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PrEP, Earlier ART and Better HIV Care in the Updated National HIV/AIDS Strategy

July 30, 2015

Today, the White House Office of National AIDS Policy (ONAP) announced an update to the National HIV/AIDS Strategy that will guide our nation's efforts to reduce new infections, improve HIV care, and reduce HIV-related disparities through year 2020. Taking into consideration the HIV science and policy progress made in the last five years, the update calls for federally-funded support for PrEP and PEP; better retention of people with HIV in care; increased rates of viral suppression; and earlier HIV treatment among other priorities.

President Barack Obama introduced the update, saying, "Our work is far from finished. One in eight people with HIV still go undiagnosed. Only three in ten people with HIV have suppressed the virus in their system, lowering it to an undetectable level. And this disease still affects different ages, races, sexual orientations, and even different regions of the country in disproportionate ways. That's why this is the first administration to release a comprehensive strategy on HIV/AIDS. And that's why we are updating it for the rest of this decade."

The four main goals of the Strategy are to: 1) reduce new HIV infections; 2) increase access to care and improve health outcomes for people living with HIV; 3) reduce HIV-related disparities and health inequalities; and, 4) achieve a more coordinated National response.

Here's what the update says about:


1. PrEP and PEP

President Obama tasked ONAP with creating the first National HIV/AIDS Strategy in 2010, prior to the FDA's approval of once-daily oral Truvada-based PrEP for the prevention of HIV. With the 2012 FDA approval of Truvada PrEP along with substantial evidence that Truvada PrEP can reduce HIV risk by more than 90%, PrEP uptake is a key component that will support the update's first goal -- to reduce new HIV infections.

The Strategy recommends that our nation must "expand access to effective HIV prevention services, including PrEP and PEP." It specifies that "Health care coverage programs should maximize HIV prevention by including the use of antiretrovirals for PrEP." And, that "federal funds should support ... bringing to scale and expanding access to effective HIV prevention services that optimize investments and have the greatest potential for impact for high-risk populations."

Does this mean that -- when appropriate and fiscally feasible -- federal funds would help people pay for PrEP? ONAP director Douglas Brooks indicated during a question and answer session that important conversations around PrEP are imminent. The Strategy suggests a mechanism for this to work -- by establishing PrEP drug assistance programs, which would operate similarly to federally-funded AIDS Drug Assistance Programs.

This excerpt was cross-posted with the permission of Read the full article.

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