Office of National AIDS Policy Blog

  • Helping Understand and Treat HIV Through Community-Based Leadership

    The lesbian, gay, bisexual and transgender (LGBT) community have helped bring about much of the tremendous progress in understanding and treating HIV, ranging from increasing HIV awareness, to fighting HIV-related discrimination, to volunteering for cutting-edge research. This legacy of community-based leadership is one to note on this 5th Annual National Gay Men’s HIV/Awareness Day.

    In 2010, President Obama released the nation’s first comprehensive National HIV/AIDS Strategy, which called for aligning resources where HIV is most concentrated, and implementing evidence-based, high-impact interventions to reduce new HIV infections, improving HIV-related health outcomes, and reducing HIV-related disparities. The Strategy has focused Federal, State, and local efforts on a combination prevention approach for gay men and other populations at high risk, including increasing HIV testing and HIV treatment, because studies demonstrate that increasing diagnosis rates and reducing viral loads will significantly reduce new HIV infections in disproportionately affected communities.

    The National HIV/AIDS Strategy also calls for addressing stigma and discrimination as part of a comprehensive response to the HIV epidemic. In keeping with the goals of the Strategy, the Department of Justice has taken steps to enforce civil rights laws that protect the rights of persons living with HIV/AIDS, and has launched a website dedicated to fighting discrimination against people living with HIV/AIDS. 

  • National HIV/AIDS and Aging Awareness Day: Recognizing the Challenges of Growing Older with HIV/AIDS

    Today marks the fifth observance of National HIV/AIDS and Aging Awareness Day.  It is a day where we recognize that while the progress made in reducing HIV mortality and morbidity is remarkable, people aging with HIV face multiple, unique challenges. By 2015 over half of all people living with HIV in the US will be over age 50. A major reason for the ‘greying’ of HIV in the US is due to the tremendous success of medications that have dramatically increased the lifespans of people living with HIV.

    About 10% of new HIV infections in the United States occur among persons over 50. HIV prevention among older adults is complicated because clinicians are less likely to consider the possibility of HIV infection in this population. Part of the reason for this is that the overwhelming majority of new HIV infections in the US occur among younger populations. However, decreased testing rates mean that older adults are more likely than younger adults to be diagnosed later in their disease progression (i.e. more likely to be diagnosed with AIDS less than a year after diagnosis).

    Racial and ethnic disparities observed in the US HIV epidemic overall are reflected among older persons living with HIV. The rates of HIV/AIDS among people over 50 are 12 times higher for African-Americans and 5 times higher for Latinos compared with whites, which has implications for life expectancy as well as HIV transmission because black and Latino populations generally are less likely to have access to clinical care. 

    While more people aging with HIV are living healthier, more productive lives than ever before, growing older with HIV may present multiple medical challenges. Because the immune systems of people living with HIV are constantly fighting infection, they are more prone to ongoing inflammation which is associated with co-morbid conditions associated with aging such as diabetes, heart disease, hypertension, and cancer. Liver disease, often the result of co-infection with hepatitis C, is prevalent. Decreased bone density is also common, potential due to combination of the normal aging process, medication side effects, and the direct effects of the virus itself

  • Implementation of the National HIV/AIDS Strategy: Grand Rounds at the CDC

    This week, I traveled to the Centers for Disease Control and Prevention’s (CDC) headquarters in Atlanta to present at CDC’s Public Health Grand Rounds, an ongoing series of monthly presentations on health-related topics pertinent to the health of Americans.

    This session consisted of four presentations directly relevant to the National HIV/AIDS Strategy (NHAS). After introductory remarks by CDC Director Dr. Tom Frieden, Dr. Jonathan Mermin presented “The Science of Optimizing HIV Prevention,” describing strategies to maximize the effectiveness of HIV prevention strategies, including integration of prevention and clinical care at the local level. Dr. Irene Hall presented “HIV Surveillance in Action,” reviewing advances in HIV surveillance that enable CDC data to be used for public health action at the provider and individual level. Dr. Stephanie Sansom followed with “Modeling to Identify Optimal Allocation of HIV Prevention Resources in a City Health Department,” focusing on how Philadelphia has used evidence-based modeling to set resource allocation priorities.

    I closed the session by providing an overview of NHAS implementation, emphasizing the importance of the Affordable Care Act in helping to meet NHAS goals and improving the health and wellness of people living with HIV. These presentations are an excellent reminder of the critical ongoing role that NHAS plays in fighting domestic epidemic. To watch this month’s Public Health Grand Rounds, please visit the CDC website.  

    Grant Colfax is the Director of the Office of National AIDS Policy

  • Continuing to Fight the HIV/AIDS Epidemic

    This has been an important month in the fight against HIV/AIDS: not only did we welcome people from around the world to the United States for the first time in 22 years to participate in the 2012 International AIDS Conference, but is it also the second anniversary of the release of the National HIV/AIDS Strategy. Last  week, the Office of National AIDS Policy (ONAP) released the second annual report on the progress made toward achieving the Strategy’s primary goals. 
     
    As a result of the Strategy, we are we are working together and making smarter investments than ever before. It has focused and intensified Federal prevention and care resources in communities where HIV is most heavily concentrated.
     
    President Obama has also made critical investments to expand access to HIV treatment and care. Since the President took office, domestic HIV/AIDS funding has increased by approximately $2.5 billion, and in his Fiscal Year 2013 Budget the President proposed $22 billion dollars for domestic HIV/AIDS programs.
     
    The Affordable Care Act has already provided millions of Americans increased access to HIV testing, and will extend coverage to 30 million more Americans, including tens of thousands of people living with HIV. The Act also prohibits lifetime dollar limits on benefits, phases out annual dollar limits, and ensures no one is denied coverage based on HIV status. 

  • Secretary Clinton to AIDS 2012: “We Will Not Back Off, We Will Not Back Down”

    I don’t think it’s an overstatement to say that Secretary Clinton electrified the AIDS 2012 audience with her keynote address at this week’s conference. Her speech was a perfect combination of substance and inspiration, and the enthusiastic reception made it clear that she had hit all the right notes.

    Last November, of course, she articulated the goal, made possible by recent scientific advances, of an AIDS-free generation. This laid the groundwork for President Obama’s groundbreaking announcement on World AIDS Day of ambitious new combination prevention goals for PEPFAR, including a 50% increase in our treatment goal, to 6 million by the end of fiscal year 2013.

    In her remarks this week, the Secretary updated the world on PEPFAR’s progress since then. We’ve dramatically increased the pace of treatment enrollment, reaching nearly 4.5 million with treatment through the first half of this fiscal year – putting us on track to meet the 6 million goal on time. One of the other goals was to reach 1.5 million HIV-positive pregnant women with services to prevent mother-to-child transmission of HIV – and we’re on target to achieve that as well, reaching 370,000 women in the first half of FY 2012. We’ve also performed 400,000 voluntary medical male circumcisions in that same time frame – with an accelerating pace as countries come to understand what a cost-effective, smart investment it is. Looking to the future, Secretary Clinton announced that she has asked me to produce, by World AIDS Day this year, a blueprint for the next steps in America’s contribution to an AIDS-free generation.

  • How Far We've Come: Gayle Smith on AIDS

    This week, the International AIDS Conference is being held in in Washington, D.C.  The Conference provides an opportunity for Administration officials to reflect on the effect that HIV/AIDS has had in their own lives, and how far we’ve come in the fight against the terrible disease. In the below video, Gayle Smith, Special Assistant to the President and Senior Director for Development and Democracy for the National Security Staff, shares how HIV/AIDS has personally impacted her life: