By Erica Rothschild
Many people think the HIV epidemic in the U.S. is under control, that there is no longer a sense of urgency. Yes, we have lifesaving medications, but only 25% of the 1.1 million Americans living with HIV are effectively controlling their HIV with medications. Thirty-three percent of those living with HIV are not even linked to any medical care. Nearly 20% of those who are HIV-positive do not even know they have HIV. Despite the fact that we have the tools to contain and even end this epidemic, many barriers stand in the way of reaching an AIDS free generation.
We need a plan that will break through those barriers, allowing people to know their status and to be linked to medical care. President Obama agrees.
On July 15, in honor of the three-year anniversary of the National HIV/AIDS Strategy, the President signed an Executive Order outlining his latest plan to help us reach an AIDS free generation. The National HIV/AIDS Strategy pledged to reduce new HIV infections and improve health outcomes for those living with HIV/AIDS. To help fulfill that pledge, the Executive Order establishes a new, interagency HIV Continuum of Care Working Group, which is charged with meeting three main goals: 1) increasing HIV testing (especially for people ages 15-65); 2) ensuring earlier treatment for HIV-positive people after their diagnosis; and 3) providing them with access to care.
President Obama recognizes that because of advancements in research and treatment, we are in the greatest position we have ever been to end the epidemic. Yet it will only happen if we take the necessary steps, and the President gave the Working Group 180 days to recommend evidence-based solutions that effectively address these goals.
The President’s plan instructs the Working Group to identify impediments to improving outcomes along the HIV care continuum, particularly for populations at greatest risk, and then identify opportunities to tackle those impediments.
As the Community Organizer at GMHC, I work with women and men affected by HIV and AIDS every day to help them identify and overcome impediments to living healthier lives. These include access to stable housing, obtaining medications while incarcerated, finding work after extended unemployment, and battling insurance companies. Each year we fight budget cuts at the city, state, and federal level that threaten our nutritional hot meals programs and reduce supportive housing options, among other critical services. GMHC’s clients will tell you that improving health outcomes is about a lot more than just having access to medication.
Recognizing this need to fight HIV on all fronts, The President’s new Working Group includes representatives from the Departments of Justice, Labor, Health and Human Services, Housing and Urban Development, and Veterans Affairs.
You may ask what the Department of Justice (DOJ) has to do with the HIV epidemic. It’s simple – HIV is four times more prevalent in incarcerated populations than in the general public. Once released, previously incarcerated people suffer from a lack of resources and are less likely to have health care. Therefore, they are less able to effectively control their virus.
You may ask what the Department of Housing and Urban Development (HUD) has to do with the HIV epidemic. Well, due to the high cost of medications and higher rates of unemployment (because of discrimination or health-related absences), 50% of people living with HIV are at risk of becoming homeless and need access to financial support that helps keep a roof over their heads. Many people who come to GMHC are homeless or living in untenable situations. GMHC has to resolve their housing situations before they can be successfully connected to care, and begin to get their HIV under control.
The HIV epidemic has always been interconnected with issues beyond physical health. GMHC salutes the President for including the DOJ, HUD and many other federal agencies as a part of the Working Group – their participation is critical to achieving success. All agencies (from local to federal) must create policies, programs and services that positively affect the lives of not only people living with HIV/AIDS, but also those most at risk of infection.
Moving forward, this plan is not just an opportunity for bureaucrats to make recommendations. The White House is offering $30.7 million in grants to turn policy recommendations into practice. In an environment where funding for HIV services is being cut at all levels of government, this support is crucial to meeting the goals of the National HIV/AIDS Strategy.
The President’s comprehensive solution to ending the epidemic is much-needed and long overdue. The structure of the cross-departmental Working Group, in combination with new funding, will help turn innovative ideas into action. This makes me optimistic that we will begin to see more traction in fighting HIV and AIDS on a domestic level. In this era of budget cuts, people living with HIV are struggling more than ever to find resources that enable them to stay healthy. This plan is an important next step to reaching an AIDS free generation.