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2015 WORLD AIDS DAY

The first World AIDS Day was in 1988. It is always observed on December 1st and is a day to honor and remember those who have passed. So much has changed and so much progress has been made since the grim days of 1988 in the fight against HIV and AIDS, but there is still more to do.

In 2010, the federal government laid out their National HIV/AIDS Strategy For The United States. That particular strategy was supposed to be in effect and continue through the end of this year, 2015. The goal for that 5-year plan and the aim was high, which was both good and bad. Good, because goals should be set high and also not so much because the stated goal or "Vision" hasn't been met yet. Here was the 2010 Vision statement:

“The United States will 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."

There are still some hurdles that need to be leapt to make the above vision statement a reality but the government is aware of that. One thing, that to a great extent would have made the statement more attainable by now, is if the Affordable Care Act (ACA/Obamacare) would have come into effect sooner than really just last year. And, as we all know, stigma and discrimination still exist.

There has been progress made toward the goal over the past 5-years however and some of these include:

- Increasing the percentage of people living with HIV who are diagnosed from 81 to 87%
- Eliminating the AIDS Drug Assistance Program waiting lists
- Increasing focus and funding on most-affected populations through the CDC’s High Impact Prevention

- Enriching knowledge about HIV prevention, treatment and care through groundbreaking research funded by the National Institutes of Health, especially related to treatment as prevention and pre-exposure prophylaxis (PrEP)
- Modernizing the Federal HIV testing and treatment guidelines
- Implementing the Affordable Care Act, which has allowed millions of Americans to access health coverage and benefit from access to preventive services such as HIV testing without cost sharing

- Fighting stigma and addressing discrimination through the Department of Justice, and improving access to employment and housing services through the Department of Labor and Department of Housing and Urban Development.

So where do we go from here?

The federal government released the Federal Action Plan for 2016-2020, which outlines specific Federal agency actions to implement the Strategy from next year through 2020. The "Vision Statement" remains very much the same as the 2010-2015 statement, obviously because those goals were solid and meaningful yet not met. Included in the Federal Action Plan are 170 action items that agencies will undertake over the next five years. Some of the action items include:

To improve widespread HIV testing and linkage to care:

The Center for Medicare and Medicaid Services will provide information to State Medicaid Directors on the latest treatment guidelines, scientific advances in prevention, and program flexibility available for increased access to testing and improved care coordination.

The Centers for Disease Control and Prevention (CDC) will establish new standards for linkage to care (within 1 month of diagnosis) for all new funding announcements and demonstration projects.

CDC will collaborate with the Health Resources and Services Administration (HRSA) to assess and identify ways to increase HIV testing among patients in health centers who are diagnosed with acute sexually transmitted infections, an important indicator of risk for HIV infection.

To improve broad support and attain universal viral suppression for people living with HIV:

CDC will scale up use of the Data to Care public health strategy, which uses HIV data to identify those not in care, by including use of the strategy in all relevant HIV funding opportunities.

HRSA, in consultation with CDC, will develop a Data to Care learning collaborative across communities served by the Ryan White program to share effective models for addressing gaps along the HIV care continuum.

HUD will work to improve the ability of HUD-funded "Continuums of Care" to identify homeless persons living with HIV and link them to housing assistance, medical care, and other services.

To improve full access to comprehensive PrEP services:

CDC will increase awareness and uptake of PrEP by rapidly disseminating lessons learned from demonstration projects and implementation research.

Agencies including HRSA, HHS Office of Minority Health, SAMHSA, Indian Health Services, and Department of Veterans Affairs, will disseminate information and provide education about PrEP to their award recipients and service providers in order to improve access and increase uptake.

HHS will develop an inventory of current, federally-funded PrEP programs, policies, research, and technical assistance activities, and conduct a gap analysis to identify high-priority research and policy needs, as well as potential geographic and population targets where PrEP access should be scaled up.

To reduce discrimination against people living with HIV:

The Department of Justice (DOJ) will continue to open new investigations, as appropriate, of HIV/AIDS discrimination under the Barrier-Free Health Care Initiative, as well as under the Fair Housing Act to address discrimination by housing providers.

The Equal Employment Opportunity Commission will educate job applicants and employees living with HIV of their employment non-discrimination rights by developing materials for distribution through new channels, including health care delivery sites.

The DOJ will send to all State Attorneys General, its Best Practices Guide to Reform HIV-Specific Criminal Laws to Align with Scientifically Supported Factors, with a cover letter alerting them to its purpose and contents.

These action items, if achieved over the next 5-years, will go a long way to achieve the fed's vision and goal of rare, new HIV infections and eliminating stigma. Broader use of PrEP and the full acceptance of the Affordable Care Act will also contribute to making the goal a reality.

For a PDF of the full National HIV/AIDS Strategy updated to 2020, please visit: www.whitehouse.gov/sites/default/files/docs/national_hiv_aids_strategy_update_2020.

 

 

 

 

 

 

 

 

Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!