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Transparency, Ownership, Accountability: Monitoring the Updated National HIV/AIDS Strategy

Summary: 
The Administration releases the Indicator Supplement -- a companion document to the recently updated National HIV/AIDS Strategy.

Last month, the Administration, led by the Office of National AIDS Policy (ONAP), released the National HIV/AIDS Strategy: Updated to 2020 at an event at Morehouse School of Medicine in Atlanta, GA. The Update aims to reinvigorate national efforts to stem the HIV epidemic in the United States, and sets goals and priorities through the rest of the decade.

Today, we are releasing the Indicator Supplement, a companion document to the Update. It provides detailed information on each of 10 quantitative indicators that will be used to measure progress toward meeting the Strategy’s national HIV prevention, treatment, and care goals. For each indicator, the supplement highlights annual targets leading up to 2020, as well as information about the rationale, data sources and measures (e.g., numerator, denominator), expanding on details outlined in the “Indicator Development and Progress” Appendix of the Update.

The updated indicators are a central part of national efforts to monitor and evaluate implementation of the Strategy. Information about progress toward indicator targets will be included in an annual report released at the end of each year by ONAP, in conjunction with other White House offices and Federal agencies.

Developing the Indicators

As part of the Update process, in January 2015 a working group comprised of Federal agency representatives was charged with developing recommendations for indicators, measures, and targets to monitor progress toward achieving the Strategy goals.

Over the following six months, the working group:

  • Established criteria for reviewing existing, and developing new, indicators; selecting data sources; and determining indicator measures and targets;
  • Reviewed surveillance data and pertinent published literature; and consulted with stakeholders from the Federal government, academia, clinical care, and advocacy organizations;
  • Sought to develop updated indicators with ambitious, yet feasible, targets that would inspire action. 

The result was 10 quantitative indicators to measure progress toward meeting the Strategy’s HIV prevention, treatment, and care outcomes; five are new indicators and five are revised from the original 2010 indicators.

The working group considered many more options for indicators than the 10 that were selected. Many possible options did not meet one or more of the established criteria (e.g. nationally representative data that are routinely reported on a timely basis; valid, simple measures).

Of note, three key issues were designated as “developmental indicators.” These three issues are stigma, uptake of PrEP (pre-exposure prophylaxis), and HIV among transgender persons. Data and measures exist for all three but do not currently meet the indicator criteria. Working with stakeholders, the Federal government will develop indicators for these three issues over the next five years. When the indicators are finalized, we can monitor progress thereafter.

With the information in the updated Strategy and the Indicator Supplement, the Administration seeks to reach a new level of transparency, ownership, and accountability in working to reduce new infections, improve access to and outcomes from HIV medical care, reduce HIV-related health disparities, and achieve a more coordinated national response to the HIV epidemic in the United States.

Dr. Amy Lansky is a Senior Policy Advisor for the Office of National AIDS Policy and Office of National Drug Control Policy. Dr. Andrew Forsyth is Senior Science Advisor for the HHS Office of HIV/AIDS and Infectious Disease Policy. They are co-chairs of the Data Subgroup of the National HIV/AIDS Strategy Federal Interagency Working Group, which also includes Dr. Gina Brown (NIH), Ms. Antigone Dempsey (HRSA), Dr. Patty Dietz (CDC), Dr. Norma Harris (CDC), Ms. Heather Hauck (HRSA), Dr. Kevin Larsen (HHS), Dr. Eugene McCray (CDC), and Dr. Richard Wolitski (CDC).