National HIV/AIDS Strategy in the Spotlight at 2015 National HIV Prevention Conference

Cross posted from AIDS.gov, by Ronald O. Valdiserri, MD, MPH

The CDC’s 2015 National HIV Prevention Conference got underway last evening in Atlanta. Dr. Jonathan Mermin, Director of CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention, welcomed the more than 3,000 participants who have gathered under the conference theme of “Accelerating Progress: Prevent Infections. Strengthen Care. Reduce Disparities.”

The opening plenary session featured remarks about theNational HIV/AIDS Strategy: Updated to 2020 from Mr. Douglas Brooks, Director of the White House Office of National AIDS Policy (ONAP).  Douglas provided an overview of the Strategy, highlighting its vision, goals, and key principles. He also stressed the Strategy’s focus on reaching the right people in the right places with the right practices, which include widespread HIV testing and linkage to care, full support for people living with HIV to remain engaged in care and adherent to treatment, universal viral suppression, and access to pre-exposure prophylaxis (PrEP) for those for whom it is appropriate and desired.

To implement the Strategy, Douglas explained how federal agencies collaborated with ONAP to develop the NHAS Federal Action Plan, which was released at the White House on World AIDS Day. It details 170 action items that those agencies will undertake to best leverage resources, capacity, and expertise as they work collaboratively to achieve the goals of the Strategy. Those actions include, Douglas observed, many for which the HIV community had advocated.

A number of these actions are already underway, Douglas explained. As an example, he announced the launch of Know The Facts First, an awareness and education campaign to provide teen girls with accurate information about sexually transmitted infections and how they can prevent them. The campaign was developed by the HHS Office on Women’s Health in collaboration with the National Alliance of State and Territorial AIDS Directors (NASTAD) and the National Coalition of STD Directors. The new campaign addresses two of the key recommendations from the updated Strategy: developing and deploying evidence-based social marketing and education campaigns, and promoting age-appropriate HIV and STI prevention education.

Douglas also discussed how the Affordable Care Act is a critical tool in our efforts to prevent HIV infections, help individuals learn their HIV status, and improve the health of those living with HIV. He reminded participants that the open enrollment period for 2016 coverage available through the Health Insurance Marketplace continues through January 31, 2016, and he encouraged conference participants to help clients, family members, or friends enroll in coverage between now and then.

NHAS Community Action Plan Framework Released

Federal efforts alone, however, cannot achieve the goals of the Strategy, as Douglas reminded the conference participants. The Strategy makes clear that the efforts of non-federal partners from all sectors of society are vital to achieving those goals, including all of the organizations represented at the prevention conference. To assist non-federal partners in aligning their actions with the principles and priorities of the Strategy, Douglas introduced the NHAS Community Action Plan Framework. This new tool is designed to help organizations carefully focus work they may already be doing as well as identify new activities tailored to their organization’s mission and capacity. He explained that he hoped that the Framework can be used to stimulate dialogue and action within organizations and across communities so that, together, we achieve an even bigger impact.

HIV Diagnoses Decline Almost 20 Percent over Past Decade, Progress Uneven

During his plenary address, Dr. Eugene McCray, Director of CDC’s Division of HIV/AIDS Prevention, shared new data revealing that annual HIV diagnoses in the United States fell by 19 percent from 2005 to 2014, driven by dramatic and continuing declines over the decade among several populations including heterosexuals, people who inject drugs, and African Americans—with the steepest declines among Black women.

Dr. McCray cautioned, however, that same level of success was not seen among all gay, bisexual and other men who have sex with men (MSM), with diagnoses among Black and Latino gay and bisexual men increasing over the decade. Analysis of the more recent years’ data (2010-2014) provides more encouraging signs, he noted, with diagnoses stabilizing among Black MSM overall and young Black MSM after years of steep increases.  However, diagnoses continued to increase among Latino gay and bisexual men—both over the decade (by 24 percent from 5,492 to 6,829) and in more recent years (by 13 percent from 6,060 to 6,829). Dr. McCray also shared that the data shows uneven progress across states, with noteworthy disparities in many states in the South in both the proportion of infected people who are aware of their HIV status and death rates among people living with HIV.

Additional Perspectives to Lay Foundation for the Conference

After these stage-setting presentations by Mr. Brooks and Dr. McCray, the participants heard additional presentations designed to provide a foundation for the next three days of the meeting. These included:

• Dr. Tony Fauci, Director of NIH’s National Institute of Allergy and Infectious Diseases, who framed the end of the HIV/AIDS pandemic as an achievable goal in light of current science. He underscored the critical role that medications now play in both the HIV treatment and prevention continuums, concluding “The science has spoken. There can now be no excuse for inaction.”

• Dr. Mindy Fullilove, Professor of Clinical Psychiatry at Columbia University’s Mailman School of Public Health, who discussed some of the broader social determinants of health and proposed that the national HIV-response requires an urbanism-informed approach to public health.

• A panel discussion examined the perspectives and needs of persons living with HIV and touched on a range of issues that will be covered during the conference and must continue to be integral parts of our work responding to HIV. These included sharpening our HIV prevention and care approaches for the transgender community; combating stigma as well as its effects on people living with HIV; addressing the health and mental health issues related to aging with HIV; and factoring housing, food security, and other social determinants of health into our efforts.

Together, these presentations helped set the stage for a productive conference – providing us with important data on the state of the epidemic in the U.S., the state of the science, and many of the intersecting issues that our response to HIV must address.

National HIV Prevention Conference

The 2015 National HIV Prevention Conference, convened by the CDC and many public, private, and government agencies, is taking place in Atlanta, December 6-9, 2015. Under the theme “Accelerating Progress: Prevent Infections. Strengthen Care. Reduce Disparities,” the conference has gathered more than 3,000 scientists, public health officials, community workers, clinicians, and persons living with HIV from a wide variety of organizations to exchange information about effective approaches across the full spectrum of HIV prevention. Over the next several days, we will continue to share highlights from the conference.

Dr. Ron Valdiserri is the Deputy Assistant Secretary for Health, Infectious Diseases at the U.S. Department of Health and Human Services.