White House Launches HIV Care Continuum Initiative
July 15, 2013 by Shane Snowdon, Director, Health & Aging Program
HRC Senior Public Policy Advocate Andrea Levario and I attended today’s launch at the White House of the new HIV Care Continuum Initiative, created via an Executive Order signed by President Obama this morning. As the President noted in signing what he called “the next step” in the HIV/AIDS strategy, “We’ve got to keep pushing."
The launch was scheduled on the third anniversary of the President’s National HIV/AIDS Strategy (NHAS), since the initiative reflects and responds to major HIV/AIDS-related developments in the last three years. Launch attendees included dozens of HIV/AIDS organizations, advocates, clinicians, government officials and researchers from around the country.
Speakers at the launch included senior presidential advisor Valerie Jarrett, who spoke movingly of her sister-in-law’s death from AIDS and noted that the battle against HIV/AIDS “for so many of us is personal.” She was followed by U.S. Health & Human Services Secretary Kathleen Sebelius, whose rallying-cry was “an AIDS-free generation.” Secy. Sebelius described what the Affordable Care Act has done and will do for people living with HIV/AIDS and others, including the removal of lifetime dollar limits on benefits, the prohibition of coverage denials for pre-existing conditions, an expanded Medicaid program and state health insurance marketplaces.
Secy. Sebelius also joined other speakers in describing the fall-off in the “continuum of care” that the new initiative is designed to address: of the 1.1 million Americans estimated to be living with HIV infection, 82% are aware they are infected, 66% have been linked to care, 37% have been retained in care, 33% are taking ART (HIV) medications and in only 25% is the virus effectively controlled. In other words, she said, only 1 in 4 Americans living with HIV receives the full benefits of treatment—and she joined other speakers in calling for that ratio to become “4 in 4.”
Rep. Barbara Lee, the Democrat who represents Oakland and nearby areas in Congress, spoke candidly about her well-known work to increase HIV/AIDS awareness and resources as the co-chair of the Congressional Caucus on HIV/AIDS and a member of the powerful House Appropriations Committee. “We’re not getting enough,” she told us, “but we’re getting some things, and we’re going to get more.”
She was followed by Carl Dieffenbach, Director of the Division of AIDS within the National Institute of Allergy and Infectious Diseases, who provided an overview of major developments since the NHAS was announced three years ago. Among those he highlighted are the federal recommendation that all Americans living with HIV receive antiretroviral treatment, the research showing that treatment reduces the risk of HIV transmission and the recommendation that all Americans 15-65 be screened for HIV.
The perspectives of clinicians, people living with HIV/AIDS, public health and community-based organizations were represented via a lively panel moderated by JoAnne Keatley of the UCSF Center of Excellence for Transgender Health. Amanda Castel of the George Washington University School of Public Health, Carlos del Rio of the Emory University Center for AIDS Research, DeAnn Gruber of the Louisiana state health department, Kali Lindsey of the National Minority AIDS Council, Scott McPherson of The Stigma Project and Gloria Searson of the Coalition on Positive Health Empowerment all spoke to what one attendee called “the real-life challenges” of decreasing the fall-off in care that the new initiative targets.
Grant Colfax, who has served as Director of the White House Office of National AIDS Policy (or “AIDS policy czar”) since March 2012, concluded the launch with a description of the new Care Continuum Initiative. To be overseen by his office and implemented by a cross-federal agency workgroup, the initiative has these goals:
- Support further integration of HIV prevention and care efforts
- Promote expansion of successful HIV testing and service delivery models
- Encourage innovative approaches to addressing barriers to accessing testing and treatment
- Ensure that federal resources are appropriately focused on implementing evidence-based interventions along the HIV care continuum
The launch event announced one new source of funding in relation to the initiative, $8.5-10 million for “Integrating HIV Prevention and Care Services to Improve HIV Outcomes in Areas of High Unmet Need.” As described by Secy. Sebelius, whose department will provide the funding, it will support “a new demonstration project to expand the capacity of community health centers, local health departments and their grantees to provide integrated HIV prevention and treatment services across the HIV care continuum.”
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