UPDATED: National HIV/AIDS Strategy

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

One of the signature domestic policy accomplishments under the Presidency of Barack Obama was the first-ever unveiling of a National HIV/AIDS Strategy in the United States. It might have been decades overdue, but it represented a significant paradigm shift in how public health addressed HIV in this country. On World AIDS Day 2021, President Joseph R. Biden, Jr. renewed the commitment made by his former boss with the release of the updated National HIV/AIDS Strategy for the United States 2022-2025. The news was received by the HIV community with applause.

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Upon issuing the Proclamation on World AIDS Day, 2021, President Biden referenced the updated Strategy by saying: 

"My Administration remains steadfast in our efforts to end the HIV epidemic, confront systems and policies that perpetuate entrenched health inequities, and build a healthier world for all people.  Earlier this year, I reinstated the White House Office of National AIDS Policy to coordinate our efforts to reduce the number of HIV infections across our Nation.  This week, my Administration is releasing an updated National HIV/AIDS Strategy to decrease health inequities in new diagnoses and improve access to comprehensive, evidence-based HIV-prevention tools. This updated strategy will make equity a cornerstone of our response and bring a whole-of-government approach to fighting HIV.

My budget request includes $670 million to support the Department of Health and Human Services’ Ending the HIV Epidemic in the U.S. Initiative — to reduce HIV diagnoses and AIDS-related deaths.  My Administration has also strengthened the Presidential Advisory Council on HIV/AIDS by adding members from diverse backgrounds who bring the knowledge and expertise needed to further our Nation’s HIV response."[1]

According to the updated Strategy, it sets forth bold targets for ending the HIV epidemic in the United States by 2030, including a 75% reduction in new HIV infections by 2025 and a 90% reduction by 2030.[2] It also aligns with the ongoing Ending the HIV Epidemic (EHE) in the United States.

The updated Strategy includes four pillars. They include preventing new HIV infections, improving HIV-related health outcomes of people living with HIV, reducing HIV-related disparities and health inequities, and achieving integrated, coordinated efforts that address the HIV epidemic among all partners and interested parties.[3]

Of particular interest to the ADAP Advocacy Association is addressing health disparities, namely because Black and Hispanic men are being left behind on the declining HIV rates in the United States.[4] The racial and ethnic health disparities are even more evident among men who have sex with men (MSM), according to the Centers for Disease Control & Prevention (CDC).[5]

The CDC's Vital Signs demonstrates the challenges with ongoing racial/ethnic differences in knowledge of status and HIV prevention and treatment outcomes among gay and bisexual men. Approximately one in five (1:5) Hispanic/Latinos and Black/African Americans are unaware of their status. Among gay and bisexual men who could benefit from PrEP, communities of color lag behind their white peers, and they also have lower rates of viral suppression. Additionally, HIV-related stigma disproportionate impacts Black/African American and Hispanic/Latino gay and bisexual men.[6]

Equally important is the updated Strategy emphasizing the importance of the ‘Undetectable equals Untransmissible’ message around HIV treatment as prevention. It reads: "Evidence has definitively shown that people with HIV who achieve and maintain an undetectable viral load by taking HIV medication as directed will not sexually transmit the virus to an HIV-negative partner." 

The ADAP Advocacy Association is among the 1,053 organizations from 105 countries have signed on to share the U=U message. Doing so has complemented our organization's efforts around promoting HIV medication adherence. Much work remains ahead of us, but it just got a bit easier with the updated Strategy.

The updated National HIV/AIDS Strategy is available online here.

[1] White House, The (2021, November 30). A Proclamation on World AIDS Day, 2021. Retrieved online at https://www.whitehouse.gov/briefing-room/presidential-actions/2021/11/30/a-proclamation-on-world-aids-day-2021/
[2] White House, The (2021, December 1). National HIV/AIDS Strategy 2022–2025. Retrieved online at https://www.whitehouse.gov/wp-content/uploads/2021/11/National-HIV-AIDS-Strategy.pdf?utm_campaign=wp_the_health_202&utm_medium=email&utm_source=newsletter&wpisrc=nl_health202
[3] White House, The (2021, December 1). National HIV/AIDS Strategy 2022–2025. Retrieved online at https://www.whitehouse.gov/wp-content/uploads/2021/11/National-HIV-AIDS-Strategy.pdf?utm_campaign=wp_the_health_202&utm_medium=email&utm_source=newsletter&wpisrc=nl_health202
[4] Firth, Shannon (2021, November 30). Black, Hispanic Men Left Behind on Declining HIV Rates in the U.S.. MedPage Today. Retrieved online at https://www.medpagetoday.com/hivaids/hivaids/95943?xid=nl_mpt_DHE_2021-12-01&eun=g1964022d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202021-12-01&utm_term=NL_Daily_DHE_dual-gmail-definition
[5] Centers for Disease Control & Prevention (November 2021). Vital Signs - HIV and Gay and Bisexual Men. U.S. Department of Health & Human Services. Retrieved online at https://www.cdc.gov/vitalsigns/hivgaybimen/index.html
[6] Centers for Disease Control & Prevention (November 2021). Vital Signs - HIV and Gay and Bisexual Men. U.S. Department of Health & Human Services. Retrieved online at https://www.cdc.gov/vitalsigns/hivgaybimen/index.html

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.  

Social Workers & HIV Community Resources

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

The ADAP Advocacy Association prides itself on bringing together ALL stakeholders concerned about improving access to care and treatment for people living with HIV/AIDS, namely through the AIDS Drug Assistance Program (ADAP). To that end, one of the most important — and arguably most under appreciated — stakeholder groups in this fight are social workers. Social workers specializing in HIV/AIDS-related supports and services often facilitate critical linkages to care for their patients.

The National HIV/AIDS Strategy (NHAS) recognizes the critical role being played by social workers because they are uniquely positioned to integrate all facets of the care continuum. In fact, many of the NHAS' key indicators cannot be achieved without social workers on the front lines — mainly increasing the percentage of persons with diagnosed HIV infection who are retained in HIV medical care to at least 90 percent, and reducing the percentage of persons in HIV medical care who are homeless to no more than 5 percent.[1]

Since the dawn of the epidemic, social workers have made the difference between life and death for countless people living with the disease. In fact, Michael Shernoff, MSW summarized it best in 1990 when he penned the following:

"This profession can be justly proud of the often pioneering work done by social workers from the onset of the AIDS health crisis in developing psychosocial services of singular diversity and effectiveness that reach out to people infected and affected by HIV. Even before the significance of HIV was known and complete knowledge of the modes of transmission was verified, social workers began to make important contributions to all professionals' understanding of AIDS."[2]

Linkages to care characterizes where social workers fit within the care continuum.We need to be doing more to support their efforts, too.

The premier event for social workers specializing in the HIV/AIDS treatment area is the National Conference on Social Work and HIV/AIDS. In fact, on May 25—28 in Atlanta, Georgia, social workers will convene annually for the 29th time to participate in discussions focusing on "Ending HIV/AIDS through Social Justice: Health Equity for All!" The Boston College School of Social Work sponsors the conference.

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The ADAP Advocacy Association for the last several years has convened its ADAP Regional Summit in the South, in order to call attention to the epidemic's disproportionate impact on the region. We're excited to see that the National Conference on Social Work and HIV/AIDS is convening in the South for that very same reason. According to the conference website, "...the Southern region of the U.S. is experiencing an unprecedented increase in HIV cases; which is why it is fitting for us to convene this year’s conference in the heart of the South."

In 1990, Shernoff lamented the social injustice faced by people living with HIV/AIDS during the previous decade. Nearly twenty years later, his words still ring true evidenced by the chosen theme for the 29th Annual National Conference on Social Work and HIV/AIDS. No matter how much things change, they stay the same.

Learn more about the conference online at http://nationalconferenceonsocialworkandhivaids.com. Questions? Contact them at Info@NationalConferenceOnSocialWorkandHivAids.com.

Additional resources include:

• Professional Association of Social Workers in HIV & AIDS (PASWHA)
• National Association of Social Workers HIV/AIDS Spectrum (NASW)
• Canadian Association of Social Workers (CASW)

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[1] AIDS.gov; U.S. Department of Health & Human Services; "National AIDS Strategy"; 2017.

[2] Shernoff, Michael; The Body Dot Com; "Why Every Social Worker Should Be Challenged by AIDS"; 1990.