White House updates HIV/AIDS strategy

The Obama administration last week released the first update to the National HIV/AIDS Strategy.

The plan was first unveiled in 2010 with a five-year outlook. Last week’s update includes plans for up to 2020.

It aims to reduce new infections by at least 25 percent, with a refocused attention on populations disproportionately affected by the disease, such as men who have sex with men.

The four goals of the plan remain unchanged: to reduce new HIV infections; increase access to care and improve health outcomes for people living with HIV; reduce HIV-related disparities and health inequities; and achieve a more coordinated national response to the epidemic.

Those goals are organized under the vision that the plan will help the nation “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.”

The strategy calls for a multifaceted approach to that aim, including integrated and patient-centered HIV and STI screening, with expanded access to PrEP and PEP. It proposes a focus on linking people to care immediately after a diagnosis, increasing the capacity and diversity of health providers and addressing co-occurring conditions and challenges, such as housing. To advance federal collaboration, the plan calls for streamlined grantee-reporting requirements and enhanced program accountability. To reduce disparities, the strategy urges expanded services to gay and bisexual men, especially young black men, black women and Southern residents.

According to the plan, more than 50 percent of new HIV diagnoses in 2013, the most recent year for which data are available, were in the South. The Northeast made up about 19 percent of new diagnoses, followed by the West and Midwest.

In a statement, AIDS Healthcare Foundation applauded the new focus on the South, but expressed concern about prioritizing PrEP.

“We believe a much greater focus — and commensurate resources — need to be dedicated to ‘treatment as prevention’ in order to identify and link the 70 percent of the 1.2-million Americans living with HIV/AIDS today who do not have their virus suppressed,” AHF said. “Treatment as prevention is a far more prudent health approach to really breaking the chain of new infections than a widespread public-health strategy that includes an overreliance on PrEP.” 

The new plan notes that the last five years have seen major changes in the health-care industry, such as the implementation of the Affordable Care Act, the approval of PrEP in 2012, groundbreaking work by National Institutes of Health and Centers for Disease Control, funding increases for AIDS Drug Assistance Programs and new collaboration among federal agencies. 

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