By Christopher Bates , M.P.A., Executive
Director, Presidential Advisory Council on HIV/AIDS, and Senior Advisor to the Deputy Assistant Secretary for Health,
Infectious Diseases, U.S. Department of Health and Human Services
This is the final in
our series of daily highlights from
the U.S. Conference on AIDS, which wrapped up Sunday in Chicago. In addition to highlights from the final day's activities, we
also wanted to share a short interview with Mr. Jeffrey Crowley, Director of the White House Office of National AIDS Policy, we
captured at the conference.
Closing Plenary Luncheon: Looking Forward to 2012
Sunday's closing plenary session looked forward to some significant opportunities for the HIV/AIDS movement in the near future,
including applying recent scientific advances and scaling up treatment as prevention, the 2012 International AIDS Conference,
and implementation of the Affordable Care Act and the National HIV/AIDS Strategy.
Dr. Julio Montaner,
Director of the British Columbia Centre for Excellence in HIV/AIDS and past
president of the International AIDS Society, discussed the idea of treatment as prevention, sharing findings from his research in
British Columbia. That research showed that as they expanded the number of HIV positive individuals on highly active
antiretroviral therapy (HAART), there was a corresponding reduction the number of new HIV infections. This
reduction occurred because, Dr. Montaner explained, HAART stops viral replication, which, in turn, causes
HIV levels fall to undetectable levels in blood as well as in sexual fluids making transmission of the
virus much less likely. Dr. Montaner suggested that expanded HAART coverage is now among the
strongest tools in the combination prevention toolbox. "This is about treating people who need
life saving therapy; but, if we do it right, we can stop the epidemic," he said. He praised
Secretary of State Hillary Clinton's acknowledgment of treatment as prevention as
integral to the global fight against AIDS in her speech last
week about creating an AIDS-free generation.
In his remarks,
Mr. Bertrand Audoin, Executive Director of the International AIDS Society , looked forward
to AIDS 2012 , the 19th International AIDS Conference that will be held
July 22-27, 2012, in Washington, DC. He urged USCA conference participants to take full advantage of the international
conference returning to the United States for the first time in more than 20 years, noting that the diversity of sessions,
speakers, and activities allow many opportunities to learn from and even form partnerships with individuals and
organizations working to end the HIV/AIDS epidemic across the globe. The conference theme, "Turning the
Tide Together," Mr. Audoin observed, reflects the renewed optimism that a change of course in the epidemic
is possible due to recent scientific advances in HIV treatment and biomedical prevention, including
treatment as prevention, which Dr. Montaner and others discussed at the conference. AIDS 2012
will emphasize solutions and moving new scientific advances to implementation, Mr. Audoin observed.
Finally, Dr. Mary Wakefield,
Administrator of the Health Resources and Services Administration ( HRSA ),
closed the conference with an update on the implementation of the Patient Protection and Affordable Care Act (ACA)
and the National HIV/AIDS Strategy across her agency, which administers
programs including the Ryan White CARE Program and the network of federally-supported Community Health Centers. Dr. Wakefield
observed that across the several bureaus and offices that comprise HRSA, she and her colleagues are actively involved in
the Administration's efforts to protect the interests of people living with HIV/AIDS (PLWH/A), deliver care to PLWH/A,
and improve access to and the quality of HIV care and treatment. She also shared that as we move towards
reauthorization of the Ryan White program in 2013, and full-implementation of the ACA one year later,
HRSA is hard at work figuring out how the Ryan White program wraps around the Affordable Care Act.
Many activities also consistent with the National HIV/AIDS Strategy, she noted, are already underway, including:
Studies underway at the HIV/AIDS Bureau looking at the HIV clinician workforce and staffing requirements and the critical problem of retention in treatment.
HRSA's Bureau of Health Professions is working in partnership with 11 universities to develop teaching modules for future clinicians on a host of issues, ranging from HIV in elderly patients and chronic disease management in vulnerable populations to on-site training for medical students in outreach centers for homeless people living with HIV.
HRSA's Bureau of Primary Health Care, which oversees the health center program, is working to expand HIV testing and care across 8,100 clinical sites. They recently reported a 30% increase in the number of individuals screened for HIV over the past year with more than 780,000 people tested at a health center last year.
HRSA is also working to assist AIDS Services Organizations and LGBT health clinics with planning grants to help them become health centers. At the same time, it is working with existing health centers to strengthen their capacity to deliver HIV/AIDS specialty care and also better meet the health care needs of the LGBT community through both the activities of the National Center for HIV Care in Minority Communities and a new technical assistance and training center on LGBT health.
In conclusion, Dr. Wakefield urged continued collaborative efforts, "If we are to meet the challenge of achieving and
HIV-free generation as Secretary Clinton has challenged the world to do, it is critically important that all of us from local,
community, state and Federal levels work as effectively and efficiently as possible to deploy all available resources, seek
new opportunities to leverage them, and deliver high quality HIV prevention, care and treatment."
AIDS 2012 Community Roundtable
Another session Sunday featured an overview of the 2012 International AIDS Conference (AIDS 2012). Both conference
organizers and participants in prior conference encouraged USCA participants to take advantage of the global gathering being
held in the U.S. for the first time in more than 20 years and plan to attend. They also offered tips on making the
most of the many aspects conference including the presentations on the latest HIV science, poster sessions, the global
village, and many other activities being planned. For those who will not be able to travel to Washington, DC for the
conference, presenters urged that they consider planning or participating
in a hub session , many
of which will take place in cities around the world.
Medicaid and Other Safety Net Programs
AIDS.gov also attended the workshop "Why HIV Advocates Should Care: Making Sense of Federal and State Threats to
Medicaid and other Safety-net Programs" with presentations by the HIV Medicine Association, Project Inform, and Treatment Access
Expansion Project. They highlighted political and economic issues that could impact the Medicaid program and other critical
programs supporting health care for people living with HIV/AIDS at the Federal and state levels. Among the topics
discussed was the Pre-existing Condition Insurance Program (PCIP), a temporary high-risk health insurance pool
program created by last year's health care reform law, the Affordable Care Act. More information about PCIP
is available at www.pcip.gov.