Research recently released a report on HIV and aging. The comprehensive report, based upon consultation from an expert working group, 1) summarizes knowledge and state the problem in research area; 2) identifies priority research areas; 3) points out specific knowledge gaps; and 4) suggest research to address gaps.

Progress has been made in research and programs with regard to aging and HIV, but more remains to be done. As part of the National HIV/AIDS Strategy, Federal efforts will continue to help people aging with HIV not only live longer, but maximize their health and wellness.

Dr. Grant Colfax is the Director of the Office of National AIDS Policy.

Implementation of the National HIV/AIDS Strategy: Grand Rounds at the CDC

Dr. Grant Colfax — Fri, 24 Aug 2012 16:00:53 +0000

This week, I traveled to the Centers for Disease Control and Prevention’s (CDC) headquarters in Atlanta to present at CDC’s Public Health Grand Rounds, an ongoing series of monthly presentations on health-related topics pertinent to the health of Americans.

This session consisted of four presentations directly relevant to the National HIV/AIDS Strategy (NHAS). After introductory remarks by CDC Director Dr. Tom Frieden, Dr. Jonathan Mermin presented “The Science of Optimizing HIV Prevention,” describing strategies to maximize the effectiveness of HIV prevention strategies, including integration of prevention and clinical care at the local level. Dr. Irene Hall presented “HIV Surveillance in Action,” reviewing advances in HIV surveillance that enable CDC data to be used for public health action at the provider and individual level. Dr. Stephanie Sansom followed with “Modeling to Identify Optimal Allocation of HIV Prevention Resources in a City Health Department,” focusing on how Philadelphia has used evidence-based modeling to set resource allocation priorities.

I closed the session by providing an overview of NHAS implementation, emphasizing the importance of the Affordable Care Act in helping to meet NHAS goals and improving the health and wellness of people living with HIV. These presentations are an excellent reminder of the critical ongoing role that NHAS plays in fighting domestic epidemic. To watch this month’s Public Health Grand Rounds, please visit the CDC website.

Grant Colfax is the Director of the Office of National AIDS Policy

Continuing to Fight the HIV/AIDS Epidemic

Dr. Grant Colfax — Mon, 30 Jul 2012 16:34:15 +0000

This has been an important month in the fight against HIV/AIDS: not only did we welcome people from around the world to the United States for the first time in 22 years to participate in the 2012 International AIDS Conference, but is it also the second anniversary of the release of the National HIV/AIDS Strategy. Last week, the Office of National AIDS Policy (ONAP) released the second annual report on the progress made toward achieving the Strategy’s primary goals.

As a result of the Strategy, we are we are working together and making smarter investments than ever before. It has focused and intensified Federal prevention and care resources in communities where HIV is most heavily concentrated.

President Obama has also made critical investments to expand access to HIV treatment and care. Since the President took office, domestic HIV/AIDS funding has increased by approximately $2.5 billion, and in his Fiscal Year 2013 Budget the President proposed $22 billion dollars for domestic HIV/AIDS programs.

The Affordable Care Act has already provided millions of Americans increased access to HIV testing, and will extend coverage to 30 million more Americans, including tens of thousands of people living with HIV. The Act also prohibits lifetime dollar limits on benefits, phases out annual dollar limits, and ensures no one is denied coverage based on HIV status.

Recently the Administration announced nearly $80 million in grants that will end current State AIDS Drug Assistant Program waitlists so that all people living with HIV/AIDS have access to live-saving health care and medications. Additionally, the Food and Drug Administration recently approved the first rapid HIV home test kit and Truvada, the first drug shown to reduce the risk of HIV prevention, for use as a preventive measure for people at high risk of acquiring HIV through sexual activity.

As our understanding of the HIV epidemic continues to grow, these investments, guided by the National HIV/AIDS Strategy and strengthened by the Affordable Care Act, have put us on the right path to meeting the strategy's goals and moving towards an aids free generation.

President Barack Obama talks with Grant Colfax, Director of the Office of National AIDS Policy, in the Red Room before the White House International AIDS Conference reception, July 26, 2012. (Official White House Photo by Pete Souza)

Grant Colfax is the director of the Office of National AIDS Policy.

Secretary Clinton to AIDS 2012: “We Will Not Back Off, We Will Not Back Down”

Ambassador Eric P. Goosby, MD — Thu, 26 Jul 2012 18:38:56 +0000

I don’t think it’s an overstatement to say that Secretary Clinton electrified the AIDS 2012 audience with her keynote address at this week’s conference. Her speech was a perfect combination of substance and inspiration, and the enthusiastic reception made it clear that she had hit all the right notes.

Last November, of course, she articulated the goal, made possible by recent scientific advances, of an AIDS-free generation. This laid the groundwork for President Obama’s groundbreaking announcement on World AIDS Day of ambitious new combination prevention goals for PEPFAR, including a 50% increase in our treatment goal, to 6 million by the end of fiscal year 2013.

In her remarks this week, the Secretary updated the world on PEPFAR’s progress since then. We’ve dramatically increased the pace of treatment enrollment, reaching nearly 4.5 million with treatment through the first half of this fiscal year – putting us on track to meet the 6 million goal on time. One of the other goals was to reach 1.5 million HIV-positive pregnant women with services to prevent mother-to-child transmission of HIV – and we’re on target to achieve that as well, reaching 370,000 women in the first half of FY 2012. We’ve also performed 400,000 voluntary medical male circumcisions in that same time frame – with an accelerating pace as countries come to understand what a cost-effective, smart investment it is. Looking to the future, Secretary Clinton announced that she has asked me to produce, by World AIDS Day this year, a blueprint for the next steps in America’s contribution to an AIDS-free generation.

So there was plenty of substance. But there was also much to inspire. In words that resonated powerfully with the many attendees from developing countries, the Secretary spoke about the U.S. commitment to support country leadership in the response. She was forceful about ensuring that our programs meet the needs of those who face the highest risks, including men who have sex with men, people who inject drugs, and sex workers. The audience warmly welcomed her announcement of several new PEPFAR investments in work with these groups. And Secretary Clinton did not shy away from challenging the world by asserting that AIDS is a global, shared responsibility – one that requires all nations, not only the U.S., to step up, with the Global Fund to Fight AIDS, Tuberculosis and Malaria an essential vehicle to do so.

Finally, the Secretary movingly described visiting the AIDS Quilt on the National Mall in 1996 with President Clinton. She pointed the way forward to the day “when we can stop adding names.” I believe that after today, no one doubts America’s commitment to that day when we celebrate an AIDS-free generation at last.

Eric P. Goosby is the United States Global AIDS Coordinator

How Far We've Come: Gayle Smith on AIDS

Tue, 24 Jul 2012 17:30:52 +0000

This week, the International AIDS Conference is being held in in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Gayle Smith, Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff, shares how HIV/AIDS has personally impacted her life:

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

John Berry, Director of the Office of Personnel Management
Grant Colfax, Director of the Office of National AIDS Policy
Valerie Jarrett, Senior Advisor to the President
Brad Kiley, Director of the Office of Management and Administration
Cecilia Muñoz, Director of the White House Domestic Policy Council
Tina Tchen, Chief of Staff to the First Lady

Lifting Up All Women

Valerie Jarrett — Tue, 24 Jul 2012 17:28:08 +0000

Ed. note: This first appeared in The Huffington Post

This week, the United States is hosting the 19th International AIDS Conference. As we welcome 22,000 leaders, advocates and experts from around the world with the goal of ending HIV/AIDS, I thought it was important not to forget those living with HIV/AIDS here in our home town. Among the 1.1 million people living with HIV/AIDS in the United States, African Americans make up almost half of all cases, despite representing only 14% of the U.S. population. Women comprise 23% of new HIV infections in this country, and African American women make up nearly two-thirds of these cases. Here in D.C., we have one of the highest HIV rates in the country, with 2.7% of all D.C. residents living with HIV/AIDS, and women comprise 28% of the cases. Of the 4,000 women living with HIV in D.C., 92% are African American. Compared with men in D.C., women living with HIV are still more likely to be tested later in the course of their disease, and are less likely to be linked to care.

On Saturday, R&B legend Alicia Keys and I joined the Kaiser Family Foundation and the National Black Women's HIV/AIDS Network for an inspirational meeting with a community gathering of courageous black women living with HIV/AIDS. Our goal was to lift their stories up to provide insight and guidance for our efforts to end HIV/AIDS here at home.

For so many of us, our commitment to fighting AIDS comes from the heart. Every day, I carry with me the pain of watching the excruciating death of my sister-in-law, Julie, eighteen years ago. Julie went for months without being properly diagnosed because it simply never occurred to her doctor to check for HIV. By the time she was diagnosed, it was too late. Julie left behind a devastated husband and a five-year-old daughter, Tracy. Tracy, who is now all grown up, accompanied me on Saturday.

We heard from Dr. Adaora Adimora, Professor of Medicine at the University of North Carolina, about the many social and economic factors that place African Americans at greater risk for HIV infection. Next, Dr. Lisa Fitzpatrick, an infectious disease physician, moderated a panel of five African American women all living with HIV. Their willingness to be open and candid about deeply personal experiences was truly amazing. They shared their poignant stories with grace and dignity, with the profound hope that, in so doing, we all would learn and understand their journey.

I was profoundly touched by their incredible strength and resilience as they described their fight for their health and their lives. They spoke about confronting and overcoming the stigma and discrimination associated with being HIV-positive, yet none of the women allowed HIV to define them. They revealed how and when they disclose their status and the impact doing so had on others. They reflected on dating and relationships, self-esteem, the importance of faith, and their ever growing empowerment as women in the face of adversity. They each emphasized the importance of HIV testing, and discussed their struggles to accept and embrace the need for life-extending treatment becoming a part of their daily routine. And they all spoke of being nurtured and strengthened by other women who gave them the emotional support to not just survive, but to thrive.

It is exactly this sort of community mobilization that is starting to help us turn the tide against the HIV epidemic here in D.C., where no infants have been born with HIV since 2009. Due to expanded testing efforts, people are being diagnosed with HIV earlier in the course of the infection, meaning they can take steps sooner to protect their health and the health of others. More people are accessing effective treatment earlier. For instance, the proportion of people diagnosed with HIV who entered care within three months of their initial diagnosis increased in the District by 31% between 2006 and 2010. That is real progress.

The women were thrilled to meet Alicia Keys, who was deeply moved by their stories and committed to add her powerful international voice to the epidemic here in the U.S. Alicia and I intended to lift up the women. But really, their strength lifted us up.

Valerie Jarrett is Senior Advisor and Assistant to the President for Intergovernmental Affairs and Public Engagement

How Far We've Come: Valerie Jarrett on AIDS

Mon, 23 Jul 2012 16:31:55 +0000

This week, the International AIDS Conference is being held in in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Valerie Jarrett, Senior Advisor to the President, shares how HIV/AIDS has personally impacted her life.

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

John Berry, Director of the Office of Personnel Management
Grant Colfax, Director of the Office of National AIDS Policy
Brad Kiley, Director of the Office of Management and Administration
Cecilia Muñoz, Director of the White House Domestic Policy Council
Gayle Smith: Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff
Tina Tchen, Chief of Staff to the First Lady

How Far We've Come: Tina Tchen on AIDS

Mon, 23 Jul 2012 16:29:20 +0000

This week, the 2012 International AIDS Conference is being held in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Tina Tchen, Chief of Staff to the First Lady, shares how HIV/AIDS has personally impacted her life.

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

John Berry, Director of the Office of Personnel Management
Valerie Jarrett, Senior Advisor to the President
Grant Colfax, Director of the Office of National AIDS Policy
Brad Kiley, Director of the Office of Management and Administration
Cecilia Muñoz, Director of the White House Domestic Policy Council
Gayle Smith: Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff

How Far We've Come: Grant Colfax on AIDS

Mon, 23 Jul 2012 16:21:14 +0000

This week, the 2012 International AIDS Conference is being held in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Grant Colfax, Director of the Office of National AIDS Policy, shares how HIV/AIDS has personally impacted his life:

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

John Berry, Director of the Office of Personnel Management
Valerie Jarrett, Senior Advisor to the President
Brad Kiley, Director of the Office of Management and Administration
Cecilia Muñoz, Director of the White House Domestic Policy Council
Gayle Smith: Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff
Tina Tchen, Chief of Staff to the First Lady

How Far We've Come: John Berry on AIDS

Mon, 23 Jul 2012 16:17:14 +0000

This week, the 2012 International AIDS Conference is being held in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, John Berry, Director of the Office of Personnel Management, shares how HIV/AIDS has personally impacted his life:

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

Grant Colfax, Director of the Office of National AIDS Policy
Valerie Jarrett, Senior Advisor to the President
Brad Kiley, Director of the Office of Management and Administration
Cecilia Muñoz, Director of the White House Domestic Policy Council
Gayle Smith: Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff
Tina Tchen, Chief of Staff to the First Lady

How Far We've Come: Cecilia Munoz on AIDS

Mon, 23 Jul 2012 16:05:43 +0000

This week, the 2012 International AIDS Conference is being held in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Cecilia Muñoz, Director of the White House Domestic Policy Council, shares how HIV/AIDS has personally impacted her life.

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

John Berry, Director of the Office of Personnel Management
Valerie Jarrett, Senior Advisor to the President
Grant Colfax, Director of the Office of National AIDS Policy
Brad Kiley, Director of the Office of Management and Administration
Gayle Smith: Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff
Tina Tchen, Chief of Staff to the First Lady

How Far We've Come: Brad Kiley on AIDS

Mon, 23 Jul 2012 15:56:09 +0000

This week, the 2012 International AIDS Conference is being held in Washington, D.C. The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Brad Kiley, Director of the Office of Management and Administration, shares how HIV/AIDS has personally impacted his life.

See more videos from Obama Administration officials on how their lives have been affected by HIV/AIDS:

John Berry, Director of the Office of Personnel Management
Valerie Jarrett, Senior Advisor to the President
Grant Colfax, Director of the Office of National AIDS Policy
Cecilia Muñoz, Director of the White House Domestic Policy Council
Gayle Smith: Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff
Tina Tchen, Chief of Staff to the First Lady

AIDS Memorial Quilt in the White House

Dr. Grant Colfax — Sat, 21 Jul 2012 01:34:23 +0000

The return of the International AIDS conference to the U.S. marks a moment to celebrate the American leadership and efforts that have transformed the response to the epidemic, to remember the lives lost to this disease, and to recommit to the vision of an AIDS-free generation.

One enduring symbol of the lives that have been lost is the AIDS Memorial Quilt. First started in 1987, the quilt now contains the names of more than 94,000 of individuals who have died of AIDS on more than 47,000 panels. The quilt was first displayed on the National mall in 1987. During the conference, panels of the quilt will be shown on the mall and in over 50 locations throughout the District of Columbia metropolitan area, including the White House.

Earlier this week a section of the Quilt was put on display in the East Wing, so that the hundreds of visitors that go through the halls of the building each day can stop and remember the human toll that this disease has taken, and how far we’ve come as a country in the fight against HIV/AIDS. While much work remains to be done, we all look forward to the day when there are no more panels to add to the quilt. Thanks to our collective efforts, that day is closer than ever.

As President Obama said on World AIDS Day, together we can and we will win this fight.

Grant Colfax is the Director of the Office of National AIDS Policy

President Barack Obama views a section of the AIDS quilt on display in the Booksellers area of the White House, July 18, 2012. (Official White House Photo by Pete Souza)

Turning The Tide Together

Secretary Hilda Solis — Fri, 20 Jul 2012 22:30:15 +0000

Ed. note: This is cross-posted from Work in Progress.

Next week, thousands of scientists, researchers, government leaders, public health officials and advocates from around the world will convene in Washington for the XIX International AIDS Conference (AIDS 2012). It is the first time the United States will host this important conclave in 20 years.

Much has changed in that time: new scientific discoveries, more effective treatments, and better and more effective ways to approach education and prevention of HIV/AIDS. People are living longer, healthier lives, and managing the disease.

HIV/AIDS education, prevention and medicines are working. But for me, the big question is: are people living with HIV/AIDS successfully working? And are we effectively addressing workplace issues so that they can bring their very best to the workplace?

I have always believed that work is more than a source of income. It’s a source of dignity. That’s why, as part of the week’s events, my department is co-hosting with the National Working Positive Coalition an Institute on HIV/AIDS and Employment on Saturday, July 28. We are gathering local, national and international HIV and disability stakeholders for a critical conversation about research and best practices that impact people living (and working) with HIV/AIDS.

According to the Centers for Disease Control and Prevention, about 1.2 million Americans are living with HIV. Many of these Americans proudly work in factories, hospitals, public service and other workplaces across the country. It is critical we ensure these environments are free from discrimination. We must promote the availability and use of employment and training opportunities, while educating employers, employees, and workforce professionals about work-related benefits and rights.

I believe it is essential that all people living with HIV/AIDS who want to work are able to do so. That’s why our commitment to supporting workers living with HIV/AIDS is ongoing and multi-faceted.

DOL’s Office of Federal Contract Compliance Programs enforces the employment nondiscrimination rights that are included in the Rehabilitation Act of 1973, protecting people living with HIV/AIDS who work for federal contractors. Our Wage and Hour Division enforces the Family Medical Leave Act, which provides protections for those living with a serious health condition to take time away from work because of your own HIV/AIDS status, or because you need to care for your parent, spouse, or child living with HIV/AIDS. Our Office of Disability Employment Policy, which promotes the employment of all people with disabilities, has developed a suite of specific resources and tools directed to employers, service providers and individuals with HIV/AIDS who are looking to enter or reenter the workplace. ODEP’s Job Accommodation Network also provides a resource for workplace accommodations and disability employment issues. And our Bureau of International Labor Affairs is impacting workplace and education policies across the world.

We have come so far together, turning the tide over the course of this crisis to improve and save millions of lives. As we move toward the exciting activities of AIDS 2012 and beyond, I hope you will join me to learn more and support employment for people living with HIV/AIDS.

Let’s do more to turn the tide even further. And eventually, we will reach our shared goal of a world free of AIDS.

Hilda L. Solis is the United States Secretary of Labor

Trade and Access to Medicines: Working to Make the Two Go Hand in Hand

Ambassador Ron Kirk — Fri, 20 Jul 2012 19:26:33 +0000

Ed. note: This is cross-posted from ustr.gov.

As the nineteenth International AIDS Conference kicks off in Washington, DC, experts and activists from around the world are bringing together their best ideas to fight this disease. As part of this conversation, some are taking a careful look at trade policy issues and so is the Obama Administration.

Stakeholders on all sides of this issue recognize the need to balance trade’s long-standing role in the promotion of pharmaceutical innovation through intellectual property rights with the imperative to ensure access to life-saving medicines for people around the world.

The Obama Administration is committed to developing policies that do both. We believe that we can increase access to medicines and support innovation for the development of new and improved drugs for HIV/AIDS and other diseases. And with input from the public, global health and development experts, innovative and generic drug companies, and Federal agencies that serve these sectors, the Office of the U.S. Trade Representative is working in the Trans-Pacific Partnership (TPP) – a major Asia-Pacific trade agreement now under negotiation – to get this balance right.

We all know that innovation is essential to create new tools in the fight for global health, and the President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund for AIDS, TB and Malaria, FDA, NIH and U.S. generic and innovator companies with voluntary licensing programs are demonstrating that innovation and access can thrive together with the right policies.

We have never wavered in our support for the Doha Declaration on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and Public Health, including affirming that the TRIPS Agreement can and should be interpreted and implemented in a manner supportive of WTO members' right to protect public health.

We have underscored this priority in the TPP, and stated clearly that the “TPP countries have agreed to reflect in the text a shared commitment to the Doha Declaration on TRIPS and Public Health.”

Furthermore, in the TPP we are seeking to expand U.S. exports of both innovative and generic drugs in a way that drives access to medicines in the developing world while promoting innovation.

It is a difficult balance to strike. We have heard a great deal of feedback on our early proposals -- including on the treatment of lesser-developed countries, such as Vietnam -- and are carefully reflecting upon that feedback.

We want to get the balance right and to work with the public and with our trading partners to get there. This process will take some time and, as we work over the course of the next several months, we will be very interested in additional input.

Trade alone can’t provide access to medicines. So these trade policies we are refining will go hand in hand with other approaches by the Obama Administration to encourage pharmaceutical innovation and promote access to medicines. Here are some great examples of what’s going on across the government in this regard:

Anti-retroviral drugs purchased by PEPFARare now over 98 percent generic and the Global Fund to Fight HIV/AIDS, TB and Malaria, to which the U.S. is the largest donor, also procures a high percentage of effective and low cost generic medicines to treat HIV/AIDS.
Innovative approaches by the U.S. Food and Drug Administration (FDA) to provide tentative approval for generic drugs have contributed to PEPFAR’s success. This has led to nearly 150 antiretrovirals being made available, at lower cost; as a result, the U.S. will directly support life-saving antiretroviral treatment for 6 million men, women and children worldwide by the end of 2013.
The U.S. National Institutes of Health (NIH) and co-patent owner the University of Illinois at Chicago were the first patent holders ever to share their intellectual property with the Medicines Patent Pool Foundation. President Obama leveraged our contribution and last year along with the other G-8 Leaders called on all rights holders – public and private – to consider entering into license agreements with the Foundation. USTR supported that call by citing this kind of patent-sharing practice in its 2012 “Special 301” Report.
The NIH successfully licensed a technology developed by the FDA to the international non-profit PATH to develop MenAfriVac, a lifesaving meningitis vaccine for sub-Saharan Africa. The Serum Institute of India Limited now produces that vaccine at low cost. Over 20 million people have been vaccinated in Africa’s meningitis belt at below USD $0.50 because of this effort. To replicate this success and expedite technology transfer to not-for-profit institutions with a demonstrated commitment to global health, the NIH developed a model licensing agreement which was subsequently adopted by the G8.
The U.S. Patent and Trademark Office (PTO) launched Patents for Humanity to reward companies that use patented technologies for humanitarian endeavors. Winning participants will receive vouchers for accelerated processing for select matters in front of the PTO.

With a full complement of efforts, the Obama Administration intends to ensure that access to medicines is as robust as in prior administrations, and to ensure that important programs like PEPFAR remain effective. We’ll continue to work with you to deliver on that promise.

Ambassador Ron Kirk is the United States Trade Representative.