SEATTLE — Nearly three decades after the AIDS epidemic began
in the United States in June 1981, the Obama administration is crafting what
supporters say is a first: a comprehensive national plan for combating and
treating a disease that has largely morphed into a chronic, yet still
stigmatized, illness.
Two of the top federal officials on HIV/AIDS policy will be
in Seattle Wednesday as part of a five-city community discussions on how best
to corral a virus that infects 56,000 Americans annually.
“HIV is a completely preventable epidemic,” said
Dr. Howard Koh, assistant secretary for health with the U.S. Department of
Health and Human Services.
Koh will appear Wednesday night at an HIV/AIDS community
town hall at Seattle’s Asian Counseling and Referral Services. He will be
joined by Christopher Bates, director of HHS’s Office of HIV/AIDS Policy, and
other health officials.
Koh and Bates are among the key people charged with carrying
out President Barack Obama’s three goals for HIV/AIDS: to reduce the number of
new HIV infections; to improve the care and health of those with HIV or AIDS,
and to reduce health disparities caused by HIV, which in this country hits
black gay and bisexual men and black women the hardest.
Public health officials and patients’ advocates welcomed the
premise of a singular strategy as a way to prevent goals and means from
clashing.
For instance, the U.S. Centers for Disease Control and
Prevention since 2006 has recommended HIV screening for all people between 13
and 64. Yet routine HIV testing is not covered by even some government
insurance plans, including Medicaid, which covers millions of pregnant women.
Medicare, which covers seniors, on Tuesday said it would pay for HIV screening
for any member who requests it.
What’s more, decisions about sex education classes are left
to local school authorities, with the result that some students never learn
about safer-sex practices.
Dr. Bob Wood, King County’s top AIDS control officer, said
he believes that it no longer makes sense to confine HIV testing largely to
people in high-risk categories, such as men who have sex with men or those who
uses needles to do drugs.
As many as a quarter of the people with HIV do not know they
are infected, Wood said. Making tests routine — such as is done in Washington
state to screen pregnant women for syphilis — would help de-stigmatize the
disease and reduce virus transmissions.
“We need to bring HIV back into the realm of sexually
transmitted diseases,” said Wood, 66, an openly gay man who has been HIV
positive since 1985 and who has made reducing HIV infections a personal and
professional crusade.
Though a vaccine to prevent HIV infections does not yet
exist, a cocktail of antiretroviral drugs has, for many, turned AIDS into a
manageable, chronic condition. More than 1.1 million Americans are HIV positive
or have developed AIDS. Globally, an estimated 33 million people are living
with HIV or AIDS.
John Peppert, director of infectious diseases and
reproductive health for the Washington State Department of Health, noted that
HIV/AIDS has taken very different tolls in different parts of the country.
In King County, for example, 69 percent of those with HIV
are gay men, compared to 47 percent for the nation as a whole. In areas such as
Washington, D.C., Peppert said, the epidemic has hit a disproportionately
higher percentage of black women and intravenous drug users.
“Policy decisions are most effective when they
recognize that communities vary” in the nature of their challenges,
Peppert said.
Worldwide, women and girls account for 60 percent of HIV
cases, according to the CDC.
Sean Cahill, managing director of public policy at Gay Men’s
Health Crisis, a New York City nonprofit advocacy group, contends that the view
of HIV as primarily a disease of gay men and IV drug users has kept it from
being regarded as a greater public-health menace.
Cahill said he hoped the new national strategy will embrace
the full spectrum of needs for people infected — and not yet infected — with
HIV, from insurance coverage to acceptance of homosexuality.
Via McClatchy-Tribune News Service.
