The Obama administration this week unveiled its domestic HIV/AIDS plan, a $30-million initiative that focuses significantly on prevention efforts among men who have sex with men (MSM).
The National HIV/AIDS Strategy, undertaken by the Office of National AIDS Policy and unveiled at a White House press conference Tuesday, outlines three priorities: reducing the number of new infections, increasing access to care and reducing HIV-related health disparities.
The five-year plan proposes that by 2015, the number of new annual HIV infections in the United States — a figure that now stands at more than 56,000 — should be reduced by 25 percent, along with a reduction of 30 percent in transmission rates, the number of new infections in relation to the number of people living with HIV, and an increase in the number of people who know their HIV status from 79 to 90 percent.
One of the main components of the reduction plan is to “intensify” prevention efforts among communities that are disproportionately affected by HIV infection.
According to the Centers for Disease Control and Prevention, gay men, who make up only about 2 percent of the American population, comprise about 53 percent of all new HIV infections. MSM are the only demographic in the country in which the number of new infections is rising annually.
“Given the starkness and the enduring nature of the disparate impact on gay and bisexual men, it is important to significantly reprioritize resources and attention on this community,” the plan stated. “The United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men. Our national commitment to this population has not always reached a level of HIV-prevention funding reflective of their risk.”
The plan mandates that by the end of this year, the Department of Health and Human Services begins planning for a meeting with leaders of national LGBT organizations to “reengage LGBT community leadership in health promotion.”
Next year, the CDC will make recommendations on funding for prevention efforts that specifically target MSM in the Fiscal Year 2011 budget, and will also work with states to increase STD surveillance systems to better collect data on the gender of sex partners. In addition, the CDC will work to ensure that state HIV-prevention programs are adequately allotting funds for prevention efforts among MSM.
Other targeted communities where similar efforts will be employed include African Americans, Latinos, Asian American and Pacific Islanders, Native Americans and intravenous-drug users.
To reduce the number of infections, the plan also proposes increasing resources and research for evidence-based prevention efforts and heightening awareness of the disease among all Americans, even those who are not at high risk for contracting it.
In terms of quality of care, the plan proposes to increase the proportion of newly diagnosed patients linked with clinical care within three months of their HIV diagnosis from 65 to 85 percent; to increase the proportion of Ryan White Program clients who are in continuous care from 73 to 80 percent; and to increase the number of Ryan White clients who have permanent housing from 82 to 86 percent.
The third priority of the plan, reducing HIV-related health disparities, aims to increase the proportion of HIV-diagnosed MSM with an undetectable viral load by 20 percent, the same figure set forth for African Americans and Latinos.
The strategy proposes that such reductions can be achieved through the development of new community-level approaches and enhanced federal support for viral-load detection systems in states and municipalities. The negative stigma surrounding the disease also needs to be alleviated, the plan proposed, through outreach efforts by faith communities, businesses, government agencies and other organizations, as well as through leadership from HIV-positive public figures and the strengthening and enforcement of state and federal discrimination laws.
Through the efforts outlined in the strategy, ONAP aims that by 2015, the U.S. will “become 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.”
Joe Solmonese, president of the Human Rights Campaign, commended the release of the plan that he called “bold and historic,” but cautioned that its successful implementation will require unprecedented cooperation.
“The goals and timetables laid out in this document cannot and will not be achieved without strong leadership and robust resources,” he said. “All of us — including the administration and Congress, state governments, service providers and advocates — must commit to ensuring that the bold vision of this plan is fulfilled.”
President Obama echoed Solmonese’s sentiments at this week’s press conference.
“Yes, government has to do its part,” Obama said. “But our ability to combat HIV/AIDS doesn’t rest on government alone. It requires companies to contribute funding and expertise to the fight. It requires us to use every source of information — from TV to film to the Internet — to promote AIDS awareness. It requires community leaders to embrace all — and not just some — who are affected by the disease. It requires each of us to act responsibly in our own lives, and it requires all of us to look inward — to ask not only how we can end this scourge, but also how we can root out the inequities and the attitudes on which this scourge thrives.”
Jen Colletta can be reached at [email protected].