3rd Anniversary of the National HIV/AIDS Strategy
July 15, 2013
Thank you all for being here today. And it’s always great to join Valerie and Cecilia in highlighting the tremendous work being done to improve the health and wellbeing of millions of Americans.
I want to especially thank our Surgeon General, Dr. Regina Benjamin, whose last day as America’s doctor is tomorrow. I’m grateful for her service.
And thanks to President Obama for his leadership on creating the HIV Care Continuum Initiative.
Our Department, with the great leadership of our Assistant Secretary Dr. Howard Koh, looks forward to being part of the working group and to continue implementing the National HIV/AIDS Strategy.
Today is an important milestone. Since President Obama launched it three years ago, our National HIV/AIDS Strategy has given a new sense of direction and purpose to our fight against HIV and AIDS here at home.
Although the number of people living with HIV infection in the U.S. continues to increase, the number of new infections per year has not changed significantly in the past few years.
In other words, there are more people are living with the virus, but there’s no corresponding increase in incidence. That’s a testament to the tremendous impact of existing HIV prevention interventions and the quality HIV medical care and treatment.
But we still lose far too many people in the United States to HIV/AIDS, particularly men who have sex with men of all races, and African American and Hispanic/Latino heterosexuals – and women, whose single greatest risk factor is sexual contact with a male partner or husband who may be unaware of his HIV infection.
But because we now have many of the tools we need to bring about an AIDS-Free generation in the United States, we have an urgent public health and moral imperative to do so.
We’re taking an important step in meeting the goals of the National HIV/AIDS Strategy by implementing the Affordable Care Act. As many of you know, the ACA is one of the most important laws in history and in our fight against HIV/AIDS.
Already, the law has expanded access to HIV screenings and ends some of the worst insurance company abuses – like denying coverage for pre-existing conditions, like HIV infection, and putting a lifetime cap on care when a patient needs it the most.
Come this October, when the online Health Insurance Marketplaces open for enrollment in every state, millions more Americans will gain access to affordable coverage with essential benefits that include HIV screenings and quality medical care.
And the health law also allows states to expand their Medicaid programs. Many people living with HIV will no longer have to wait for an AIDS diagnosis to become eligible for Medicaid.
An historic expansion of behavioral health coverage will also improve health outcomes and reduce inequities for people at risk or living with HIV, including those with co-occurring mental or substance abuse disorders.
The law will facilitate the achievement of the National HIV/AIDS Strategy’s overall goals to reduce new infections, improve access to and outcomes of quality care, and reduce HIV-associated health disparities.
These goals include fighting HIV stigma and discrimination. It includes advocating for the health of communities at greatest risk for HIV, including young, black, gay men and transgender people. It includes supporting research, in order to find more prevention and treatment breakthroughs.
And it means making smarter, more coordinated investments to fight the epidemic. And that’s really why today’s executive order on the care continuum is so important.
Because here’s what we know, as Cecilia and Valerie touched on:
- Approximately 1.1 million people age 13 or older are living with HIV infection in the United States and nearly 50,000 new infections occur each year.
- An estimated 18% of persons living with HIV infection are not aware of it and run the risk of preventable health problems and of transmitting the virus to others.
- Only 66% of those living with HIV infection, including those who are not yet diagnosed, are linked to quality care. But it gets worse: Only 37% of those living with HIV infection are retained in care and only 33% are started on health-preserving, life-extending antiretroviral medications.
- It is because of this attrition at each previous step that only 25% of those living with HIV infection in the U.S. accrue the full benefit of modern HIV medical care.
- In other words, we lose an estimated 825,000 people in the gaps between each of the steps necessary to suppress the virus, halt its adverse effects on health, and prevent transmitting the virus to others.
At HHS, we’re moving forward with projects designed to address many of the factors that lead people to fall out of the HIV care continuum. Here’re some of the things we’re doing:
- The NIH has expanded its investment in integrated behavioral and biomedical research to address gaps and opportunities in the HIV care continuum.
- SAMHSA is investing in screening and assessment for people living with HIV and in need of mental health or substance abuse treatment. We know that one key intervention that helps someone stay on their HIV treatment is to provide effective intervention for alcohol and substance abuse.
- HRSA is working to identify best practices to build workforce capacity in community health care centers to address each step of the HIV care cascade for persons living with HIV infection.
And today, I’m proud to announce a new demonstration project that builds on these incredible efforts:
- HRSA, OASH, and CDC will collaborate to expand the capacity of community health centers, local health departments, and their grantees to better integrate HIV prevention and treatment across the continuum of care.
- This new demonstration project will invest $8 to 10 million per year for three years to support health centers and local health departments in integrating public health practice and clinical care. The project will target areas with high numbers of racial and ethnic minorities, who are disproportionately affected by the epidemic, and communities with a substantial unmet need for comprehensive HIV services.
- Key outcomes of this new demonstration project will include increased HIV screening at health centers, as well as increased numbers of people who are diagnosed, linked to care, retained in care, treated, and achieve viral suppression.
These kinds of investments improve HIV prevention and care, but also address the barriers that can disrupt the continuum of care. And they are made possible by the incredible coordination among our dedicated agencies and world-class staff.
Today, more Americans have better access to health preserving, life-extending HIV prevention and medical care life-saving interventions than ever before.
And because of our work together, we’re saving lives and ushering in an AIDS-free generation that we know is within reach.
And I’m grateful to work with all of you on this critical effort.