In this month’s issue of the journal Future Microbiology, Emory infectious disease physician/scientists Rana Chakraborty and Wendy Armstrong from Emory School of Medicine summarize and comment on the goals and challenges of the National HIV/AIDS Strategy released July 10, 2010.
The National AIDS Strategy was the result of a directive by the Obama Administration to the Office of National AIDS Policy. The strategy’s overall goals were to reduce the number of people who become infected with HIV, to increase access to care and improve health outcomes for people living with HIV, and to reduce HIV-related health disparities.
“The National HIV/AIDS Strategy calls for a long overdue national coordinated effort to curb the rise in new HIV infections and enhance therapy in those already infected,” write the authors.
While the goals are worthy, the strategy will present many challenges, and the authors address each goal individually, and highlight challenges:
- The initiatives are expensive, and already resources in the United States are not adequate to treat all patients currently diagnosed with HIV infection.
- Convincing the general population that HIV is still a major problem and an incurable and often-fatal disease will remain a challenge.
- Nontraditional testing sites outside clinics or hospitals, such as churches, while central to enhancing testing, may present problems of confidentiality.
- Increasing the number and diversity of available providers of care is difficult given the current financial realities of the American healthcare system where medical practices with a high percentage of HIV patients often can’t break even financially.
The creation of a strategy is a positive step, say the authors, but it needs a clear financial commitment. The strategy’s strengths include a focus on specific high-risk populations, the concept of re-introducing conventional prevention methods including condom distribution and needle-exchange programs, more thorough std testing, and creating better outreach between leading HIV/AIDS centers in cities and HIV providers in rural settings.