POLICY UPDATE 7.7.18

More Research on Organ Transplantation Between People Living with HIV

The National Institutes of Health (NIH) recently launched a new study to explore the risks (if any) inherent in transplanting a kidney from a donor living with HIV into a recipient also living with HIV. According to NPR, 468,000 Americans are on dialysis due to end-stage renal disease. Of these, about 1.5% also have HIV. If kidney donation from a healthy person living with HIV can assist a person in that 1.5%, that donation benefits not only that specific recipient but also helps other people awaiting donor kidneys. As Principal Investigator Christine Durand of Johns Hopkins University told NPR, “Every time someone with HIV gets an organ transplant they move everybody else up on the waitlist.”

In 2015, the NIH published criteria for doing research on transplantation between people living with HIV and Congress passed the HOPE Act which allows transplantation of organs from and to people living with HIV as long as it is done in the context of a research study. The Act also requires that the findings of such research be used to develop “safeguards and criteria for the conduct of such research”.

Be on the lookout for the July issue of AAHIVM’s HIV Specialist which will focus on clinical advances in the transplantation of organs between people living with HIV.

First National HIV/AIDS Strategy Progress Report Issued since 2016

In its annual National HIV/AIDS Strategy (NHAS) Progress Report, the Department of Health and Human Services describes its “important progress in reducing new HIV infections, improving health outcomes among people living with HIV, and reducing some HIV-related disparities.”

The National Association of County and City Health Officials, however, pointed out that “it also shows that progress has not been equal across all populations and regions”, noting particularly the ongoing “disparities in HIV risk and diagnoses for gay and bisexual men, stable housing among people living with HIV, and HIV diagnoses in the Southern United States.”

AIDS United criticized the report’s dearth of information about major policy changes in health care made since its last NHAS report issued in 2016, particularly its silence regarding the “Trump administration’s repeated efforts to repeal the Affordable Care Act which has provided health care access for millions of people living with or at risk of contracting HIV.”

At the White House, the Office of the National AIDS Policy Director (informally known as the AIDS Czar) has been vacant since January 2017. The former members of the Presidential Advisory Council on HIV/AIDS (a body first convened in 1995) were advised of their dismissal from the Council by FedEx last December and have not yet been replaced. As a result, AIDS United noted, “the 2017 NHAS Progress Report was created in a political vacuum, almost entirely separated from the world HIV advocates live in.”

Medicaid Work Requirements Watch – New Hampshire

In May, New Hampshire became the fourth state to receive federal approval to require that most adult Medicaid recipients work at least 20 hours per week in a job or some other form of “community engagement”. The Hill reports that “the waiver program will also require [insurance] co-pays for Medicaid recipients who make more than 100 percent of the poverty level.”