Office of National AIDS Policy Blog

  • Institute of Medicine Issues Second Report on HIV Screening and Access to Care

    Today, the Institute of Medicine (IOM) released the second report in a series that evaluates HIV testing policies and access to care. This report, which is entitled “HIV Screening and Access to Care: Exploring the Impact of Policies on Access to and Provision of HIV Care”, examines 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. The report found that the lack of integration in State and Federal programs that assist people with HIV creates or exacerbates barriers to adequate HIV treatment. In addition, the report concludes that patients often experience medical and social difficulties as a result of their HIV status that, in turn, interfere with their HIV treatment.

    In 2009, the White House Office of National AIDS Policy (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 final forthcoming report in the series will focus on the current capacity of the health care system to administer a great number of HIV tests and to accommodate new HIV diagnoses.

    Last July, the President released the National HIV/AIDS Strategy for the United States that includes three primary goals of (1) reducing new HIV infections; (2) increasing access to care; and (3) reducing HIV-related health disparities. Of note, the goal of increasing access to care is tied to the implementation of the Affordable Care Act, which will significantly expand access to care for people with HIV. This report highlights the opportunities within the Affordable Care Act to expand access, but also addresses the potential challenges we face with respect to ensuring services are coordinated and integrated to improve the quality of care for people with HIV.  As we work toward implementing the goals of the Strategy and the Affordable Care Act, we expect that the issues raised in the report will aid in our implementation efforts.

    To obtain a copy of today’s report or the first report released from the Committee, please visit the IOM website at www.IOM.edu.  

    Chantelle Britton is the Policy Advisor for the Office of National AIDS Policy

  • ONAP Staff: It Gets Better

    Yesterday several White House staff posted a blog and video as part of the ‘It Gets Better ‘project.  ‘It Gets Better’ is a national campaign targeting LGBT youth that started in the wake of several high profile suicides.  The campaign encourages LGBT youth who may be the subject of discrimination, scorn or ostracization to look beyond their current circumstances and realize that that a bright future lies ahead.  ONAP Director Jeffrey Crowley and I both participated in the video.

     

    Resources

    If you’re a young person who’s been bullied or harassed by your peers, or you’re a parent or teacher who knows a young person being bullied or harassed, here are a few resources that can help you:

    The Trevor Project 

    The Trevor Project is determined to end suicide among LBGTQ youth by providing resources and a nationwide, 24 hour hotline.  If you are considering suicide or need help, call: 866-4-U-TREVOR (866-488-7386).

    BullyingInfo.org

    BullyingInfo.org is a project of the Interagency Working Group on Youth Programs (IWGYP) focused on providing tools and resources for youth, parents, teachers and mental health providers to prevent and address bullying. 

    It Gets Better Project

    President Obama's video and Vice President Biden’s video are just a couple of the thousands of videos submitted by people across the country to inspire and encourage LGBT youth who are struggling.  You can watch more videos at ItGetsBetterProject.com.

    For even more information and resources visit or call:

    Greg Millett is ONAP Senior Policy Advisor

  • Moving Forward to Implement the National HIV/AIDS Strategy

    In July, the President released the National HIV/AIDS Strategy for the United States, the most comprehensive effort to-date to set national priorities for responding to the domestic HIV/AIDS epidemic with quantitative metrics for measuring our progress.  At that time, he also released a Federal Implementation Plan identifying specific action steps for 2010 and 2011 and a Presidential memorandum to ensure ongoing actions are taken to fully implement the Strategy. The Presidential memorandum gave lead agencies (The Departments of Health and Human Services, Housing and Urban Development, Justice, Labor, and Veterans Affairs, along with the Social Security Administration) 150 days to deliver operational plans responsive to the implementation of the Strategy.  Additionally, he tasked the Departments of Defense and State and the Equal Employment Opportunity Commission with developing reports providing recommendations and action steps to support implementation of the Strategy.  This week is the deadline for agencies to submit their plans and reports to the Office of National AIDS Policy (ONAP) and the Office of Management and Budget (OMB).  Given the high level of interest in this process and the strong momentum that we have sustained in developing the Strategy, I wanted to share the next steps of this process:

    In December, ONAP and OMB will review the submissions by the agencies.  In early January, we plan to re-convene the Federal Interagency Working Group which consists of high level HIV leaders from across the Federal government to collectively review the plans and continue to consider one of the Strategy’s key goals: improving coordination and collaboration across the Federal government. 

    In the New Year the Presidential Advisory Council on HIV/AIDS (PACHA) will also meet and reviewing these plans will be on their agenda.  In addition, ONAP will develop a synthesis document for public release early in 2011 that pulls together key activities outlined in the individual agency plans. 

    My team in ONAP and our colleagues in OMB greatly appreciate the effort by all of the Federal agencies to be responsive to the National HIV/AIDS Strategy.  The Obama Administration is committed to providing strong Federal leadership to reinvigorate the national response to HIV/AIDS in order to reduce the number of new infections, increase access to care, and reduce HIV-related health disparities.  Our actions, however, are just one part of a broader effort that will be necessary to meet the Strategy’s ambitious goals.  Our hope is that State and local government commit to developing their own implementation plans, and advocates, businesses, faith communities and others take other actions to further the goals of the Strategy.

    This is a good week for all of us.  We are doing the hard work that will lead us toward the realization of the vision of the National HIV/AIDS Strategy in which the United States is 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.

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

  • Commemorating World AIDS Day

    Download Video: mp4 (7MB) | mp3 (1MB)

    Today, Obama Administration officials and leaders in the AIDS community will speak at a World AIDS Day event at the White House to reflect on the lessons learned and the path forward in the fight against HIV and AIDS in the United States and around the world.  The White House World AIDS Day Event will include keynote remarks as well as a panel discussion with HIV/AIDS researchers and advocates and will be live streamed at 1:30 on www.whitehouse.gov/live

    World AIDS Day Ribbon at the White House

    A red ribbon is displayed on the North Portico of the White House, Nov. 30, 2010, in advance of World AIDS Day. (Official White House Photo by Lawrence Jackson) (Official White House Photo)

  • NIH-Funded Study Finds Daily Dose of Antiretroviral Drug Reduces Risk of HIV

    Today, the New England Journal of Medicine published research findings from the iPrEx study funded by the National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation testing the efficacy of pre-exposure prophylaxis (PrEP).  The study is a major step forward in our ability to prevent new HIV infections.  The study found that a daily dose of an oral antiretroviral drug taken by HIV-negative gay and bisexual men and transgender women reduced the risk of acquiring HIV infection by 43.8 percent. The data showed even higher levels of protection from infection, up to 73 percent, among those participants who adhered most closely to the daily drug regimen.

  • Highlighting HIV Issues Among Older Americans

    Over 1 million Americans are living with HIV and the number is growing.   Advances in medication have not only increased the lifespan for people living with HIV, but also the quality of our lives.  Despite this good news, it has also brought new challenges that were not anticipated back when being diagnosed with HIV carried a prognosis of a much shorter lifespan.  One of the most surprising aspects of the domestic HIV epidemic is the number of people aging with HIV.  Earlier this year, New York City’s Department of Health and Mental Hygiene reported that 75% people living with HIV in the city were 40 years old or older and 37% were 50 years of age and older.  This phenomenon is not just taking place in New York City—similar demographic trends are being observed nationally.  According to experts at Yale Medical school, is estimated that 50% of people living with HIV in the US will be 50 years old or more by 2017. Moreover, 31% of new HIV infections in the United States each year occur among those between the ages of 40 and 49 and 7% of new infections occur among those 50 years old and older. 

    This week the White House Office of National AIDS Policy convened a meeting on HIV and aging to discuss these demographic trends. The purpose of the meeting was to raise awareness about people who are aging with HIV or contracting HIV as seniors (>50 years of age); to explore unique clinical manifestations of HIV infection among older adults; to discuss existing services for seniors living with HIV and highlight successes as well as gaps; and to discuss targeted strategies for Federal and non-Federal stakeholders to realize the vision of the President’s National HIV/AIDS Strategy. The meeting was part of a series of discussions that have been convened at the White House over the past year, including meetings that have focused on women, youth, Latinos and other populations. 

    The White House HIV and aging meeting agenda included an epidemiological and clinical overview of older Americans (age 50 or older) by Dr. Amy Justice of Yale School of Medicine.  Dr. Justice discussed findings from various research studies and the complications of managing a chronic infection and the commorbid conditions related to the aging process.  This was followed by a panel discussion of people of various demographic backgrounds who are aging with HIV, and complemented by a video clip from ABC’s popular television series Brothers & Sisters where executive producer David Marshall Grant and actor Ron Rifkin discussed the storyline behind a major character on the show who is a senior and diagnosed with HIV.  

    A panel of Federal officials provided information on prevention, care, research, disability, legal and workforce issues related to people aging with HIV; and a final community panel further explored these issues at the local level.  A highlight of the meeting included recognizing Dr. Robert Franke, a retired university provost and Unitarian Universalist minister who is living with HIV and who recently won a discrimination lawsuit against a Arkansas nursing home.

    The meeting ended with a clear message that older age is not a safety net that protects people from getting HIV and that people are living with HIV for decades.  It was also clear that the many issues surrounding HIV among older adults will only increase as our country faces the continuing graying of our nation’s HIV epidemic.