A national battle plan against HIV/AIDS
Familiar. That’s what strikes me about the National HIV/AIDS Strategy for the United States released yesterday. This is not a criticism. The 60-page document is neither unimaginative nor reinventing the wheel. It rightly brings the federal government in line with the clear-eyed, innovative actions being taken across the country to stem the epidemic. What gives this approach authority is that it is backed by the power of the presidency.
I’ve written a lot about the HIV/AIDS epidemic here in Washington, where at least 3 percent of the city’s population is living with the disease. That’s a wide swath of heartache across every socio-economic strata. But we know that African Americans and men who have sex with men are bearing the brunt of the epidemic -- in the District and across the country. The District now makes HIV testing a part of routine care. And it is pushing to get people into treatment sooner than they currently are. That the city has those devastating statistics and a plan to (try to) slow the spread of the epidemic is a testament to Shannon Hader, the outgoing HIV/AIDS chief, and the man who appointed her, Mayor Adrian Fenty.
I see that same commitment and focus in the new federal plan. It’s the same commitment and focus that has made the President’s Emergency Plan for AIDS Relief (PEPFAR) a global success -- and now those lessons are being brought to bear at home. Obama has ordered six federal agencies to submit a report on how they will implement the national strategy within 150 days.
The domestic goals are reasonably ambitious, meaning they stand a chance of being met. The number of new infections should be reduced by 25 percent by 2015. By that same year, there should be a 20 percent increase (to 85 percent) in the proportion of patients linked to care within three months of their diagnosis. And within that same five-year period, the proportion of gay and bisexual men and African Americans, respectively, with undetectable viral loads should be increased by 20 percent. Obama has ordered the Office of National AIDS Policy to report to him every year on its progress in meeting these goals.
Another reason they stand a chance of being met is because the administration will focus its prevention efforts in the communities where HIV has hunkered down.
Not every person or group has an equal chance of becoming infected with HIV. Yet, for many years, too much of our Nation’s response has been conducted as though everyone is equally at risk for HIV infection. Stopping HIV transmission requires that we focus more intently on the groups and communities where the most cases of new infections are occurring.
This is bound to be a controversial statement. It could reinforce the mistaken impression that HIV/AIDS impacts “other people.” But this gets to the heart of why the HIV/AIDS epidemic has been so difficult to fight -- a lack of honest discussion, which feeds the stigma that chokes off the discussion before one can be had. We also must be honest that even if we’re not among those most at-risk, we have a responsibility to protect ourselves and others.
Every nine and a half minutes, an American becomes HIV-positive. Put more starkly, five people became infected during the 48-minute announcement ceremony at the White House yesterday. Every year, more than 56,000 Americans become HIV-positive. While this rate of infection has been rather steady over the last decade, the number of people living with HIV/AIDS -- now at 1.1 million -- continues to grow. Knowing one's HIV status is key to fighting the epidemic. Knowledge is power -- power to get into treatment if infected, power to protect yourself if you’re not. With one in five people living with HIV unaware of their status, knowledge can save your life.
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