How HIV Prevention Has to Change
By Chris Collins, 
amfAR
Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), has included the domestic HIV/AIDS epidemic on his short list of "winnable battles" in public health. But without important changes in the way our country addresses HIV/AIDS, in five years the annual rate of 56,000 new infections is more likely to grow than to decline.
Numerous studies have demonstrated that HIV prevention can be effective. Community-driven and publicly funded HIV prevention helped bring the infection rate down dramatically from its peak in the mid-1980s, and prevention programs averted more than 350,000 new infections between 1991 and 2006. And yet the HIV infection rate has not fallen in over a decade and HIV continues to have a devastating impact on the hardest hit communities, including gay men, African Americans, and Latinos.
President Obama's National HIV/AIDS Strategy, released in July, s
ets the worthy goal of reducing HIV infection by 25% over five years. It pledges reforms in the U.S. approach to AIDS, including improved coordination, accountability, and targeted use of resources for populations most at risk. These are all critically important measures, but alone are not sufficient to reach the President's Strategy goals. To do that we'll need systemic change in HIV prevention. Here are some of the priorities:
Group Issues HIV Prevention Addendum
The HIV Prevention Working Group, which issues a letter to President Obama in December 2009 with National HIV/AIDS Stratgy recommendations aimed at reducing HIV transmissions in the U.S., issued an addendum to underscore three central points of its original letter. The Addendum also adds 174 new signatories to its set of recommendations. Read the Addendum here and see the December 2009 letter here.
Endorse Prevention Recommendations for the National HIV/AIDS Strategy
This week, 34 national leaders in HIV programming and policy sent a letter to President Obama with recommendations for core points essential to creating a Strategy that will advance our nation’s HIV prevention response and lead to lower HIV incidence rates.
The Coalition is inviting individual and organizational endorsements to the letter, which can be downloaded here, or read at the end of this message if you click "continue reading."
The recommendations were developed through an independent strategy meeting sponsored by the Coalition for a National AIDS Strategy this October. The meeting was coordinated by amfAR, The Foundation for AIDS Research, the Community HIV/AIDS Mobilization Project (CHAMP), with the help of a dedicated planning committee, and hosted by Johns Hopkins University.
The Coalition is organizing three other independent consultations on aspects of the Strategy: care, disparities and research.
The letter explains:
As you know, HIV/AIDS remains a public health emergency in the United States. There is a new HIV infection every 9 ½ minutes, half of people living with HIV/AIDS are not in care, and there are disturbing and persistent gender, racial, ethnic, and geographic disparities in HIV infection rates and treatment access.
Despite these challenges, we have ample evidence that HIV prevention strategies are effective and have already averted hundreds of thousands of HIV infections in the US. With your leadership and commitment to implement a new, coordinated plan of action, a dramatic reduction in HIV infections in the U.S. is possible…
Without concrete changes in our nation’s approach, there is the very real danger that HIV prevention efforts will actually deteriorate in the coming years, leading to increasing HIV incidence.
Severe cutbacks in state budgets have already undercut health promotion programming across the country. We need a much more strategic, accountable and better-funded federal HIV prevention enterprise than we have had to date, as well as your ongoing, personal leadership to demand improved outcomes from public and private programming.
The deadline for endorsements is January 10, 2010. Click here to endorse the letter.
The Coalition is also interested in collecting and passing on additional comments on the letter.
Please send in comments on any issue that you feel is underemphasized or missing from the letter, or additional details on areas of the letter you support. The Coalition will compile and summarize this information in a letter, and also send your full comments, to the President.
To send in additional items or comments, please email info@nationalaidsstrategy.org and put “Prevention Letter” in the subject line. Please send your comments by December 22nd. Again, please be sure to put “Prevention Letter” in the subject line.
Groups Urge White House Action on Syringe Exchange
November 20, 2009
Melody Barnes, Esq.
Director
Domestic Policy Council
Executive Office of the President
Tina Tchen
Director
Office of Public Engagement
Executive Office of the President
Brian K. Bond
Deputy Director
Office of Public Engagement
Executive Office of the President
Dear Ms. Barnes, Ms. Tchen, and Mr. Bond:
As participants of the February 18th meeting on federal HIV/AIDS policy, we are deeply appreciative of your early outreach to us as partners in the fight against HIV/AIDS. We thank you for inviting us to maintain open communication on issues of national import. In that spirit, we are bringing to your attention today just such an issue.
Without immediate White House action, congressional negotiations between the House and Senate may fail to adopt the Obama Administration’s position to allow federal funding for proven-effective syringe-exchange services in order to curb HIV and viral hepatitis infections. Moreover, the District of Columbia, where HIV prevalence rates rival those in Sub-Saharan Africa, could face a significant set-back in its efforts to control HIV/AIDS in our nation’s capital. Just last year, Washington, DC secured the legal authority in legislation signed by President George W. Bush to dedicate municipal taxpayer dollars for syringe-exchange services as part of a comprehensive response to the epidemic. It would be a travesty, and an embarrassment for President Obama, if the District of Columbia were to again be restricted by law from responding to the health needs of its residents.
Coalition issues letter to President Obama: Remove ban on syringe exchange funding
As Congress continues to consider legislation to remove the federal ban on syringe exchange funding, the Coalition for a National AIDS Strategy called on President Obama to take a leadership role, pushing Congress to send him a bill this year.
The letter was delivered to the President on October 9, 2009. The full text is below:
Dear Mr. President,
Thank you for your commitment to developing and implementing a National HIV/AIDS Strategy (NHAS) for the United States. We are among the 500 organizations and 2,400 individuals who signed the Call to Action for a NHAS and who, for the past several years, have been advocating for a more coordinated, accountable and outcomes-oriented approach to HIV/AIDS in the United States through a NHAS.
As organizations and individuals committed to an evidence-based, effective HIV prevention effort, we also understand the urgency of removing the ban on federal funds for syringe exchange programs (SEPs). As you know, numerous federally funded studies have found that SEPs reduce HIV and hepatitis C incidence without increasing drug use or crime. Yet lack of resources makes it impossible for SEPs around the country to meet communities’ needs for the essential prevention, treatment and other services these programs provide. The challenge is particularly acute as states across the country grapple with fiscal shortfalls by reducing state funding for vital HIV/AIDS prevention programming, including SEPs.
Earlier this year, you reaffirmed your support for removing the ban on federal funding for SEPs and indicated you want to eliminate the ban as part of the NHAS process. We are writing to let you know that efforts to remove the SEPs ban cannot wait until completion of your Administration’s NHAS.
(Click below to read the rest.)