The Obama Administration's commitment to fighting HIV/AIDS, as well as state and local service providers' responses and report on their own progress, was the focus of an Aug. 5 panel at Chicago Cultural Center, 78 E. Washington St.
Douglas Brooks, director of the White House's Office of National AIDS Policy, spoke of the federal government's efforts to curb new infections and reported on the administration's goal, from 2010, of reducing the number of new infections by 25% by 2015.
The federal government spends about $15 billion annually on HIV/AIDS initiatives, of which about $7 million is discretionary spending. Brooks said that the FY 2015 budget appropriately reflects the administration's priorities but needs a "big push."
Brooks is living with HIV and added that his post "is the intersection of the personal and professional for me." He noted that he feels the pressure not just to meet the 2015 goal, but to make significant progress before a new administration comes in.
"I feel very much under the gun," Brooks said. "I'm a presidential appointee so when the president leaves, I leave, so I hear that voice in my head: '28 months, 28 months, 28 months.'"
He reiterated the commitment government officials and researchers have to addressing problems that befall Americans with HIV/AIDS.
"It may not always feel like it to you, but there are really smart people who could be elsewhere, making a lot more money, committed to working [on HIV/AIDS] …optimizing health outcomes and reducing disparities. We are really lucky to have the people that we have doing their work," Brooks noted.
Ronald O Valdiserri, deputy assistant secretary for Health and director of the Office of HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services, outlined the key components and resolutions within current strategies: differentiated models of care for different populations; confronting stigma and discrimination within various communities; strengthening data collection; prioritizing and promoting research initiatives; and providing information, resources and technical assistance across the healthcare continuum.
While the government has seen some success in reducing the number of new infections, the infection rate is still stubbornly high among young gay men, especially young gay men of color.
"This situation is not unique to the United States," Valdiserri added. "In many nations of the world, and not just in the developing world…we're struggling with infections among these men."
Other goals Valdiserri noted included identifying and testing the 183,000 individuals who are living with HIV, but do not know it, and helping the 29% of people who fall out of medical care to get back in.
Government officials are not yet certain what impact the Affordable Care Act will have upon previously uninsured or underinsured persons with HIV/AIDS, but Valdiserri noted that the Ryan White Act would still be essential to help close any remaining gaps in private and public insurance.
"We know that there are some people who may never be able to be enrolled in care," added Brooks.
Cheryl Ward, HIV/AIDS Surveillance Program administrator at Illinois Department of Public Health ( IDPH ), and Nik Prachand, director of Surveillance Epidemiology and Research Section at Chicago Department of Public Health ( CDPH ), also spoke about current initiatives in their agencies following the report from federal officials.
A panel comprised of local service providers offered some criticism of the government officials' remarks, aside from their own reports. Rev. Stan Sloan of Chicago House and Social Service Agency said he was disappointed that so far into the afternoon there had been little discussion of a correlation between HIV and poverty.
"People are as stigmatized by poverty and criminal records as they are by HIV," Sloan added, noting that individuals at different income levels might need different guidance about HIV prevention and care.
Both Sloan and Robert Garofalo, division head of Adolescent Medicine at Ann And Robert H. Lurie Children's Hospital were also critical that little discussion in the afternoon session was dedicated to Pre-Exposure Prophylaxis, or PrEP. Garofalo noted that PrEP's implementation had been hindered in part by enormous insurance co-pays as well as a lack of education among healthcare providers, who very often do not know of its benefits.
Garofalo suggested that the solution was probably not a widespread effort to educate them though. "What we need to do is identify healthcare providers who can be 'champions' within healthcare systems…who take it upon themselves to implement PrEP," he said.
Activist Keith Green; Cheryl Potts and Debra Janiszewski of Chicago Area HIV Integrated Services Council; and AIDS Legal Council of Chicago deputy director Ricardo Cifuentes also spoke on the service provider panel. Opening remarks were given by CDPH commissioner Bechara Choucair and U.S. Rep. Danny K. Davis. IDPH HIV/AIDS Section Chief Mildred Williamson emceed the program.
