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New U.S. AIDS Strategy Aims to Reduce New Infections by 25%

The Obama administration on Tuesday released a wide-ranging domestic AIDS policy plan that aims to reduce the annual number of new HIV infections by 25 percent by 2015 and calls for more targeted efforts to slow the spread of HIV among high-risk populations like blacks, Hispanics and gay men.

The document also sets specific targets to increase the percentage of infected people who know their HIV status and to provide more quick and comprehensive care for patients, among other goals.

“We can’t afford complacency — not when in the ten minutes I’ve been talking to you, another American has just contracted HIV,” Health and Human Services Secretary Kathleen Sebelius said in a statement. “That’s why our strategy calls for aggressive efforts to educate Americans about how dangerous this disease still is and the steps they can take to protect themselves and their loved ones.”

Secretary Sebelius also announced that $30 million of the health care reform act’s prevention fund will be dedicated to implementing the new strategy.

But the 60-page plan is not a budget document — the plan itself does not increase the amount of federal funding available for HIV/AIDS prevention and treatment; instead it suggests more coordination among federal, state and local governments and some reallocation of resources.

The plan is considered by many to be the first time the federal government has released a comprehensive national strategy for dealing with AIDS — something it requests from other countries before providing AIDS funding — said Jennifer Kates, HIV policy director at the Kaiser Family Foundation.

“When we give funding to other countries we ask for a strategy from them,” she noted. “It’s important to have one ourselves.”

In the plan, the administration says that the U.S. is at a “crossroads” in dealing with HIV/AIDS:

We have the knowledge and tools needed to slow the spread of HIV infection and improve the health of people living with HIV. Despite this potential, however, the public’s sense of urgency associated with combating the epidemic appears to be declining.

The document points out that in 1995, 44 percent of Americans believed that AIDS was the most urgent health problem facing the nation. In 2009, only six percent of people believed the same. But even as treatments have allowed many HIV-positive patients to live long and healthy lives, more Americans than ever before are living with AIDS — and approximately 56,000 more people become infected every year.

The problem is particularly acute among some high-risk groups, including blacks, Hispanics and gay men. Black men and women, for example, are only about 13 percent of the population, but make up 46 percent of all HIV patients. Gay and bisexual men are 2 percent of the population, but make up 53 percent of all new HIV infections, according to the report. And AIDS cases are particularly concentrated in the Northeast and South (Watch this NewsHour report from 2008 on AIDS in Washington, D.C.)

The new strategy instructs federal, state and local governments to direct more resources to these high-risk groups.

It also sets out some specific goals, including:

• Reducing the HIV transmission rate by 30 percent.

• Increasing the number of HIV-positive people who their HIV status from 79 percent to 90 percent by 2015.

• Increasing the proportion of people who get clinical care within three months of being diagnosed with HIV from 65 percent to 85 percent by 2015.

Many AIDS policy experts and activists say they are pleased with the directions and goals laid out in the new plan.

“We think the ideas are aggressive and would go a long way toward combating [the AIDS epidemic]” says Andy Izquierdo, director of government and media relations for the National Minority AIDS council.

Julie Scofield, executive director of the National Association of State and Territorial AIDS Directors, concurs. She says that the improved federal coordination is key: “We have over time developed so many different silos of funding that have gone out to state and local health departments, without coordination as to reporting requirements, data and all those things […] greater coordination at the federal level could really make programs more efficient.”

But Scofield and Izquierdo both emphasize that the plan’s success will hinge on implementation and resources — and that resources are stretched thin right now.
One example: Last week, Health and Human Services Secretary Kathleen Sebelius announced that the department would reallocate $25 million to provide medications for AIDS patients, thousands of whom are on waiting lists with state AIDS drug assistance programs.

Experts told the New York Times that the money would help, but would likely not be enough to eliminate the waiting lists.

Scofield says she hopes the new strategy will mobilize Congress to provide more funding for AIDS prevention and treatment.

And Izquierdo says: “The ideas [in the plan] are good. But the issue goes beyond reallocation [of resources]. We need to start talking about new money and putting that into place, because that’s what will really make a difference.”

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