December 8, 2021
On World AIDS Day, the White House Office of National AIDS Policy (ONAP) released the updated the National HIV/AIDS Strategy with a goal of ending the HIV epidemic by 2030. As background, the Obama Administration was the first to unveil a National HIV/AIDS Strategy in the U.S. and it was considered a signature domestic policy achievement of the Administration. The Strategy has been updated twice over the years, with each Administration adjusting the goals and tactics. President Biden stated in his World AIDS Day address that the new Strategy reflects his Administration’s intention of bringing a “whole-of-government approach” to fighting the disease.
The Strategy begins by establishing a vision: “The United States will be a place where new HIV infections are prevented, every person knows their status, and every person with HIV has high-quality care and treatment, lives free from stigma and discrimination, and can achieve their full potential for health and well-being across the lifespan. This vision includes all people, regardless of age, sex, gender identity, sexual orientation, race, ethnicity, religion, disability, geographic location, or socioeconomic circumstance.” As providers of quality HIV care, Academy members undoubtedly support such a robust vision for HIV prevention, treatment and care and we look forward to supporting the Administration in these efforts.
The Strategy sets targets for ending the HIV epidemic that are complementary to the existing Ending the HIV Epidemic in the U.S. plan, including a 75 percent reduction in new HIV infections by 2025 and a 90 percent reduction by 2030. The Strategy establishes four main goals for ending HIV. And interwoven throughout the Strategy are approaches to address the “individual, community, and structural factors and inequities that contribute to the spread of HIV, such as stigma and social determinants of health.” Importantly, the NHAS also identifies opportunities to “integrate HIV prevention, care, and treatment into prevention and treatment for sexually transmitted infections, viral hepatitis, mental health and substance use disorders, and other public health efforts by leveraging capacity and infrastructure across the domains and breaking down operational and funding silos.” This is a critical element to achieving success.
There are a number of noteworthy interventions in the Strategy, but some highlights include:
Goal 1: Prevent New HIV Infections
- Expand and improve interventions, including treatment as prevention (U=U), PrEP, PEP, and SSPs, and develop new options
- Increase the diversity and capacity of health care delivery systems, community health, public health, and the health workforce to prevent and diagnose HIV
Goal 2: Improve HIV-Related Health Outcomes of People with HIV
- Link people to care immediately after diagnosis and provide low-barrier access to HIV treatment
- Increase retention in care and adherence to HIV treatment to achieve and maintain long-term viral suppression and provide integrative HIV services for HIV-associated comorbidities, coinfections, and complications, including STIs
- Increase the diversity of the workforce of providers who deliver HIV care and supportive services
- Expand capacity to provide whole-person care to older adults with HIV and long-term survivors
Goal 3: Reduce HIV-Related Disparities and Health Inequities
- Reduce HIV-related stigma and discrimination
- Train and expand a diverse HIV workforce by further developing and promoting opportunities to support the next generation of HIV providers including health care workers, researchers, and community partners, particularly from underrepresented populations
Goal 4: Achieve Integrated, Coordinated Efforts That Address the HIV Epidemic among All Partners and Interested Parties
- Integrate programs to address the syndemic of HIV, STIs, viral hepatitis, and substance use and mental health disorders in the context of social and structural/institutional factors including stigma, discrimination and violence
The Academy will continue to work alongside our community and government partners to implement such a robust strategy and vision, including advocating for all necessary funding through Congressional and state-level channels. The Academy also released a statement on the Administration’s revised NHAS, outlining the need for efforts that bolster the healthcare workforce. That can be viewed here
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