Towards AIDS 2012: Accomplishments and Challenges in the U.S. Epidemic

We’re less than a month away from the beginning of the International AIDS Society (IAS) Conference – AIDS 2012 - in Washington, D.C.  In the coming weeks, the Office of National AIDS Policy is looking forward to bringing you a series of blogs that we hope inform the discussions at the IAS Conference. 

AIDS 2012 takes place at an historic moment in the fight against HIV/AIDS. Scientific advances, funded in large part by the United States, have made it possible to set our sights on creating an AIDS-free generation. To achieve this goal, we must all share in the responsibility to make smart investments that will improve and save even more lives. 

We know that we have our work cut out for us. On the domestic front, we must continue to target populations at the greatest risk and increase the availability of HIV testing and treatment. We will measure success in the best way it can be measured – whether we are preventing HIV infections and making lives better for people living with HIV/AIDS.

The Obama Administration is committed to continuing American leadership in both the domestic and global fight against this disease. As President Obama said on World AIDS Day, together, we can and we will win this fight. 

A month from now, thousands of people from across the globe will be coming to Washington, D.C. to discuss the latest innovative scientific and policy advances in HIV prevention and care at the annual International AIDS conference. Hosted by the International AIDS Society, the conference is returning to the United States for the first time since 1990 because of this and the prior Administration’s successful efforts to end the HIV/AIDS Entry Ban.

The conference’s return to the U.S comes at a pivotal moment in the history of the fight against HIV/AIDS.  Thanks to ongoing scientific advances, we’re now at the point, as described by President Obama on World AIDS day, where we can envision  an AIDS-free generation. 

In the 22 years since the IAS conference has been in the U.S., remarkable progress has been made in addressing the domestic epidemic. In 1990 we did not have effective treatments and thousands of Americans were dying from AIDS-related complications. Today, we have multiple effective medications to control the virus. Hundreds of thousands of Americans are alive because of these treatments.  Center for Disease Control reports show that due to widespread testing and treatment of pregnant women here in the United States, mother-to-child transmissions have dropped by nearly 90%.

We’ve also made great strides in raising HIV awareness – dispelling the myth that HIV can be transmitted through casual contact such as hugging or shaking hands – and promoting efforts that prevent infections such as using condoms, reducing numbers of sexual partners, using clean needles among people who inject drugs, and getting HIV tested on a regular basis.

Our legacy in the fight against HIV/AIDS in America is one that should inspire pride from all.  President Obama has continued this legacy– and these efforts are producing tangible results.  For the first time ever, we have a National HIV/AIDS Strategy to help ensure that we are making smart investments that will ultimately improve and save more lives.  Examples of recent progress include:

• Recent groundbreaking research sponsored by the National Institutes of Health proved that medications used to treat HIV also reduce the risk of transmission of the virus, ensuring that treatment and prevention are inexorably linked.
• Through the Center for Disease Control and Prevention’s  expanded testing initiative, thousands of people in the U.S. have been newly diagnosed with HIV and linked to life-extending treatment - - and by diagnosing people earlier,  the program saved $2 in future health costs for every dollar spent.  
• Nearly half a million persons living with HIV receive care and treatment through the Ryan White program, which supports successful “medical home” models that ensure people living with HIV receive comprehensive, complete care.
• The Affordable Care Act is producing important HIV prevention and care benefits now: millions of Americans can get HIV tested through their insurance plans without cost-sharing; AIDS drug assistance program (ADAP) contributions offset cost sharing, helping people move through the Medicare part D “donut hole” more quickly; and thousands of people living with HIV have insurance through state-based pre-existing condition insurance plans.  And in 2014, Americans cannot be denied or charged more for insurance based on a pre-existing condition, a huge benefit to persons living with HIV.     

We know that we have our work cut out for us as we endeavor to reduce new HIV infections, improve the health of people living with HIV and reduce HIV-related health disparities.  We also know that we can’t do it alone.  Fighting HIV/AIDS is and will continue to be a collective effort, engaging stakeholders from Federal, State, and local governments, the private sector, community-based organizations, and, most importantly, community members.

Our collective accomplishments are laudable, but we cannot rest on our laurels as we continue to address the domestic HIV epidemic.  As we work to provide more effective prevention and care interventions than ever before, we have an unprecedented opportunity to truly, as the IAS Conference theme states, turn the tide together.   

Grant Colfax, MD is Director of the Office of National AIDS Policy