May 21, 2012
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Along with several federal colleagues, I had the opportunity late last month to discuss the National HIV/AIDS Strategy (NHAS) and the Action Plan for the Prevention Care and Treatment of Viral Hepatitis (Action Plan) during a panel presentation at a national healthcare conference. We shared highlights of our efforts to coordinate activities as we implement both of these important plans with an audience interested in efforts to better synchronize networks of HIV and primary care, including representatives of a many community health centers at the conference organized by HealthHIV. Since many of the comments may be of interest to a wider audience, I wanted to share some of the highlights of those presentations.
In his opening statement, Dr. Kevin Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, noted that both the NHAS and the Action Plan call for closer coordination of efforts among federal and local agencies and non-federal partners to build on successes and move toward the clear and specific goals set forth in each. Expanding prevention through healthcare, Dr. Fenton observed, is a major crosscutting priority. This includes making HIV and hepatitis screening routine.
Panel at HealthHIV (photo by V. Maldonado).
I shared with the audience that implementation of the NHAS was continuing not only across the Department of Health and Human Services (HHS), but also in the five other federal departments designated as leaders in the Strategy -- the Departments of Housing and Urban Development, Justice, Labor, Veterans Affairs and the Social Security Administration. Meeting regularly, representatives of these agencies are seeking to improve coordination of HIV programs across departments and are seeking to identify one or more collaborative projects that will have a payoff at the service-delivery level. Within HHS, I shared that we are already engaged in conversations with the Secretary and the White House about reauthorization of the Ryan White Care Act. Finally, I shared that HHS is preparing a report highlighting important accomplishments in implementation of the NHAS over the past year. We anticipate this report will be released this summer.
Regarding the Viral Hepatitis Action Plan, I observed that an implementation group comprised of representatives from numerous HHS agencies and offices, including CDC, HRSA, IHS, NIH and SAMHSA, as well as the Department of Justice's Bureau of Prisons and the Department of Veterans Affairs has been meeting regularly to advance implementation since the release of the Action Plan last May. We are also in the process of compiling a report of actions completed during the first year of the Action Plan and will also be sharing that this summer. Among the chief accomplishments of the first year has been significantly raising the profile of viral hepatitis as a significant health problem across all the participating agencies and laying the foundation for collaborative activities.
Dr. Deborah Parham Hopson, HRSA's Associate Administrator for the HIV/AIDS Bureau, noted that three key challenges facing providers are identifying people with HIV earlier in the course of their infection, linking those people to HIV care, and keeping them in care. She spoke about how the Ryan White HIV/AIDS Program, which provides services to more than 500,000 people living with HIV (PLWH) across the U.S. -- approximately one-half of the PLWH in the country -- is working to address these challenges as well as supporting and expanding the HIV care workforce. On the latter, she highlighted HIV HRSA efforts to disseminate HIV information to providers in the National Health Service Corps, to integrate HIV training into residency programs, and to extend support to HIV providers in rural areas via a telehealth program. Dr. Parham Hopson also informed that participants that their input will be important as HRSA begins making plans for reauthorization of the Ryan White Program. She noted that HRSA will be gathering stakeholder input via a series of community meetings around the country as well as an opportunity to provide input online, which we blogged about last week. Finally, Deborah highlighted some of HRSA's important work in implementing the Viral Hepatitis Action Plan, including efforts by the network of AIDS Education and Training Centers to scale up training on viral hepatitis diagnosis, care and treatment, noting that thousands of healthcare providers receive training annually through these centers.
Discussing efforts underway to expand and strengthen HIV care at the network of Community Health Centers (CHCs), Dr. Seiji Hayashi, Chief Medical Officer of HRSA's Bureau of Primary Health Care (BPHC), shared that the 8,100 clinics supported through the health center program serve more than 20 million patients, approximately 90,000 of whom have a primary or secondary diagnosis of HIV according to 2010 data. More than 750,000 patients received HIV tests at CHCs in 2010. BPHC is working to increase the availability of HIV services by moving more health centers along the spectrum of HIV service delivery through various means, including program assistance letters, project officer training on HIV care, technical assistance for clinics, and other incentives.
Other important issues that were discussed during the panel presentation included violence against women, housing insecurity and homelessness, and behavioral health disorders. They were addressed by, respectively, Mr. David Vos, Director of the Housing Opportunities for People With AIDS program at the U.S. Department of Housing and Urban Development, Ms. Mary Bowers of the HHS Office on Women's Health, and Mr. Warren Hewitt of the Substance Abuse and Mental Health Services Administration. Their comments helped place HIV/AIDS in a larger context as well as featured related federal activities that the providers may find helpful for their patients.
Ronald Valdiserri, M.D., M.P.H. is deputy assistant secretary for health, infectious diseases and director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services.
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