WhiteHouse.gov Blog Feed: Office of National AIDS Policy

Commemorating National Black HIV/AIDS Awareness Day

Valerie Jarrett — Tue, 07 Feb 2012 14:00:00 +0000

On this, the 12th annual National Black HIV/AIDS Awareness Day, I remember my sister-in-law’s fight with the disease. Tragically, she did not win that fight – she left behind a devastated husband and five-year old daughter. But it is in her memory, and the memory of all the friends and loved ones we have lost, that we vow to keep working toward the day when HIV/AIDS is history.

This past December, on World AIDS Day, President Obama spoke about the United States’ commitment to ending HIV/AIDS. In a speech at George Washington University, he told the audience, “Make no mistake, we are going to win this fight. But the fight is not over … not by a long shot.”

Sadly, this is especially true in the African-American community. Black Americans represent 12 percent of the U.S. population, but they account for 44 percent of new HIV infections. Among young black gay men alone, infections have increased by nearly 50 percent in just three years, and black women account for the largest share of HIV infections among women. We each must do our part by getting tested regularly, and by educating those in our community about what they can do to help end the epidemic.

President Obama is committed to doing his part as well. In 2010, he released the nation’s first comprehensive HIV/AIDS plan. Together with Secretary Clinton, he has helped assemble a coalition of governments, healthcare professionals, and service providers. They have set a goal that would have been unthinkable just a few decades ago: an AIDS-free generation, in which virtually all children are born HIV-free, and prevention tools help them stay HIV-free throughout their lives.

Conversations on National Black HIV/AIDS Awareness Day

James Albino — Tue, 07 Feb 2012 13:45:00 +0000

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

February 7, 2012 marks the 12th year for National Black HIV/AIDS Awareness Day (NBHAAD), a national community mobilization initiative that focuses on promoting HIV education, testing, involvement, and treatment to African Americans, who are disproportionately at risk for HIV/AIDS. As part of the Federal observance of NBHAAD, I spoke with three people who are helping to lead the response to HIV/AIDS in the African American community. They included:

Dr. Kevin Fenton, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, at the Centers for Disease Control and Prevention (CDC)
Dr. Deborah Parham Hopson, Associate Administrator, HIV/AIDS Bureau, at the Health Resources and Services Administration (HRSA)
Mr. Ronald Johnson, Vice President of Policy and Advocacy, AIDS United.

Each of the interviewees had an opportunity to discuss how NBHAAD can make communities more effective in responding to HIV/AIDS.

Recognizing National Black HIV/AIDS Awareness day

James Albino — Mon, 06 Feb 2012 23:10:03 +0000

In recognition of National Black HIV/AIDS Awareness Day – February 7, Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention released the following message:

On this National Black HIV/AIDS Awareness Day, we have greater opportunity than ever before to reverse the HIV epidemic in Black America and the nation as a whole.

Today, we have a National HIV/AIDS Strategy that directs the nation to focus its prevention efforts on communities at greatest risk, including African-Americans – the racial group most severely impacted by HIV. We have an African-American community that is mobilized like never before, with many of the nation’s longstanding black national organizations making HIV prevention a key priority.

Over the past several years, we have also witnessed tremendous breakthroughs in HIV prevention that can help alter the course of the epidemic. Rates of HIV testing are growing and are at an all-time high. Yet research now shows that early treatment not only provides improved health and much longer lives for people living with HIV, but it also can reduce their risk of passing the virus to partners by 96 percent. And new prevention tools – like a daily pill – have been shown to significantly reduce the risk of HIV infection in some high-risk populations, when combined with other prevention measures.

Now despite these important advances, the fight against this disease is far from over. The harsh reality is that today, even in the face of great hope and promise, African-American communities continue to be devastated by HIV. Although only 14 percent of the U.S. population, African-Americans account for almost half of those living and dying with HIV/ AIDS in this country.

And HIV touches every corner of the black community and the impact of HIV has been especially devastating among black youth. Approximately 40 percent of new infections among blacks are now occurring among those aged 13 and 29 years. Young black gay and bisexual men are the most severely affected, experiencing a nearly 50 percent increase in new HIV infections over the past few years. In addition, HIV is now the third leading cause of death among black women in the prime of their lives – those aged 35 to 44 years.

Now to turn the tide on this epidemic, we must confront the complex social and environmental conditions that help fuel the HIV epidemic in African-American communities. Lack of access to health care plays an important role. We know that those who don’t have the means to see a doctor may not get an HIV test or HIV treatment until it’s far too late. We also know that nearly one in five African-Americans are without health insurance.

Where you live and where you choose your sexual partners also has a significant impact on your HIV risk. Higher rates of HIV that exist in black communities and the fact that African-Americans tend to select partners who are of the same race increases the likelihood of being exposed to HIV infection with each sexual encounter.

Homophobia and stigma – far too prevalent in many communities – prevents too many in the black community from getting tested, and if HIV positive, from getting treated.

HIV prevention in black communities remains one of our top public health priorities. Last year, for example, CDC invested more than half of its HIV prevention budget to fight HIV among African-Americans. We’ve expanded initiatives to reach more African-Americans with HIV testing and increased the number and reach of HIV prevention programs in black communities. We are working with our partners, like those in the Act Against AIDS Leadership Initiative, to launch campaigns and undertake activities aimed at increasing HIV testing and awareness among black women and black gay and bisexual men, among other groups.

Yet together we have much more work to do. Today, I call on the faith community, the public health and community leaders, teachers, parents and business leaders – both within and outside black communities – to maximize the powerful tools we now have at our fingertips and to work together to bring this epidemic to an end.

I also urge each of you to do your part. Get tested for HIV. If you are sexually active, use condoms consistently and correctly to protect yourself and your partners. If you are a person living with HIV, get and stay in treatment and take the necessary steps to prevent HIV transmission to your partners. You can learn more at www.actagainstaids.org. We can end this crisis. And we must remember that HIV is completely preventable. By working together, we can put an end to this epidemic in our lifetimes.

For more information, visit AIDS.gov

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

Persistence, Promise, and Hope for the End: A New Year’s Message

James Albino — Thu, 12 Jan 2012 23:08:37 +0000

Ed. Note: Cross-posted from blog.AIDS.gov

In the tumult of the holiday shopping, seasonal traffic delays, and endless bowls of eggnog, it was easy to miss the news that Science—one of the world’s leading scientific research journals—had chosen an HIV-related clinical trial as its 2011 Breakthrough of the Year. I caught that news while trying to wrap up some last-minute items, and, later, I took a moment to reflect on this announcement. This was perhaps the first time in many years that Science magazine had featured an issue related to HIV/AIDS research so prominently on its cover. I would like to highlight the importance of that piece of news and share some perspective on what it might mean for the future.

In the December 23 issue, Science said: “The year 2011 saw scientific research that stretched from the farthest reaches of the universe to the deepest mysteries of the cell. Following a yearly tradition, Science‘s editors and news staff have selected one Scientific Breakthrough of the Year and nine runners-up.” Their choice was the HPTN 052 clinical trial, an international HIV-prevention trial sponsored by the National Institute of Allergy and Infectious Diseases (NIAID).

A Focus on Women and AIDS: Nationally and Abroad

Riana Lynn — Wed, 07 Dec 2011 18:11:49 +0000

“When black women feel forgotten, even though they account for most of the new cases among women, then we’ve got to do more." --President Obama, December 1, 2011

December 1 marked World AIDS Day, a time to remember those that have been affected by the HIV/AIDS epidemic over the past 30 years. Today, we must also continue to recognize and push forth the efforts to aid individuals affected across the globe. In recent years, we have seen success in programs such as the President’s Emergency Plan for AIDS Relief, but we must remember the toll this disease takes on our women, and ultimately our communities. Although rates of HIV/AIDS have been decreasing across many countries, there are many factors that have kept women and girls at risk. Globally, many prevention efforts and treatments still need to be successfully implemented in order to change uneven progress in the health of the world’s women and girls. With the world facing many battles, young women in many parts of the world are still becoming infected with HIV/AIDS. As of today, HIV is the leading cause of death and disease among women aged 15 to 49 years worldwide. Domestically, rates in many communities continue to effect women disproportionately, in better words: we’ve got to do more. President Obama and his Administration are committed to solving the AIDS crisis; an epidemic that has put women, and their families, at great risk.

During his speech at an event called “The Beginning of the End of AIDS,” at George Washington University, marking World AIDS Day, the President announced that the Administration is directing $50 million in increased funding for domestic HIV/AIDS treatment and care. The data shows a clear need for this increase in funding. According to 2009 HIV surveillance data by the Centers for Disease Control, women represented 24% of all diagnoses of HIV infection among United States (US) adults and adolescents in 40 states. Black and Latina women are disproportionately affected at all stages of HIV infection compared with women of other races/ethnicities. At some point in her lifetime, 1 in 139 women will be diagnosed with HIV infection; with Black and Hispanic/Latina women at higher risk than women of other races/ethnicity.

Over the past several years, the global HIV/AIDS epidemic has been met with increasing efforts across the international community and shown great potential. As stated by the Office of Women’s Health, numerous initiatives to promote prevention and treatment efforts have been implemented by governments and organizations worldwide. They have also noted that, in 33 countries, HIV incidence has dropped by more than 25 percent over the past decade; 22 of those countries are in sub-Saharan Africa. Even with these improvements, we must remember that challenges still remain.

Getting to Zero on World AIDS Day

Thu, 01 Dec 2011 20:02:12 +0000

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President Obama today marked World AIDS Day, speaking at an event called "The Beginning of the End of AIDS" where he outlined the progress that has been made in the global fight against the pandemic:

Because we invested in anti-retroviral treatment, people who would have died, some of whom are here today, are living full and vibrant lives. Because we developed new tools, more and more mothers are giving birth to children free from this disease. And because of a persistent focus on awareness, the global rate of new infections and deaths is declining. So make no mistake, we are going to win this fight.

AIDS has claimed 30 million lives over the past three decades, and while the rate of new infections is going down in many countries, the President acknowledged that it is not declining in America:

The infection rate here has been holding steady for over a decade. There are communities in this country being devastated, still, by this disease.

When new infections among young black gay men increase by nearly 50 percent in 3 years, we need to do more to show them that their lives matter. When Latinos are dying sooner than other groups, and when black women feel forgotten, even though they account for most of the new cases among women, then we’ve got to do more.

So this fight is not over. Not for the 1.2 million Americans who are living with HIV right now. Not for the Americans who are infected every day. This fight is not over for them, it’s not over for their families, and as a consequence, it can’t be over for anybody in this room -- and it certainly isn’t over for your President.

President Barack Obama delivers remarks on World Aid's Day event at George Washington University in Washington, Dec. 1, 2011. (Official White House Photo by Lawrence Jackson)

The President announced that he is directing $50 million in increased funding for domestic HIV/AIDS treatment and care -- an additional $15 million for the Ryan White program for HIV medical clinics across the country. and an additional $35 million for state AIDS Drug Assistance Programs. He also pledged that America will continue to be a leader in the global fight against the pandemic:

Now, as we go forward, we’ve got to keep refining our strategy so that we’re saving as many lives as possible. We need to listen when the scientific community focuses on prevention. That’s why, as a matter of policy, we’re now investing in what works -- from medical procedures to promoting healthy behavior.

And that’s why we’re setting a goal of providing anti-retroviral drugs to more than 1.5 million HIV-positive pregnant women over the next two years so that they have the chance to give birth to HIV-free babies.

We’re not going to stop there. We know that treatment is also prevention. And today, we’re setting a new target of helping 6 million people get treatment by the end of 2013. That’s 2 million more people than our original goal.

Today’s event was sponsored by the ONE and (Red) campaigns and also featured remarks from Presidents George W. Bush and Bill Clinton, via satellite.

Musician Bono, center, listens as President Barack Obama delivers remarks at a World AIDS Day event at George Washington University in Washington, D.C., Dec. 1, 2011. (Official White House Photo by Pete Souza)

New Update: Registering for the NHAS Implementation Dialogues

James Albino — Thu, 20 Oct 2011 14:26:15 +0000

In earlier blog posts we outlined the topic and format for a series of regional dialogues that the White House Office of National AIDS Policy will convene to focus attention on issues related to implementation of the National HIV/AIDS Strategy. These events will be a forum for Federal, state and local agency representatives, researchers, clinicians, the HIV community, and leaders from the business, foundation, faith and media sectors to share their diverse expertise, and collaborative experience.

The events are free, open to the public, anyone can attend. To help us better plan each event we ask that you register in advance for each of the events that you are interested in attending. You may register for as many events as you wish to attend.

Using National Latino AIDS Awareness Day (NLAAD) to Redouble Our Efforts to Respond to the HIV Prevention and Care Needs of Latinos

James Albino and Miguel Gomez — Sun, 16 Oct 2011 20:58:16 +0000

According to CDC estimates, 9,400 Latinos in the United States were newly infected with HIV in 2009. Latinos make up 16% of the U.S. population, but approximately 20% of new infections. Sixty-four percent (or nearly two-thirds) of all HIV infections in the Latino community occur among gay and bisexual men. Among women, 1,700 heterosexual Latinas became infected in 2009, making them more than four times more likely to become infected with HIV than white women.

As Latinos working to support the National HIV/AIDS Strategy (NHAS), we see our families and friends living with HIV and some who are newly infected, and we look at these numbers with a sense of both sadness and urgency. In this 30th year of the AIDS epidemic, it is completely unacceptable that HIV infection rates among Latinos are so high.

National Latino AIDS Awareness Day (NLAAD) gives us an opportunity to re-examine the impact of the HIV/AIDS epidemic on Latinos, and to redouble our efforts to find effective ways to respond to the epidemic in the U.S.

The NHAS is helping us to do this by requiring us to focus on three important goals: reducing HIV incidence; increasing access to care and improving health outcomes for people living with HIV/AIDS; and reducing HIV-related health disparities. The NHAS also calls on all of us to target our collective efforts at the populations at greatest risk. Latinos are not only disproportionately impacted, they also tend to be diagnosed later in the course of their HIV infection—meaning that they are more likely to develop AIDS within a year of their diagnosis. According to the National Institute of Allergy and Infectious Diseases, Latinos progress more quickly to AIDS after an HIV diagnosis than any other U.S. racial or ethnic group. Exciting new research data has been published this year showing how effective HIV treatment can be at stopping HIV transmission and current drugs are helping HIV positive individuals lead long and healthy lives. If Latinos are being diagnosed with advanced HIV infection and are quickly progressing to AIDS, they are missing important opportunities to get the maximum benefits of the highly effective treatments we currently have available.

Seattle Meeting Focuses on Ideas to Strengthen the HIV Workforce

Chantelle Britton — Wed, 12 Oct 2011 19:06:39 +0000

On October 4, 2011, the Office of National AIDS Policy (ONAP) hosted the second in a series of five Implementation Dialogues in Seattle Washington at Swedish Medical Center. The theme for this meeting was “Building Capacity Within the HIV Workforce so that it Delivers What We Need Today and Tomorrow”. The meeting was an opportunity to focus attention on the multi-faceted challenges we face with the HIV workforce, spark conversations around this issue, and encourage action and collaboration at the State and local levels. The meeting began with a Federal update, followed by a presentation on HIV workforce issues, a panel discussion, and a discussion between the panel and the audience, which included policy makers, academic experts, clinicians, providers, community advocates, patients, and other health professionals.

ONAP Director Jeffrey S. Crowley opened the meeting with remarks about the challenges we face with the HIV workforce and opportunities made available in the Affordable Care Act to bolster the workforce of clinicians and other health care providers. Dr. Todd Strumwasser, Vice President of Medical Affairs at Swedish Medical Center, provided opening remarks and emphasized that this meeting was a way to reaffirm our collective commitment to focus more attention on the domestic epidemic in our communities and around the country. Dr. David Spach, the Principal Investigator for the Northwest AIDS Education and Training Center at the University of Washington, gave an informative presentation on the key factors contributing to HIV workforce shortages in the nation. Dr. Spach focused on several key issues regarding the workforce supply, including the lack of exposure to an HIV curriculum during a medical student’s academic or residency training; the complexity of providing HIV care; the financial disincentives faced by medical students and medical residents; the competition between global HIV health work and domestic HIV health work; and the reluctance of some individuals to work with people living with HIV. Dr. Spach’s provided several recommendations that could be adopted to expand the HIV workforce, including the importance of active recruiting during a clinician’s medical school training or during their residency; increasing the amount of pilot programs for recruitment; supporting mentorships and building relationships between current HIV clinicians and future clinicians; providing innovative financial incentives for clinicians; and developing more programs that increase provider diversity.

Birmingham Kicks Off First of Five Fall Implementation Dialogues on the NHAS

Joan Romaine — Fri, 07 Oct 2011 15:15:22 +0000

The first of a series of five Implementation Dialogues was held on September 27 in Birmingham, Alabama, at the University of Alabama at Birmingham’s Alys Robinson Stephens Preforming Arts Center. The meeting focused on “Incorporating Prevention and Care Research Into HIV Programs” brought together speakers and panelists from across federal, state and local government, as well as experts from the HIV/AIDS community and research areas. Jeffrey S. Crowley, Director of the Office of National AIDS Policy (ONAP) welcomed the more than 150 guests, and thanked them for their work in support of the National HIV/AIDS Strategy. UAB President Carol Garrison, and Dr. Howard Koh, Assistant Secretary for Health, U.S. Department of Health and Human Services also spoke. Dr. Koh encouraged participants to make the National HIV/AIDS Strategy real in the southeast and around the country. He recalled the early days of the AIDS epidemic thirty years ago, and the extreme fear and stigma surrounding the treatment of the first patients, and the challenge of providing care with no plan or coordinated approach in place. He noted that while there is still a great deal of stigma and health disparities around HIV/AIDS, there is now a plan of action in the National HIV/AIDS Strategy, which he said has, “catalyzed the country”.

Mobilizing Public and Private Sector Investments to Support Critical HIV Services

Joan Romaine and James Albino — Thu, 06 Oct 2011 18:25:40 +0000

The White House Office of Social Innovation and Civic Participation and the Office of National AIDS Policy held a joint meeting on Friday, September 9th on “Mobilizing Public and Private Sector Investments to Support the Goals of the National HIV/AIDS Strategy,” in which 25 members from the private sector and philanthropic community gathered to discuss ways to enhance existing support and investments targeted at HIV/AIDS prevention, care and treatment, as well as to strategize on ways to bring new people to the table to foster new investments and commitments.

Office of National AIDS Policy (ONAP) Director, Jeffrey Crowley welcomed guests and reiterated the President’s message that the Federal government cannot do this essential work alone. At this “all-hands-on-deck” moment, we must work together in new ways to make lasting progress on persistent social problems. Marta Urquilla, Senior Policy Advisor in the Office of Social Innovation and Civic Participation, explained how the Social Innovation Fund (SIF), which invested in AIDS United as part of its inaugural portfolio in 2010, reflects a new way of doing business for the federal government. The SIF invests in intermediaries to identify promising community solutions that are achieving results and support the growth, validation and scale of those innovations. A vehicle for public-private investment, the SIF leverages 3 private dollars for every 1 Federal dollar, and drives capital to communities in need, including those that are historically under-resourced.

Addressing the HIV Epidemic among Gay and Bisexual Men

Kevin Fenton — Tue, 27 Sep 2011 13:00:00 +0000

In 1981, our nation and its public health system were grappling with a new disease that was taking the lives of gay men across the United States. Thirty years later, HIV/AIDS continues to be a crisis among gay and bisexual men. The latest data show men who have sex with men (MSM) remain most affected in this country. Although MSM represent 2% of the population, they account for 64% of all new infections (including 3% among MSM who are injection drug users [IDUs]). CDC estimates that there were more than 30,000 new HIV infections in 2009 among MSM, including MSM-IDU. Though the numbers have gone down dramatically, approximately 7,000 MSM with an AIDS diagnoses still die each year and nearly 300,000 MSM with AIDS have died since the beginning of the epidemic.

Today, we commemorate the fourth annual National Gay Men’s HIV/AIDS Awareness Day, an observance founded by the National Association of People with AIDS to raise awareness of the HIV/AIDS epidemic among gay and bisexual men. This annual observance is one way we are focusing attention and resources on those populations at highest risk for HIV infection, including gay and bisexual men. This focus is a top priority outlined in the National HIV/AIDS Strategy (NHAS).

National HIV/AIDS and Aging Awareness Day: A Perspective from the National Institutes of Health

Paolo Miotti and Scott Proestel — Fri, 16 Sep 2011 16:31:52 +0000

On September 18, 2011, we mark the fourth observance of National HIV/AIDS and Aging Awareness Day. The remarkable success of antiretroviral therapies in prolonging the lives of HIV-infected individuals who have access to and can tolerate these drugs has led to many more HIV-infected people living into middle and old age. In 2008, an estimated 29 percent of HIV-infected adults in the U.S. were at least 50 years of age, and in 2009, individuals in that age group accounted for 17% of all new HIV diagnoses. Both of these percentages have been increasing in recent years. As the benefits of improved therapies for HIV continue to accrue, research into the complex relationship between aging and HIV becomes increasingly critical.

A major goal of HIV and aging research at the National Institutes of Health (NIH) is to achieve greater understanding of how premature aging of the immune system may be occurring in people living with HIV, and clarifying the fundamental mechanisms of inflammation. Understanding the complex interaction between HIV and aging will require considerable effort on multiple fronts. The NIH Institutes and Centers support a broad range of research on HIV and aging. For example, this past April, three NIH Institutes (National Institute on Aging, National Institute of Mental Health, and the National Institute of Neurological Disorders and Stroke) announced that they will fund research into the effects of HIV on the brain in aging populations taking antiretroviral therapy. Within the National Institute of Allergy and Infectious Diseases (NIAID) programs, research on HIV and aging is ongoing in the Women’s Interagency HIV Study (WIHS) and the Multicenter AIDS Cohort Study (MACS). These long term follow-up studies of HIV infected women (WIHS) and men (MACS) have defined some of the important differences in HIV risk, pathogenesis and treatment response between the sexes. The International Epidemiologic Database to Evaluate AIDS (IeDEA) provides domestic and international information about the epidemic including pathogenesis differences between HIV infected adults who are growing older and newly infected older individuals. In addition, studies conducted by the Centers for AIDS Research (CFAR), AIDS Clinical Trials Group (ACTG), and the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) are pursuing HIV and aging-related scientific questions.

Latest Update: Registering for the NHAS Implementation Dialogues

James Albino — Tue, 13 Sep 2011 16:23:47 +0000

NHAS Implementation Dialogues

In two earlier blog posts we outlined the topic and format for a series of regional dialogues that the White House Office of National AIDS Policy will convene to focus attention on issues related to implementation of the National HIV/AIDS Strategy. These events will be a forum for Federal, state and local agency representatives, researchers, clinicians, the HIV community, and leaders from the business, foundation, faith and media sectors to share their diverse expertise, and collaborative experience.

Registering for the Events

Upon submitting your registration, you will receive a detailed confirmation letter via email.

Dialogue Topics and Locations: Updated September 12, 2011

We are planning five dialogues on distinct topics related to implementing the Strategy.

Incorporating Prevention and Care Research Into HIV Programs

Date:         Tuesday, September 27, 2011
Time:      2:00 – 4:30 pm
Location:     Alys Robinson Stephens Performing Arts Center, University of Alabama, B 1200 10th Ave. S. Birmingham, AL

Building Capacity within the HIV Workforce so that it Delivers What We Need Today and Tomorrow

Date:         Tuesday, October 4, 2011
Time:          5:30 – 8:00 pm
Location:     Swedish Medical Center, Glaser Auditorium, 747 Broadway, Seattle, WA

Sustaining the Community-Based Response to HIV

Date:       Thursday, October 20, 2011
Time:       3:00 – 5:30 pm (new time)
Location:   University of Pennsylvania, Jon M. Huntsman Hall, Dhirubhai Ambani Auditorium, 3730 Walnut Street, Philadelphia, PA

Fostering Collaboration Between all Public and Private Stakeholders at the State and Local Level

Date:          Tuesday, October 25, 2011
Time:         6:00pm-8:30pm
Location:   Manship Theatre at the Shaw Center for the Arts, 100 Lafayette Street, Baton Rouge, LA 70801

Maximizing Impact in Low-Prevalence Jurisdictions

Des Moines, Iowa (Early November 2011)

Additional dates, times, locations will be announced soon. Please continue to check the ONAP and AIDS.gov websites for more information.

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

Update: National HIV/AIDS Strategy Implementation Dialogues

James Albino — Thu, 01 Sep 2011 19:35:36 +0000

Our Federal partners, as well as so many community members, people living with HIV, funders, businesses, faith leaders and other stakeholders have demonstrated encouraging support and enthusiasm for the implementation of the National HIV/AIDS Strategy. Perhaps one of the most encouraging developments has been the way the NHAS has helped steer the national HIV conversation in the direction of the Strategy’s goals. States and local jurisdictions have already begun the process of developing their own Strategy and implementation plans.

NHAS Implementation Dialogues: To sustain this effort the Office of National AIDS Policy will convene a series of regional dialogues to focus attention on issues related to implementation of the Strategy. These dialogues will serve as a forum for Federal and state agency representatives, researchers, clinicians, the HIV community, and leaders from the business, foundation, faith and media sectors to share their diverse expertise, and collaborative experience.

We are planning five dialogues on distinct topics related to implementing the Strategy. Here are the updated dialogue topics and locations:

Announcing National HIV/AIDS Strategy Implementation Dialogues

James Albino — Tue, 16 Aug 2011 18:07:27 +0000

As we shared in our blog last month, significant progress has been made in implementing the National HIV/AIDS Strategy (Strategy) in its first year. We are proud of the enthusiasm, support and contributions of our Federal partners, as well as so many community members, people living with HIV, funders, businesses, faith leaders and other stakeholders.

As these stakeholders have demonstrated, the success of the Strategy doesn’t lie in the hands of the Federal government alone. One of the most encouraging developments over the last year has been the manner in which the Strategy has served to steer a conversation about HIV in the direction of the strategic steps that individuals, communities, states, and the Nation need to take to achieve the Strategy’s goals. In various state and local jurisdictions across the country, agencies have either developed their own Strategy implementation plans, or they have started the process of doing so. Additionally, numerous HIV services and advocacy organizations have held meetings and community dialogues about what the Strategy means for their own communities. These actions are critically important and must continue.

White House Commemorates World Hepatitis Day 2011

Ronald Valdiserri — Thu, 28 Jul 2011 20:43:37 +0000

Today, I was honored to participate in a special White House event to commemorate the first official World Hepatitis Day. This event was one of many held across the United States and around the world for communities to join together and focus attention on the global health threat of viral hepatitis and promote actions to confront it.

Worldwide, one in twelve persons are estimated to be living with viral hepatitis and about one million people around the world die every year because of viral hepatitis. Many people infected with viral hepatitis are unaware of their status, and as a result, may unknowingly transmit the infection to others. Without knowing their status, these patients also face the possibility of developing otherwise preventable debilitating or fatal liver disease. Last year, in recognition of this “silent epidemic,” the World Health Assembly resolved that July 28 should be designated as World Hepatitis Day, providing an opportunity to increase awareness and understanding of viral hepatitis and recognize it as a major global health problem. The theme for this first official World Hepatitis Dayis “This is hepatitis... Know it. Confront it. Hepatitis affects everyone, everywhere.”

In the United States, an estimated 3.5-5.3 million persons are living with hepatitis B or hepatitis C virus. Viral hepatitis impacts Americans of all backgrounds but affects some U.S. populations more than others. Half of all hepatitis B infected persons in the U.S. are Asian Americans and Pacific Islanders; African-Americans are twice as likely to be infected with hepatitis C when compared with the general population. To actively address these disparities and to accelerate our efforts to fight viral hepatitis, the U.S. Department of Health and Human Services (HHS) developed an Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. The plan outlines actions to increase viral hepatitis awareness and knowledge among health care providers and communities, and steps that will improve access to quality prevention, care, and treatment services for viral hepatitis. Improved coordination across HHS, along with the active engagement of other governmental and nongovernmental partners—including informed communities—will be crucial to our success.

Today’s World Hepatitis Day Event was hosted by the White House Office of National AIDS Policy with active support from the HHS Office of the Assistant Secretary for Health. Dr. Howard K. Koh, the Assistant Secretary for Health, emphasized that marking this day in such a special way provides an opportunity to reaffirm our collective commitment to focus more attention on this pressing public health issue. Dr. Koh was among the dignitaries who provided opening remarks at the event and read a World Hepatitis Day proclamation on behalf of President Obama. I was pleased to then hear from several members of Congress, including Representatives Bill Cassidy, Judy Chu, Michael Honda, Hank Johnson, and Barbara Lee, who have been leaders in raising hepatitis awareness. I moderated a panel that highlighted opportunities across the federal government to implement the HHS Action Plan for Viral Hepatitis. This discussion was followed by a session led by health care providers and patients living with viral hepatitis who shared their individual experiences with fighting viral hepatitis. Mr. Jeffrey Crowley, Director of the White House Office of National AIDS Policy, provided a closing statement to the audience, which included government leaders, policy makers, community advocates, patients, and health professionals.

To learn more about World Hepatitis Day or about viral hepatitis visit the CDC’s website. Also, read the Presidential Proclamation–World Hepatitis Day.

Ronald Valdiserri, M.D., M.P.H. is the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services

The National HIV/AIDS Strategy at One Year

Jeffrey Crowley — Wed, 13 Jul 2011 15:09:31 +0000

It’s been one year since we launched the first comprehensive National HIV/AIDS Strategy and today we are releasing an implementation update to keep you up to speed on the latest work. We plan to release a more comprehensive progress report after the conclusion of the calendar year, but as we mark this critical first year, we wanted to provide some reflections on key first-year achievements.

The Strategy details President Obama’s three goals: 1) reduce the number of new HIV infections, 2) increase access to care and improve health outcomes for people living with HIV, and 3) reduce HIV-related health disparities. Our mission is for the United States to become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination. As you will see from the report, agencies throughout government are stepping up to the plate and stakeholders from all sectors are taking action.

President Barack Obama holds meeting on AIDS policy with members of the Domestic Policy Council in the Oval Office, July 12, 2011. Participating in the briefing with the President are, from left: Greg Millett, Senior Scientist and HHS/CDC Liaison to the Office of National AIDS Policy; Domestic Policy Council Director Melody Barnes; Jeffrey Crowley; Director of the Office of National AIDS Policy; and Senior Advisor Valerie Jarrett. (Official White House Photo by Pete Souza)

Ultimately, for the Strategy to be truly successful, we need you. The Strategy isn’t about what government can do alone. We know that businesses, the faith community, and all sectors have a role to play. The following video above everyday leaders implementing the strategy in their own communities. We hope that you can use this to engage more people in our collective efforts to implement the Strategy and energize key partners to continue their efforts. Go to AIDS.gov to receive more information and take action.

We thank everyone that has worked with us so far, and we look forward to new and productive collaborations over the coming year.

Download the National HIV/AIDS Strategy Implementation Update.

Jeffrey Crowley is the Director of the Office of National AIDS Strategy.

National HIV Testing Day 2011

Thomas R. Frieden — Mon, 27 Jun 2011 16:29:25 +0000

Note: Today President Obama issued a statement on National HIV Testing Day

Thirty years ago, at the beginning of the HIV/AIDS epidemic, there was no test for HIV, the virus that causes AIDS. For many, there was only the long and worrisome wait for the signs of infection. Once those signs appeared, no treatment for the virus was available. I personally cared for many, many patients in this era, and I am thankful that those days are over. Today, HIV testing is accurate, widely available, and often free—and treatment can help people living with HIV enjoy long, healthy lives, especially when they get diagnosed early.

The good news is that more people are being tested for HIV than ever before. It is estimated that almost 83 million American adults between 18 and 64 have been tested for HIV, as of 2009. That’s an increase of more than 11 million from 2006 when the Centers for Disease Control and Prevention(CDC) recommended that HIV testing become a routine part of medical care for adults and adolescents.

Inspiration for a Future Free of HIV

Ambassador Eric Goosby — Thu, 23 Jun 2011 17:42:28 +0000

This week, First Lady Michelle Obama is visiting South Africa and Botswana, focusing on youth leadership, education, health and wellness. Today, Mrs. Obama met with organizations dedicated to combating HIV/AIDS in South Africa, including groups that use soccer to convene and educate children about HIV/AIDS. Tomorrow, she will meet with a Teen Club in Botswana that teaches teens about leadership and how to educate others about HIV.

During her meetings with African youth, Mrs. Obama is highlighting the importance of youth leadership in fighting HIV/AIDS. These young men and women grew up watching family members and friends taken by this devastating virus. But today they know there is hope. They have seen dramatic change in recent years – thanks to strong leadership from their Government with support from the American people – where people who were once dying are now living. These youth can be the generation that ends HIV/AIDS.

The United States is proud to be supporting South Africa, Botswana and countries around the world in leading their fight against HIV/AIDS. In South Africa, there are more than one million people on life-saving HIV treatment today, a far cry from the 50,000 people on treatment in all of sub-Saharan Africa in 2003. And Botswana is now closing in on the goal of eliminating mother-to-child HIV transmission.

These successes are being replicated in countries around the world thanks to support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Globally, the United States is supporting more than 3.2 million people on life-saving treatment. In 2010, PEPFAR directly supported 11 million people on care, including 3.8 million orphans and vulnerable children. And PEPFAR-supported programs reached over 600,000 mothers with services to prevent mother-to-child transmission of HIV, leading to more than 114,000 infants being born HIV-free in 2010 alone. For millions of youth around the world, these numbers represent parents, friends and community leaders who are now living with HIV instead of dying from it. As we focus on results, America is also supporting countries so they can lead their fight in the future and continue to save even more lives.

The Obama Administration is more committed than ever to build on the successes of the last decadeand to continue to work with other governments and partners as we all work toward our shared goal of a world without HIV/AIDS. And we hope the millions of lives saved to date will inspire youth in Africa and around the world to continue their fight for an HIV-free future.

Ambassador Eric Goosby is the U.S. Global AIDS Coordinator at the U.S. Department of State.

Raising HIV/AIDS Awareness in the Caribbean Community

Greg Millett — Wed, 08 Jun 2011 13:00:00 +0000

Today, Wednesday, June 8, 2010 is the sixth annual observance of Caribbean-American HIV/AIDS Awareness Day. Caribbean-American HIV/AIDS Awareness Day is designed to raise awareness of HIV/AIDS in Caribbean communities in the United States and its territories. Raising awareness is a necessity because Caribbean communities are at elevated risk for HIV infection.

There are 30 countries in the Caribbean stemming from the 3 most populous (Cuba, Dominican Republic, and Haiti) to the least populous (Saint Barts, Saint Eustatius, and Saba). After sub-Saharan Africa, the Caribbean has the second highest HIV prevalence in the world. HIV prevalence among adults in the Caribbean was approximately 1.1% between 2001 and 2007, although rates vary among countries. Cuba has a low HIV prevalence (0.1%) among adults while the Bahamas has the highest HIV adult prevalence in the region (3.1%). According to CDC, except for sub-Saharan Africa, the Caribbean is the only region where the proportion of women and girls living with HIV (53%) is higher than the proportion of men and boys. Unprotected heterosexual sex is the main HIV transmission mode in the Caribbean. However, transmission categories differ by country. Injection drug users are a primary driver of the HIV epidemic in Puerto Rico, whereas gay and bisexual men and heterosexuals are primarily affected in Cuba and the Dominican Republic (respectively).

CDC recently published surveillance data of HIV among blacks in the United States who are of Caribbean origin. Of an estimated 100,013 black adults and adolescents diagnosed with HIV infection from 2001 to 2007, 11.7% were foreign-born, with most from the Caribbean (54.1%) and Africa (41.5%). Most Caribbean foreign born blacks with HIV in the US are from Haiti (66.9%), 18.2% from Jamaica, 6.3% from Trinidad and Tobago, 3.3% from the Bahamas, 1.4% from Barbados, and 3.8% from other areas of the Caribbean. Males account for the majority (56.6%) of HIV diagnoses among black people born in the Caribbean. Females account for 57.4% of diagnoses among HIV-positive black Americans born in Africa.

Additional information about HIV in the Caribbean is available at UNAIDS, World Health Organization and Pan American Health Organization. Additional information of HIV among Caribbean born individuals in the United States is available on the Centers for Disease Control website. In addition, links to other informational resources are available at the Florida/ Caribbean AIDS Education and Training Center.

Greg Millett is a Senior Scientist and HHS/CDC Liaison to the Office of National AIDS Policy

Continuing Steps to Implement the National HIV/AIDS Strategy as the Pandemic Turns 30

Jeffrey S. Crowley — Tue, 07 Jun 2011 19:22:29 +0000

As we reflect on the thirtieth year of the HIV pandemic, our work continues. I wanted to share with you two developments at the White House as we mark this somber, but important milestone.

HHS Announces New Steps to Implement the National HIV/AIDS Strategy

Yesterday, I participated in a call with Health and Human Services Secretary Kathleen Sebelius and key leaders in her Department who announced new actions to support the implementation of the National HIV/AIDS Strategy.

Mary Wakefield, PhD, RN, Administrator of the Health Resources and Services Administration (HRSA)discussed the Administration’s continued commitment to supporting States in responding to the challenge of state waiting lists in the AIDS Drug Assistance Program (ADAP). Funding for ADAP has enjoyed broad bipartisan support. Even in a tough budget climate and at a time when other critical health programs received cuts, the Administration fought for and achieved a $50 million increase in funding for ADAP in FY 2011 compared to the enacted level for FY 2010. This year, the Federal government alone will invest $885 million in the ADAP program. Administrator Wakefield announced that the increased funding will allow a temporary program established last summer with $25 million in emergency funds to continue and HRSA will allocate the remaining increase through both the ADAP formula program and through a targeted, competitive grant process to assist States with waiting lists or other cost containment measures that could impede access to critical medications. While there are challenges in ensuring that individuals have access to life saving medications, HRSA is working closely with states and encouraging pharmaceutical companies to help bridge the gap in this program until state economic conditions improve and the Affordable Care Act alleviates some of the pressure on this program.

Ms. Cindy Mann, Deputy Administrator of the Centers for Medicare and Medicaid Services (CMS) and Director of the Center for Medicaid, CHIP, and Survey and Certificationdiscussed a State Medicaid Director (SMD) letter, issued yesterday, that informs States of various opportunities in Medicaid to improve care coordination and care delivery for people living with HIV, as well as opportunities to use Section 1115 HIV demonstration waivers to expand access to Medicaid for people living with HIV. To facilitate States considering a Section 1115 demonstration waiver, CMS also issued a template and stated that they will work with States to develop streamlined and flexible approaches to meeting legal and policy requirements for these waivers. The commitment to issue this waiver guidance was made in the Federal Implementation Plan for the National HIV/AIDS Strategy and in some states, could provide a mechanism for relieving pressure on ADAP while also providing more coordinated and high-quality care.

A blog post by CMS Administrator Don Berwick can be found HERE. The SMD issued by CMS can be found HERE.

Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention (CDC)described CDC’s vision for high-impact HIV prevention. He announced that even in a very difficult budget environment, CDC was increasing its investment in HIV prevention services by $31 million in FY 2011. He also described some of the targeted new prevention investments CDC is making as it realigns its entire HIV prevention portfolio to have a bigger impact. He spoke of the need, articulated in the National HIV/AIDS Strategy, to focus on the geographic, demographic, and programmatic characteristics of the HIV epidemic. In particular, he highlighted the need to better address gay and bisexual men of all races and ethnicities (but especially gay and bisexual men of color), because they reflect the majority of new infections and the only group in the US where infection rates are rising. He discussed the Enhanced Comprehensive HIV Prevention Planning (ECHPP) initiative in the twelve cities and surrounding metropolitan areas that account for nearly half (44%) of the HIV cases in the United States. He described this as a platform for making improvements in planning that will be applied across CDC’s HIV prevention programs. He discussed CDC’s investments in helping state and local jurisdictions track and report CD4 and viral load measurements in order to track community viral load. Research studies have demonstrated that when a community is able to lower the mean viral load across all people living with HIV in that community that this leads to a lowering in HIV incidence. Therefore, tracking community viral load is an important tool for reducing the number of new infections. CDC is doing important work to support states and localities in building their capacity to track community viral load.

Each of these agencies announced significant new initiatives yesterday that move us forward in implementing the National HIV/AIDS Strategy. Their impact, however, is greatest when viewed together. We have a stronger evidence base than ever before and a clearer vision of how to support individuals and communities in lowering their risk of becoming infected with HIV, helping individuals living with HIV to learn their status, and how to bolster the programs that support individuals with HIV in accessing the care and services they need (including access to antiretroviral therapy). Our work continues, but we are making definite forward progress.

Champions of Change

Champions of Change is a weekly White House initiative to highlight Americans who are making an impact in their communities and helping our country rise to meet the many challenges of the 21st century. Last week, we invited a diverse group of people living with HIV to join me; Health and Human Services Assistant Secretary for Health, Dr. Howard Koh; Brian Bond, Deputy Director of Public Engagement and former ONAP staffer and Senior Scientist at CDC, Greg Millett - both people living with HIV; as well as Allison Nichol and David Knight of the Civil Rights Division at the Department of Justice and David Vos, Director of the Office of HIV/AIDS Housing at the Department of Housing and Urban Development for a round table to discuss their experiences as people living with HIV.

For more than two years we’ve been working in close partnership with many members of the HIV community and as we enter our fourth decade fighting HIV/AIDS, we believed it was important to again hear from the collective wisdom of people living with HIV in order to assess our progress and make plans for concerted efforts going forward. Everyone has something to contribute toward ending this pandemic. That’s why we have been working with people living with HIV every step of the way. We felt it was important to meet with HIV positive leaders and hear about the lived experiences of people who may be still facing stigma in their own communities. Many who may still struggle to gain access to services, yet who are working everyday to support their communities as they respond to HIV. The discussion was very powerful and it generated a lot of good ideas.

Check out this introductory post from Brian Bond HERE and learn about these incredible individuals HERE. And check back, as this page will be updated throughout the week with posts by each of these individuals.

Jeffrey S. Crowley is the Director of the Office of National AIDS Policy

What You Missed: Open for Questions 30 Years of AIDS

Thu, 02 Jun 2011 17:39:12 +0000

Yesterday, Surgeon General Dr. Regina Benjamin, Director of the White House Office of National AIDS Policy Jeffrey Crowley and Director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, NIH, Dr. Carl Dieffenbach came to the White House for a special live chat on 30th anniversary of the AIDS epidemic. Check out the video of the chat below.

For events, timelines and more information about the 30th anniversary of AIDS visit AIDS.gov. And to find out more information about HIV testing and treatment, as well a mental health, substance abuse, family planning and housing services, check out the HIV/AIDS Prevention and Services locator.

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Open for Questions: 30 Years of AIDS

Tue, 31 May 2011 13:16:24 +0000

On Wednesday June 1, 2011 at 3 p.m. EDT, Surgeon General Dr. Regina Benjamin, Director of the White House Office of National AIDS Policy Jeffrey Crowley and Director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, NIH, Dr. Carl Dieffenbach will be hosting a special live discussion on the 30th anniversary of the AIDS epidemic. Submit your questions in advance and tune in to WhiteHouse.gov/live to watch the discussion.

What: Open for Question: 30 Years of AIDS
When: June 1 at 3 p.m. EDT
Who: Surgeon General Dr. Regina Benjamin, Director of the White House Office of National AIDS Policy Jeffrey Crowley and Director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, NIH Dr. Carl Dieffenbach
Where: Submit questions in advance, watch live at WhiteHouse.gov/live and submit live questions during the discussion on Facebook.

My Visit to Swaziland: The Country with the World’s Highest HIV Prevalence Rate

Jeffrey S. Crowley — Thu, 26 May 2011 21:08:48 +0000

Last week, I wrote about my attendance at the PEPFAR annual meeting in South Africa, the country that has more people living with HIV (over 5 million) than any other country in the world. After this meeting, I visited the neighboring country of Swaziland, which has the unwelcome distinction of having the highest HIV and TB prevalence rates in the world.

This part of my trip had special personal significance for me. Twenty-one years ago, I had the privilege of serving as a United States Peace Corps volunteer in Swaziland, where I worked as a high school science teacher. This trip really was part homecoming as Swaziland remains a part of me, and it gave me a chance to reconnect with many friends whom I haven’t seen in more than a decade. But, I also spent several days with the PEPFAR team in the country – especially the Peace Corps - learning about the broad range of ways that the United States government is extending a hand of friendship and is partnering with Swaziland to respond to their HIV epidemic.

National Asian and Pacific Islander HIV/AIDS Awareness Day

Dr. Howard K. Koh — Thu, 19 May 2011 13:00:00 +0000

“Saving face can't make you safe. Talk about HIV – for me, for you, for everyone.”

That’s the motto for National Asian and Pacific Islander HIV/AIDS Awareness Day on May 19.

According to the Banyan Tree Project, which sponsors this Awareness Day on behalf of a wide cross-section of organizations serving Asians and Pacific Islanders:

"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.

As an Asian-American physician who has cared for patients with HIV/AIDS, I’ve seen the stigma of HIV firsthand. It’s time to put an end to it.

Last May, I had the honor of blogging about the importance of observing National Asian and Pacific Islander HIV/AIDS Awareness Day. I want to reiterate some important points I made then— and also highlight that since then, the White House has released the National HIV/AIDS Strategy (NHAS), a roadmap for reducing the number of new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities.

Current data suggest that Asian Americans and Pacific Islanders (AAPIs) represent approximately one percent of diagnoses of HIV infection nationally—but the rate of HIV diagnoses among certain AAPI populations is higher than some other groups. In 2009 (the latest year for which we have data), the estimated rate of diagnoses of HIV infection among Native Hawaiian and other Pacific Islander men per 100,000 population (41.2) was nearly three times that of White men (14.8).

There were relatively few diagnoses of HIV infection among Asian and Native Hawaiian/other Pacific Islander women in 2009; however, the rates for these groups (3.4 and 13.3, respectively) were higher than the rate for White (2.4) women. The number of AAPIs diagnosed with HIV or AIDS may be larger, since we have reason to believe HIV is underreported among this group.

As part of our commitment to the NHAS, the U.S. Department of Health and Human Services is working to improve our data collection. We want to understand the full impact of HIV/AIDS on all populations, including AAPIs, because better information helps us provide better prevention, testing, and treatment options. Those options will move this country closer to ending the HIV/AIDS epidemic—for the AAPI community and everyone else too.

On June 5, we will mark 30 years since the first published reports of AIDS. One of the best ways we can commemorate that date is to talk about HIV within our families, among our friends, and in our communities. We can reaffirm our commitment to ending the suffering through HIV awareness, testing, treatment, and care.

I encourage you to visit the Banyan Tree Project’s website to find information about events, posters, and other resources in your community for National Asian and Pacific Islander HIV/AIDS Awareness Day. “Saving face” can’t make us safe—but awareness and action can. Please join us!

To find an HIV testing site or other HIV services near you, visit http://locator.AIDS.gov to access the HIV Prevention and Services Provider Locator. By entering your address or ZIP code, you can find HIV testing, mental health, substance abuse, housing, health care, and family planning resources near you.

Howard K. Koh M.D., M.P.H., is Assistant Secretary for Health, U.S. Department of Health and Human Services

HIV Vaccine Awareness Day, 2011

Dr. Anthony S. Fauci and Dr. Margaret I. (Peggy) Johnston — Tue, 17 May 2011 13:00:00 +0000

HIV Vaccine Awareness Day provides an opportunity to acknowledge the more than 35,000 individuals who have volunteered for preventive HIV vaccine trials over the past 25 years. Without their participation, the modest success that we have achieved thus far would not have been possible. Many thousands more volunteers will be needed if we are going to achieve our ultimate goal of developing a safe and effective vaccine that will help stop the spread of HIV worldwide.

Since the discovery of HIV in 1983, dozens of antiretroviral agents have been licensed and have resulted in dramatic improvements in the quality of life and life expectancy of millions of HIV-infected individuals. In addition, global access to these life-saving therapies has been progressively increasing, which not only benefits the HIV-infected individual, but makes them less likely to transmit the virus to their sexual partners. However, for every individual who gains access to these therapies globally, two to three individuals become newly infected. Treatment alone is not likely to rid the world of AIDS; the need for improved approaches to prevent new HIV infections is compelling.

Fortunately, through the combined support of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), other US Government agencies, nonprofit organizations, and others, progress in developing new technologies that prevent HIV infection has been notable. Adult male circumcision resulted in greater than 50% protection against HIV acquisition among heterosexual men in several African countries. A once a day pill was shown to reduce new infections in men who have sex with men by 44%, and protection appeared even higher in those men who adhered to the daily drug regimen. Promising results have also been achieved with a vaginally applied microbicide, which protected 39% of women in a trial in South Africa. Again, protection was higher in those who adhered to the drug use schedule. Another exciting finding is that a vaccine provided 31% protection in a heterosexual population in Thailand. Interestingly, efficacy appeared to be 60% in the earlier stages of the trial before the vaccine induced immune responses waned.

Our goal now is to improve upon these latter results. Why did this vaccine work and can we build on that knowledge to design more effective vaccines? Will a vaccine adjuvant or vaccine vector increase the level of protection? Can efficacy be achieved in higher incidence populations and in populations exposed to different subtypes of HIV? Will keeping vaccine induced immunity high for a longer period of time increase the duration of protection? Are there alternative approaches to ensuring that effective immunity is present when individuals are exposed to HIV? These are all questions that NIAID together with our partners plans to address through continued basic and clinical research.

Conducting additional clinical vaccine research presents technical, resource and logistical challenges that will require multi-sector, international partnerships to address. Engagement of the private sector and regulatory agencies will help map a path to vaccine licensure. Clinical trial specialists will apply their best strategic thinking to determine how multiple trials can be efficiently and effectively accomplished. Participation of government officials and researchers in the countries where trials will be conducted will ensure that trials are approved and carried out expeditiously and according to the highest ethical standards. Strong partnership with affected communities and trial volunteers will help make certain that they understand the risks and benefits of participation in HIV vaccine trials. Only through continued support and participation of communities and individual trial volunteers will we achieve the goal of identifying a safe and effective preventive vaccine, which would be an invaluable addition to the tool box of prevention approaches.

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

Margaret I. (Peggy) Johnston, Ph.D., is a Senior Scientific Consultant, NIAID

Learning From Our Global HIV/AIDS Programs

Jeffrey S. Crowley — Mon, 09 May 2011 19:23:43 +0000

Last week, I was in Johannesburg, South Africa, where I attended the annual meeting of the President’s Emergency Plan for AIDS Relief. Known as PEPFAR, this is the United States global HIV/AIDS program that was established by President Bush. PEPFAR has been continued and strongly supported by President Obama. The focus of this Administration has been to move the program from an emergency response to a sustainable, long-term effort that builds the capacity of host countries to take the lead in responding their HIV epidemics. Indeed, in 2009, President Obama announced his Global Health Initiative (GHI) that acknowledges the enormous success of PEPFAR and seeks to build on this effort by strengthening health systems to tackle other health problems.

It is humbling and exciting to be with this group of committed Americans and host country partners. The American people should be proud of the fact that we are leading the response to the global pandemic and our work is literally saving the lives of millions of people around the world. A couple of statistics caught my ear. Through PEPFAR, 385,000 infants have been born HIV-free who otherwise would have been born with the virus. More than 100,000 of these births have been in the last year alone. The PEPFAR program is currently supporting more than 3.2 million people on anti-retroviral therapy, an amazing achievement for a program that is only 7 years old. What an enormous achievement! I could cite facts and figures for days, but the most meaningful way to see the impact of our efforts is to visit the clinics and programs that the US government is supporting. With CDC Director Dr. Tom Frieden, I visited a local clinic and a hospital in Tembisa, a community outside of Johannesburg that is home to two million people. I also visited Helen Joseph Hospital in Johannesburg, a research hospital and one of the largest HIV treating hospitals in South Africa, as well as Nazareth House, a Catholic institution that cares for children orphaned by HIV. It is hard to describe the feeling of seeing hundreds and hundreds of people living with HIV, many of whom are on HIV treatment, and to hear them thank PEPFAR and the American people for helping to keep them alive.

I came here hoping to learn lessons from Africa and other parts of the world to apply to the domestic epidemic. There are lots of lessons as we work to implement the National HIV/AIDS Strategy. What I found is that PEPFAR is grappling with so many of the same issues. There has been a lot of talk about combination prevention. As with domestic HIV programs, there is concern here about the challenging fiscal environment—and this is leading everyone to ask if they are prioritizing the right programs and interventions to save as many lives as possible. Interestingly, there has been a lot of discussion about coordination among PEPFAR’s implementing agencies—State, CDC, USAID, Peace Corps, Department of Defense—and working with the host countries and their health systems. This mirrors the challenges and opportunities of coordinating CDC, CMS, HRSA, and HUD, as well as the challenges and opportunities working with state and local governments. I am not walking away with any magic solutions, but this meeting has given me a lot to think about… We definitely need to do more to integrate our domestic and global efforts.

As I left this meeting, I was energized by the committed people I met who are working so hard to achieve the vision similar to the U.S. National HIV/AIDS Strategy, but on a global scale.

Jeffrey S. Crowley is the Director of the Office of National AIDS Policy

Institute of Medicine Releases Report on Health Care System Capacity for Increased HIV Testing and Provision of Care

Jeffrey S. Crowley — Fri, 18 Mar 2011 23:06:43 +0000

Today, the Institute of Medicine (IOM) released its third and final report in a project commissioned by the Office of National AIDS Policy (ONAP). Entitled “HIV Screening and Access to Care: Health Care System Capacity for Increased HIV Testing and Provision of Care,” the report examines the current capacity of the health care system to administer a great number of HIV tests and accommodate new HIV diagnoses.

More than 200,000 people in the United States are living with HIV, but unaware of their status. Increased HIV testing may help identify these individuals, reducing the chance that they will transmit HIV to others and improving their own health outcomes. But some individuals may not receive the care they need if the health care system does not have the capacity to care for them.

The report finds that budget constraints at state and local health departments pose a barrier to more widespread HIV testing. In addition, fewer practitioners are specializing in HIV/AIDS care and the number of specialists entering the workforce is not replacing the number retiring. Among the report’s findings, the report concludes that, to meet the growing demand for care, more practitioners need training in HIV/AIDS treatment and care; and hospitals, clinics, and health departments must receive sufficient funding to maintain their staff and support screening efforts.

The Affordable Care Act (ACA), the landmark health reform legislation signed into law by President Obama in March 2010, includes several provisions to expand and better support the health care workforce. These provisions also create opportunities for addressing some of the HIV workforce challenges indentified in this report. The National HIV/AIDS Strategy for the United States recognizes the importance of ensuring that all people living with HIV know their HIV status and are well supported in a regular system of care. The Strategy states that public and private sector entities must take the steps to improve service delivery for people living with HIV by: establishing a seamless system to immediately link people to continuous and coordinated quality care when they are diagnosed with HIV; taking deliberate steps to increase the number and diversity of available providers of clinical care and related services for people living with HIV; and, supporting people living with HIV with co-occurring health conditions and those who have challenges meeting their basic needs, such as housing.

In 2009, ONAP commissioned the IOM to convene a 15-member Committee on HIV Screening and Access to Care, which was tasked with planning and conducting a series of three workshops and activities that evaluate barriers to expanded HIV testing and treatment programs. The outcome of these efforts is the issuance of three reports that examine certain questions related to HIV testing policy and access to care. The Committee’s first report focused on the extent to which Federal and State laws and policies, private health insurance policies and practices, and other factors inhibit or promote expanded HIV testing. The second report studied how Federal and State laws and policies and private health insurance policies affect entry into clinical care and the provision of continuous and sustained care for people with HIV.

ONAP thanks the Committee for its efforts. These reports will inform our collective efforts to implement the Strategy.

To view this report and the entire report series, please visit the IOM website, www.iom.edu.

Jeffrey S. Crowley is the Director of the Office of National AIDS Policy

Defying the Odds: End the Rise of HIV/AIDS in Native American Communities

Charlie Galbraith — Fri, 18 Mar 2011 18:31:50 +0000

HIV remains a highly stigmatized condition. It is a serious medical condition and people still die of AIDS. Nonetheless, we have highly effective treatments for people living with HIV and better tools than ever before to prevent infection. As uncomfortable as it may be for some people to talk about HIV and AIDS, discussing the basic facts about transmission, testing, and treatment are essential to stopping this epidemic in its tracks. That is why on Sunday, March 20th, we will commemorate the fifth annual National Native HIV/AIDS Awareness Day to educate and encourage American Indians and Alaska Natives (AI/AN) to take action to stop the spread of this disease.

The Centers for Disease Control and Prevention (CDC) estimates that American Indians and Alaska Natives represent less than 1 percent of those living with HIV. However, these communities continue to be impacted by HIV. CDC surveillance data show that from 2006 through 2009, the estimated annual rate of HIV diagnosis increased among AI/AN people. In 2009, the estimated rate of HIV diagnosis was 9.8 per 100,000, higher than the rate for white and Asian Americans. Additionally, the CDC estimates that approximately 26% of AI/AN people living with HIV are unaware of their infection. Once diagnosed with AIDS, AI/AN people are less likely to survive compared to HIV-positive individuals in other communities.