Office of National AIDS Policy Blog
- Posted byon March 29, 2013 at 12:23 PM EDT
Successful implementation of the National HIV/AIDS Strategy (the Strategy) requires ongoing collaboration among Federal, state, and local governments and key non-governmental stakeholders. As part of our ongoing efforts to support Strategy implementation, ONAP is convening community discussions across the United States. Discussions are focusing on the following key areas:
- State and local efforts to concentrate resources in communities where HIV is most common and to scale-up evidence-based interventions
- Interventions to improve outcomes along the “care cascade” (i.e. moving people from an HIV diagnosis to care, treatment, and viral suppression)
- The importance of the Affordable Care Act implementation for HIV care and prevention
To date we have visited three cities: Miami, Florida (December 18, 2012); Los Angeles, California (February 14, 2013); and Chapel Hill, North Carolina (February 21, 2013). At each meeting, state and local public health officials, representatives from community-based organizations, advocates, and other key stakeholders convene. ONAP and other Federal partners provide information about the current state of the epidemic nationally and ongoing Federal efforts to implement the Strategy. Key stakeholders provide their perspectives on implementation efforts at the State, local, and community levels. ONAP staff also visit local clinics, community-based organizations, and academic centers to hear what these organizations are doing prevent and treat HIV. The goal is to share information, identify strategic priorities, and determine next steps for moving forward.
Progress to Date: President’s Working Group on the Intersection of HIV/AIDS, Violence against Women and Girls, and Gender-Related Health DisparitiesPosted byon March 10, 2013 at 1:00 PM EDT
Violence is common in the lives of women and girls living with, and at risk for, HIV/AIDS, and the Obama Administration is working to address these intersecting issues. In March 2012, the President issued a Presidential Memorandum creating the “Intersection of HIV/AIDS, Violence against Women and Girls, and Gender-Related Health Disparities Working Group”.
Sunday marks Women and Girls HIV/AIDS Awareness Day, and we are providing an update on the Working Group’s progress. As co-chairs, we are personally committed to this work, having first-hand community and clinical experience in seeing and treating the devastating effects violence has on the lives of women and their families.
The Presidential Memorandum directed select Federal agencies to improve data collection, research, and intervention strategies related to the intersection of these issues and to improve cooperation between agencies and with external partners.
During the past year, the Working Group looked at interagency coordination and the development of actionable, evidence-based recommendations. To assess current Federal efforts, members developed an inventory of programs for each agency that works in the intersection of HIV/AIDS, violence against women and girls, and health disparities.
Identifying and analyzing research was also a priority and led to two research review sessions with members of the Working Group, academic and public health experts, and other key stakeholders. In addition, the Working Group hosted two community webinars and had an online submission process to obtain individual stories, experiences, and public comments.
Prevention and Treatment of HIV Infection in Infants Born to Infected Mothers: Need for a Fresh LookPosted byon March 8, 2013 at 3:43 PM EDT
On Monday, March 4, 2013, at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Dr. Deborah Persaud of the Johns Hopkins University presented an intriguing case study of a child who by all measures seems to be cured of HIV infection. This single case has sparked significant conversation, debate, and optimism. There are important questions that have naturally arisen from this case and we hope to examine some of the aspects of the research agenda that now need to be pursued. While this is an exciting case, we want to stress that it remains very important for people living with HIV/AIDS to continue their medications and to see their healthcare providers on a regular basis.
Certain of the facts are clear. An infant was born at a hospital in Mississippi to a woman unaware she was infected with HIV until she was already in labor. Having been born somewhat prematurely, the child was transferred to the University of Mississippi Medical Center, where the baby came under the experienced and skilled care of pediatrician Dr. Hannah Gay. Knowing that the mother was not previously treated for HIV infection (which put the infant at a high risk of becoming infected), Dr. Gay proceeded under the assumption that the infant had become infected. She started the infant on a three-drug cocktail of antiretroviral medications for HIV treatment, as opposed to the standard two-drug regimen for prophylaxis (prevention) of infection. Blood samples from the infant were repeatedly drawn, and lab results confirmed that the baby indeed had a detectable level of virus. Over the course of several weeks of treatment with antiretroviral drugs, the amount of virus in the child’s blood declined to undetectable levels. The child was discharged from the hospital on antiretroviral therapy that continued for up to 18 months, at which point the mother and child interrupted their medical care. Fast forward several months: the child reappeared in care after a significant lapse in antiretroviral therapy. Surprisingly, the child had no detectable circulating virus, no detectable anti-HIV antibodies, and was clinically healthy. Dr. Gay then reached out to Dr. Persaud and Dr. Katherine Luzuriaga of the University of Massachusetts to perform laboratory studies to help understand what had happened with this toddler.
Several aspects of how this case was dealt with stand out. First, the potential importance of this case was recognized immediately and some of the best laboratories in the world were brought in to help validate the laboratory data. Investigators with long-standing working relationships, some established a decade or more ago, collaborated on state-of-the-art analyses of specimens. The results from all the laboratory studies confirmed that there was no ongoing HIV replication in this child; all that apparently remained was miniscule snippets of viral material.
- Posted byon March 6, 2013 at 11:45 AM EDT
Ed. note: This is cross-posted from blog.aids.gov
While at the 2013 Conference on Retroviruses and Opportunistic Infections (CROI) this week, I was pleased to sit down with Dr. Grant Colfax, Director of the White House Office of National HIV/AIDS Policy. We discussed the role science plays in helping us achieve the vision of the National HIV/AIDS Strategy as well as some of the important findings being announced at CROI 2013 including a focus on the treatment cascade and research on next generation treatments and prevention methods. Watch our conversation below.
To read abstracts from presentations or view presentations on the topics they discussed, visit the conference website.
- Posted byon February 8, 2013 at 4:45 PM EDT
Ed. note: This was cross-posted from The Root.
Yesterday, on Black HIV/AIDS Awareness Day, I had the pleasure of meeting with leaders who are doing outstanding work to prevent new HIV infections and improve health outcomes for African-Americans. We shared stories and discussed the importance of engaging everyone in these efforts, including faith leaders, educators, athletes, entertainers, artists, scientists, healthcare providers as well as friends, families, and neighbors.
This approach also reflects the National HIV/AIDS Strategy, which calls for a collective response to the ongoing domestic epidemic, and sets specific goals with regard to addressing HIV-related disparities among African-Americans.
Our conversation was both sobering and inspiring. Sobering because of the challenges that remain in addressing the epidemic, including confronting the myths about HIV transmission and the virus itself. Inspiring because during our dialogue it became clear that these leaders are committed to breaking down barriers that impede our progress in preventing and treating HIV/AIDS.
Data highlight the urgency of this work. According to the Centers for Disease Control and Prevention, 1.1 million people in the United States are living with HIV/AIDS and nearly 50,000 people become infected with HIV each year. In 2010, African-Americans accounted for only 14% of the U.S. population, but 44% of new HIV infections. The majority (70%) of new HIV infections among African-Americans occur among black men, and are concentrated among gay men. In fact, young black gay and bisexual men who are the only group in the black community where new HIV infections are increasing. Black women represent 30% of new infections among African-Americans. Transgender black women are also at risk for HIV with as many as one in three in some studies diagnosed with HIV. And only 21% of black Americans have a suppressed viral load, the key health marker for HIV treatment.
- Posted byon December 19, 2012 at 4:49 PM EDT
As we commemorated World AIDS Day earlier this month, the importance of addressing the needs of women and girls as part of the National HIV/AIDS Strategy was clear. While we have made tremendous progress in learning how to prevent and treat HIV, including among women and girls, much work remains. Of the approximately 1.1 million people living with HIV/AIDS in the United States, about 290,000 are women and women account for 23 percent of new HIV infections.
This Administration has made combating the HIV/AIDS epidemic a priority. For women, that includes addressing gender-based violence and gender related health disparities. This violence can increase the risks women and girls face of acquiring HIV while decreasing their ability to seek prevention, treatment, and health services.
As directed by the National HIV/AIDS Strategy, federal agencies are collaborating and coordinating in an unprecedented manner to decrease new HIV/AIDS infections, improve HIV-related outcomes, and reduce HIV-related disparities. To continue this collaborative approach, President Obama issued a Presidential Memorandum in March 2012, establishing an interagency working group on the intersection of HIV/AIDS, violence against women and girls, and gender-related health disparities.
The working group includes representatives from the Departments of Justice, Interior, Health and Human Services, Education, Homeland Security, Veterans Affairs, Housing and Urban Development, and the Office of Management and Budget. We are also tapping into the wealth of expertise and experience of members of the Presidential Advisory Council on HIV/AIDS as well as our global Federal partners from the Department of State, the United States Agency for International Development, and the Gender Technical Working Group from the President’s Emergency Plan for AIDS Relief (PEPFAR).
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