First National HIV Strategy Relies on Prevention: Each Year, 56,000 New HIV Infections Reported in United States
Krisberg, Kim, The Nation's Health
ACCESS TO CARE, eliminating disparities and reducing infection rates are the overarching JL ML. goals of America's new National HIV/AIDS Strategy, which calls for a more coordinated response to the nation's ongoing HIV epidemic.
Three decades into the U.S. HIV epidemic, it is the first such strategy of its kind and comes at a time when more Americans than ever are living with the virus and 56,000 new infections are reported every year. Released in July at a White House news conference and developed by the Federal HIV Interagency Working Group, the strategy's vision sees a future in which "new HIV infections are rare and when they do occur, every person, regardless of age, gender, race, ethnicity, sexual orientation, gender identity or socioeconomic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination." According to recent data from the Centers for Disease Control and Prevention, U.S. HIV infection and diagnosis rates have remained relatively stable over the past few years. However, the virus disproportionately affects certain populations, such as men who have sex with men, Hispanics and blacks.
"We have learned what we can do to stop the spread of the disease," said President Barack Obama at the White House news conference. "We've learned what we can do to extend the lives of people living with it. And we've been reminded of our obligations to one another--obligations that, like the virus itself, transcend barriers of race or station or sexual orientation or faith or nationality. So the question is not whether we know what to do, but whether we will do it."
Public health and HIV/AIDS advocates are hailing the strategy for its comprehensive, inclusive vision that specifically recognizes the virus' impact among gay and bisexual men and targets the social stigmas that often help fuel the epidemic's spread.
"The domestic (HIV) epidemic has been neglected for far too long," said Chris Collins, director of public policy at amFAR, also known as the American Foundation for AIDS Research. "We haven't done as good of a job as we should in targeting our resources. We have a concentrated epidemic by population and geography and we haven't had a federal response that matched that epidemic."
Among its desired outcomes by 2015, the strategy aims to cut the number of new annual infections by 25 percent, up the number of people quickly linked to care after initial diagnosis and increase the proportion of HIV-diagnosed gay and bisexual men, blacks and Hispanics with undetectable viral loads by 20 percent each. In terms of prevention, much of which falls in the public health arena, the strategy calls for supporting evidence-based prevention and education tactics, strengthening HIV screening and surveillance, and targeting resources toward communities most at risk, including injection drug users.
The strategy also recommends increasing HIV/AIDS coordination across the federal government and between federal, state, local and tribal agencies. Within 150 days of the strategy's release, certain agencies, including the Department of Health and Human Services and Department of Housing and Urban Development, are required to report back to the White House on how they will implement the recommendations. Along with the National HIV/AIDS Strategy, the White House also released a federal implementation plan.
Collins said that the agency-specific implementation plans will be "crucial" to the strategy's overall success, noting that "business as usual is not going to get us where we want to be in the domestic AIDS response."
Marjorie Hill, PhD, CEO of Gay Men's Health Crisis, an HIV care provider founded in 1981, said the strategy will not only help direct resources, but support the most effective interventions, noting that "what might work for a heterosexual woman in Alabama might not work for a gay man living in Minnesota. …