America

Obama Unveils First National HIV/AIDS Strategy

Kathleen Sebelius

Health and Human Services Secretary Kathleen Sebelius speaks about the National HIV/AIDS Strategy in the Eisenhower Executive Office Building. Charles Dharapak/AP hide caption

itoggle caption Charles Dharapak/AP

To mixed reviews, the Obama Administration on Tuesday released its national strategy for HIV/AIDS. The White House called the document, and the Executive Branch focus it reflects, the first of their kind in the nation's fight against one of the world's most feared viral infections.

The new strategy calls for the nation to take make progress in three key areas: lowering the number of new HIV infections; improving both access to care and health outcomes for people with HIV/AIDS, and decreasing the disparities between the treatment received by white and minorities.

Health and Human Services Secretary Kathleen Sebelius introduced the Obama policy at a White House event Tuesday. An excerpt from her speech:

... Since the late 1990s, our progress in preventing new infections has slowed.  Annual infections have held steady at about 56,000 a year.  Because the number of Americans living with HIV has gone up over those years, that means we are still driving down infection rates.  But not fast enough.  We’re keeping pace, when we should be gaining ground.

That’s why President Obama called for the first-ever comprehensive, national HIV-AIDS strategy.  And after a year of information gathering and analysis – of conversations with doctors and persons living with HIV/AIDS, researchers and health workers, activists, community leaders and academics – we are announcing a plan today that has an ambitious vision.

That vision, and I quote, is that “The United States 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.”

In order to achieve that vision, this strategy outlines three concrete goals: reducing new HIV infections, increasing access to care and optimizing health outcomes for Americans with HIV/AIDS, and reducing HIV-related health disparities.

These goals aren’t necessarily new.  But the strategy for achieving them is.  We knew we couldn’t keep using the same approach and expect different results.  We also knew that at a time when all of us – the federal government, states, communities, non-profit groups, businesses – are being forced to do more with less, we couldn’t expect a big infusion of new resources.

So while this strategy does highlight areas for additional investment, it also identifies how we can use the resources we have more effectively to prevent, diagnose and treat HIV/AIDS.

To do that, we’re looking at areas where we can do better.  For example, we’ve been very successful at keeping HIV/AIDS incidence low for some populations.  If you’re a white, heterosexual woman like me, your chances of being infected by HIV/AIDS are very low – just 1 in 50,000.  But if you’re a black female who’s an injection drug user, your chances of being infected are more than 1,000 times higher – closer to 1 in 35.  If you’re a gay Hispanic man, your chances are 350 times higher.  In some U.S. cities, it’s estimated that almost half of all gay black men are HIV-positive.

So part of what this strategy says is that we’re going to intensify our prevention resources in the communities where infections are concentrated.

The new strategy was both welcomed and criticized by HIV/AIDS advocates.

Michael Saag, chair of the HIV Medicine Association, said in a statement:

The HIV Medicine Association applauds the Obama administration's release of a National HIV/AIDS Strategy that signals a strengthened national commitment to real and sustained success in the battle against HIV/AIDS. As clinicians and researchers on the frontline of this pandemic, we welcome this new comprehensive roadmap and look forward to working with diverse stakeholders at all levels of  government and within the private sector to implement it.

But the Charles King, president and chief executive officer of Housing Works which tries to ameliorate the problem of AIDS and homelessness, was disappointed. A snippet from a Housing Works press release:

“The president’s plan is so flawed that it might actually represent a step backwards in combating HIV and AIDS in the United States,” said Housing Works President and CEO Charles King. “Since his days on the campaign trail, President Obama has repeatedly said that he wants to lead the fight against AIDS. Unless he commits significant new resources intended to make major inroads against the spread of HIV, he will be regarded as a leader who did next to nothing about the most devastating epidemic of our time.”

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