Federal Response to HIV/AIDS

For nearly three decades, the federal government has invested billions of dollars in efforts to fight the epidemic by preventing new infections, treating those living with HIV and AIDS, and searching for new treatments and, ultimately, a cure.  Some of the key federal programs are described below. 

Despite the substantial expenditures on HIV and AIDS, the epidemic remains a critical public health issue, and uneven funding from year to year, as well as the imposition of ideological restrictions, have clouded our nation’s commitment to fighting HIV/AIDS.  

National HIV/AIDS Strategy

In July 2010, the White House released the National HIV/AIDS Strategy [PDF] (NHAS, the nation's first-ever comprehensive coordinated HIV/AIDS roadmap with clear and measurable targets to be achieved by 2015.  The three overarching goals of the strategy are (1) reducing new HIV infections, (2) increasing access to care and improving health outcomes for people living with HIV and (3) reducing HIV-related health disparities. 

Ryan White Comprehensive AIDS Resources Emergency (CARE) Act

First passed in 1990, the Ryan White CARE Act created the largest federal program dedicated to care and treatment for people living with HIV and AIDS.  Ryan White programs serve more than half a million people every year, providing critical care and treatment to those most in need.  Among the efforts funded by the Act is the AIDS Drug Assistance Program (ADAP), which, in financial partnership with state governments, provides access to HIV/AIDS medications to people who cannot afford them.  In 2010, over $2.2 billion was invested in Ryan White programs. 

The Ryan White CARE Act has been reauthorized twice since 1990, but the need for its critical programs continues to grow.  In particular, ADAPs are vulnerable to shortfalls in state budgets, requiring a strong federal response to ensure that those programs provide a full range of HIV/AIDS drugs and do not have to wait-list those in need of them.   

Housing Opportunities for Persons with AIDS Act

People with HIV and AIDS face an array of barriers to obtaining and maintaining affordable, stable housing.  Yet, such housing is critical to ensuring that those individuals get and stay into comprehensive, long-term care.  Recognizing this, Congress created the Housing Opportunities for People With AIDS (HOPWA) program in 1990. HOPWA is the only federal housing program that provides comprehensive, community-based housing for people with HIV and is administered by the Department of Housing and Urban Development (HUD). In 2010, HUD distributed $335 million of HOPWA funds to 133 metropolitan areas and state agencies to serve more than 90,000 households annually. 

HOPWA gives those local communities that are hardest hit by the HIV/AIDS epidemic desperately needed resources and local control over the use of those resources to meet the housing needs of people with AIDS. Communities may use HOPWA funds to develop a broad range of housing and support services, including short-term supported housing, rental assistance for low-income people with HIV/AIDS, community residences or coordinated home care services.

Federal Prevention Programs

Despite great strides in combating HIV and AIDS, the Centers for Disease Control and Prevention (CDC) estimates that the number of new HIV infections still exceeds 56,000 annually.  For each HIV infection that is prevented, an estimated $355,000 is saved in the cost of a lifetime of treatment.  CDC works with other federal agencies, state and local health departments, national organizations, community-based organizations, the private sector, and advocates to reduce the spread of HIV through behavioral interventions, HIV testing and linkage to treatment and care. 

In 2010, CDC invested more than $725 million in prevention efforts. 

Federal Research Efforts

Congress created the Office of AIDS Research at the National Institutes of Health in 1988 to coordinate research efforts throughout the federal government.  NIH scientists have conducted critical research to better understand the virus and how to prevent its spread, treat the infection and, ultimately, discover a cure.  In 2010 alone, NIH spent an estimated $3.1 billion on HIV/AIDS research.