Office of National AIDS Policy Blog
- Posted byon February 7, 2014 at 3:40 PM EDT
Ed. note: This is cross-posted from AIDS.GOV
As we observe National Black HIV/AIDS Awareness Day (NBHAAD) 2014, we are reminded that African Americans face the most severe burden of HIV/AIDS in the United States. Among African Americans, gay, bisexual and other men who have sex with men (Black MSM) are especially hard hit, representing more than half of all estimated new HIV infections among African Americans each year. A particularly disconcerting estimate in 2010 showed that young Black MSM aged 13 to 24 accounted for the greatest number (4,800) of estimated new HIV infections among African Americans.
Furthermore, from an analysis of data about African Americans diagnosed with HIV infection from 19 jurisdictions that CDC released yesterday, we know that compared to Black women, Black men — regardless of transmission category — have lower levels of linkage to and retention in HIV care and are less likely to have achieved viral suppression (i.e., have controlled the virus at a level that helps keep them healthy and reduces their risk of transmitting the virus to others). The study also revealed that by transmission category, men with infection attributed to male-to-male sexual contact had the lowest percentage of linkage to care.
These disparities highlight that, despite important strides that have been made toward national HIV prevention, care and treatment goals, we clearly have more work to do as a nation to effectively address HIV among Black MSM, especially with regard to outcomes along the HIV care continuum [PDF 1.9MB].
The National HIV/AIDS Strategy highlights both the disproportionate impact of HIV among MSM in the U.S., the concentration of HIV among Black MSM within the African American community, and clearly states that “the United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men.” The Strategy also observes that our national commitment to this population has not always been commensurate with their disproportionate burden of HIV.
So, as we mark the annual observance of NBHAAD, we all—both individually and collectively—are called to be even more thoughtful, creative, and focused about actions we can undertake to strengthen HIV prevention, testing, care and treatment for Black MSM in communities across the United States.
Among federal programs, several important activities are underway in this regard:
- Increasing the capacity, quality, and effectiveness of HIV/AIDS service providers to serve Black MSM – Applications are due later this month for a new Resource/TA Center for HIV Prevention and Care for Black MSM being supported by HRSA’s HIV/AIDS Bureau. To assist HIV service and other healthcare providers, the new center will identify, compile, and disseminate best practices and effective models for HIV clinical care and treatment across the HIV care continuum for adult and young Black MSM ages 13 to 24.
- Promoting and supporting HIV testing among Black MSM – CDC’s Testing Makes Us Stronger social marketing campaign encourages Black MSM to get tested for HIV. Through compelling campaign ads in national magazines and on targeted websites, as well as through local advertising and materials distribution in target cities, CDC emphasizes the importance of getting tested for HIV regularly to help stop the spread of the epidemic. The campaign also includes a Facebook page and a dedicated website with a suite of campaign materials available for individuals and organizations to download and distribute. Complementing this important outreach campaign, CDC makes significant investments in both health departments and community-based organizations to support high impact prevention activities, including testing.
- Supporting engagement in HIV care – The HHS Office for Civil Rights’ Information is Powerful Medicine campaign focuses specifically on Black MSM, underscoring how having access to your medical records can help you better manage your health. Access to this information empowers patients to track their progress, monitor their lab results, communicate with their treatment teams, and adhere to their important treatment plans. The campaign also provides information on e-health tools, such as the “Blue Button,” which make it easier, safer, and faster for consumers to get access to their health information.
- Strengthening state efforts for Black MSM – Under the Care and Prevention and Prevention of HIV in the U.S. (CAPUS) demonstration project, several of the eight participating states are focusing their efforts specifically on Black MSM. The three-year demonstration project is supported by the Secretary’s Minority AIDS Initiative Fund and seeks to support these states, each with disproportionately high burdens of HIV/AIDS among minority communities, to improve HIV testing, engagement, and retention in care among racial and ethnic minorities. In Illinois, for example, the state health department has launched a youth of color-specific initiative in East St. Louis to co-locate medical (including LGBT health), psychosocial, prevention and support services in a single setting by collaborating with the local health department and community-based organizations in East St. Louis, Illinois and across the river in St. Louis, Missouri.
- Supporting Implementation Research – The focus of the ongoing NIH-supported HIV Prevention Trials Network (HPTN) 073 study is determining the willingness of Black MSM to use a daily antiretroviral pill as pre-exposure prophylaxis (PrEP). Studies such as HPTN 073 are critical in bridging our understanding between biomedical advances in HIV prevention and behavioral, social and structural factors that are often in play.
“We are greatly encouraged that many of these federal activities are consistent with recommendations made during our 2012 consultation with community leaders and federal partners about HIV among Black MSM,” notes Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases. “These efforts, and many more underway at the federal as well as state and local levels, are vital to reducing new HIV infections among Black MSM and to improving outcomes all along the HIV care continuum for this disproportionately impacted population.”
Timothy Harrison is a Senior Policy Advisor in the Office of HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services
- Posted byon December 2, 2013 at 5:07 PM EDT
The theme of this year’s World AIDS Day is “Shared Responsibility: Strengthening Results for an AIDS-Free Generation.” Now more than ever, it is a fitting theme as the United States focuses, both on the domestic and global fronts, on building partnerships that strengthen our response to HIV and AIDS.
Here in the U.S., we are working with state, tribal and local governments, community groups, and other key stakeholders to implement this country’s first comprehensive National HIV/AIDS Strategy (the Strategy) launched by President Obama in 2010. Since the launch, we have made significant progress in strengthening scientific investments, expanding effective HIV prevention, and connecting stakeholders in both the public and private sectors.
Last July, as the next step in implementing the Strategy, the President established via Executive Order the HIV Care Continuum Initiative, which focuses on the gaps in care and prevention, especially among communities with the greatest HIV burden. Today the White House Office of National AIDS Policy released a report that contains the first recommendations from the Initiative describing how federal efforts will be integrated to strengthen testing, linkage to care, retention and treatment for people living with HIV.
The next stage of implementing the Strategy will be guided by the work on the Initiative, in conjunction with ongoing implementation of the Affordable Care Act, which will increase access to affordable healthcare coverage for thousands of persons living with HIV and millions at risk for infection.
- Posted byon December 2, 2013 at 4:17 PM EDT
“Federal law is a critically important tool in eradicating the discrimination that so many people living with HIV and AIDS still face in their daily lives. By enforcing the civil rights laws and educating members of the public about their rights and responsibilities, the Department of Justice seeks to eradicate the stigma and stereotypes that so often lead to unlawful treatment of people with HIV/AIDS. Along with our partner agencies under the National HIV/AIDS Strategy, we remain committed to using every tool available to protect the rights of individuals with HIV/AIDS.” -Attorney General Eric Holder
In recognition of World AIDS Day 2013, the Department of Justice reaffirms its commitment to eradicating stigma and discrimination against people living with HIV and AIDS across our country. President Obama’s National HIV/AIDS Strategy recognizes that important work as a priority. This year’s observance offers us the chance to both reflect on the work we have done in the past year to protect the rights of people with HIV/AIDS and – due to the sad truth of continuing discrimination – the significant work to be done in the year ahead.
The Justice Department’s Civil Rights Division HIV/AIDS enforcement work under the Americans with Disabilities Act (ADA) over the past year has been robust. Much of that work has involved allegations that individuals were denied care or were otherwise treated differently in health care, dentistry, or other clinical settings because they have HIV, and the department resolved those allegations through policy changes that ensure that all future individuals with HIV/AIDS would not face the same discrimination in those settings. These included settlements with a pain management clinic in North Carolina that refused to treat a patient due to her HIV status, a clinic in Missouri that refused to treat a woman with HIV for her serious eating disorder, a dentistry practice in Virginia that told a new patient with HIV that all of his appointments must be scheduled as the last appointment of the day, an alcohol treatment program in Ohio that excluded an individual from their program because of the side effects of his HIV medication, and a provider of bariatric surgeries based on the experiences of individuals in Pennsylvania and Michigan whose anticipated surgeries were cancelled or denied because of their HIV status.
- Posted byon December 2, 2013 at 12:59 PM EDT
Last July, President Obama established the HIV Care Continuum Initiative, which addresses the gaps in care and prevention, especially among communities with the greatest HIV burden. On World AIDS Day 2013, the White House Office of National AIDS Policy (ONAP) released a report outlining the first recommendations and action steps from the Initiative detailing how federal efforts will be integrated to improve outcomes along the care continuum, including strengthening linkage to care, retention and treatment.
The report also includes a first ever glimpse of national progress (via HIV surveillance data) on the nine indicators of the National HIV/AIDS Strategy. In addition, the report highlights progress being made in three major U.S. cities – New York, San Francisco and Washington, D.C. – in the fight against AIDS as well as some of the unique public-private partnerships that are responding to the National HIV/AIDS Strategy.
The next stage of implementation of the Strategy will be guided by the work on the Initiative, in conjunction with ongoing enactment of the Affordable Care Act, which will increase healthcare coverage for thousands of persons living with HIV and millions at risk for infection.
To read the report, click here.
- Posted byon November 21, 2013 at 8:25 PM EDT
President Obama’s National HIV/AIDS Strategy calls for aligning HIV-related laws and policies to be consistent with the most recent scientific evidence. Today, we took a step forward in that direction when the President signed into law the HIV Organ Policy Equity (HOPE) Act, bipartisan legislation that updates regulations from 1988 to reflect our advances in understanding and treating HIV. The President issued the following statement on this important legislation:
Earlier today, I signed into law the HIV Organ Policy Equity (HOPE) Act, a bipartisan piece of legislation that allows scientists to carry out research into organ donations from one person with HIV to another. For decades, these organ transplants have been illegal. It was even illegal to study whether they could be safe and effective. But that policy has become outdated. Our country has come a long way in our understanding of HIV and in developing effective treatments. And as our knowledge has grown, the possibility of successful organ transplants between HIV-positive people has become more real. The HOPE Act lifts the research ban. In time, it could lead to these organ donations for people living with HIV. And that, in turn, would help save and improve lives and strengthen the national supply of organs for all who need them.
Improving care for people living with HIV is critical to fighting the epidemic, and it’s a key goal of my National HIV/AIDS Strategy. The HOPE Act marks an important step in the right direction, and I thank Congress for their action.
Grant Colfax, MD is the Director of the Office of National AIDS Policy.
- Posted byon September 27, 2013 at 1:20 PM EDT
Today is National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD), an observance that reminds us that HIV continues to take a heavy toll on gay and bisexual men across the United States. Even after more than 30 years of AIDS, this community remains at the center of the U.S. epidemic.
Men who have sex with men (MSM) represent 2% of the U.S. population but more than 60% of new infections and half of all Americans living with HIV. Rates of new HIV diagnoses among MSM in the United States are more than 44 times that of other men. Especially at risk are young MSM (ages 13-24 years), the only risk group where new infections are increasing, with a 22% increase in recent years. Young Black MSM are most affected accounting for 55% of new infections among YMSM overall.
Since 2010 and the White House release of the National HIV/AIDS Strategy (NHAS) followed by the implementation plan, we have continued to follow the road map to reduce new HIV infections, increase access to care, improve health outcomes for persons living with HIV, and address HIV-related health disparities. Last week, senior leaders from across HHS agencies, including CDC, took part in a public meeting to review progress toward achieving the goals of NHAS. There is much good news.
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