Office of National AIDS Policy Blog

  • Prevention and Treatment of HIV Infection in Infants Born to Infected Mothers: Need for a Fresh Look

    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.

  • The Role of Science in Helping Achieve the Vision of the National HIV/AIDS Strategy

    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.

  • Addressing HIV in the Black Community

    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. 

  • We Want to Hear from You

    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). 

  • Moving Towards an AIDS-free Generation

    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)

    What a year it has been!  One year ago on World AIDS Day, President Obama announced ambitious new targets in the global fight against HIV/AIDS, and on the domestic front focused investment to support the first comprehensive National HIV/AIDS Strategy to fight the epidemic here at home. In the President’s speech that day he said: “we are going to win this fight. But the fight is not over…”  As we celebrate World AIDS Day 2012, it is worth taking a moment to look back at what’s been achieved and what remains to be done to meet the goal of an AIDS-free generation.

    We’re pleased to announce that the President’s commitments have translated into meaningful action over the last year and that we’re making measurable, real progress.  We’ll talk about that progress in detail this week, when the White House will host an event for World AIDS Day on November 29 from 1pm-3pm, which you can watch at www.whitehouse.gov/live. We’ll discuss the results we have achieved over the last year – including towards meeting the targets set by the President one year ago, and the next steps we will be taking to turn the tide on this epidemic. Please join us!

    This summer, we were reminded that HIV impacts all of us, no matter who we are or where we live. The International AIDS Conference returned to the United States for the first time in 22 years, thanks to President Obama concluding a successful bipartisan effort to end the entry ban on persons living with HIV. The Conference was an unqualified success, with new and exciting treatment and prevention research announced and representation of persons living with HIV from all regions of the world. President Obama welcomed delegates to the conference and hosted HIV-positive conference delegates and others for a White House reception. Six senior White House staff recorded powerful and personal videos on how the HIV/AIDS epidemic has impacted their lives. 

  • Observing National Latino HIV/AIDS Awareness Day

    Today, we observe the 10th anniversary of National Latino AIDS Awareness Day.  It is a day where we recognize how far we’ve come, but also how much more work there is to do fighting HIV/AIDS in the Latino community. In commemoration of today, Mayra Alvarez, Director of Public Health Policy in the Office of Health Reform at the U.S. Department of Health and Human Services, posted a blog discussing the sobering HIV/AIDS statistics and this Administration’s commitment to fighting HIV/AIDS in the Latino community.

    To read Mayra’s post, please visit aids.gov.