During the 57th meeting of the Presidential Advisory Council on HIV/AIDS (PACHA) on September 15, 2015, the Council shared recommendations on the implementation of the Updated National HIV/AIDS Strategy (NHAS). Mr. Douglas Brooks, MSW, Director of the White House Office of National AIDS Policy (ONAP), first provided an update about current efforts by agencies across the federal government to develop a Federal Action Plan to implement the priorities and principles articulated in the Strategy, which has been updated through 2020. He noted that his team at ONAP as well as the staff at the 12 federal agencies working to respond to the President’s order for an action plan to implement the Strategy are also reviewing community feedback received earlier this year, as the Strategy was being developed.
To help inform the development of the Federal Action Plan, PACHA shared several specific recommendations for ONAP and the federal agencies to consider. Among others, these recommendations included:
- Harmonizing definitions of quality HIV care indicators across payers;
- Educating key populations (including providers) about the effectiveness of pre-exposure prophylaxis (PrEP);
- Encouraging comprehensive sex education in schools;
- Universal adoption of CDC’s HIV screening recommendations and support of Medicaid coverage for routine HIV screening;
- Demonstration projects designed to address the mental health and substance abuse needs of justice-involved youth as well as other projects that support the integration behavioral health into primary care and HIV care;
- Regulations to address practices by some insurance plans that discourage enrollment of people living with HIV; and
- Leveraging new Affordable Care Act requirements to obtain better data on the health of LGBT populations and ensure that LGBT persons are treated fairly and equitably in healthcare facilities and training programs.
Mr. Brooks welcomed their suggestions, which the Council is working to finalize and submit formally.
“We are grateful for the thoughtful recommendations of PACHA,” observed Ms. Kaye Hayes, Executive Director of PACHA. “We look forward to their continued support of implementation of the updated Strategy through progress monitoring and additional recommendations designed to help us achieve the updated Strategy’s goals.”
Responding to HIV among Youth
Improving outcomes for youth at risk for or living with HIV is one of the priorities set forth in the updated NHAS. Possible approaches to improving youth services were explored during a panel discussion organized by Ms. Grissel Granados, MSW, Mr. Gabriel Maldonado, MBA, and Mr. Lawrence Stallworth II, the Council’s three members who are under the age of 30.
The discussion began with a review reminding PACHA members that:
- One in four new HIV infections each year in the U.S. occurs among young people under the age of 24;
- More than 50% of young people living with HIV in the U.S. don’t know they are infected; and
- Young gay and bisexual men, particularly young black gay and bisexual men, bear a particularly heavy burden of new HIV infections.
This was followed by a discussion of some of the current research efforts being supported by the NIH-funded Adolescent Trials Network for HIV Interventions and some of the future challenges ahead.
Three compelling youth speakers then shared their perspectives with the Council, encouraging, among other things attention to:
- The full spectrum of youth at risk for and living with HIV, including those who were perinatally infected and are navigating adolescence and young adulthood; are transgender; are gay, bisexual, or same-gender loving; or are from racial/ethnic minority backgrounds.
- Developing care systems that support transition from pediatric to adult HIV care.
- Leveraging networks, such as the house and ball community, that are already effectively engaging some of these youth.
- The housing needs of youth at risk for and living with HIV, many of whom experience high rates of housing instability and homelessness.
(Read more about HIV among youth in this CDC fact sheet.)
As PACHA member Ms. Granados summarized, it is important for all engaged in the response to HIV among this population to bear in mind that “young people are experts on their own truth and what the solutions for them are” so they should be engaged at every step of service planning and delivery.
The other segments of the daylong PACHA meeting also explored issues that are important for a successful national response to HIV/AIDS, including housing and the potential impact of quality measures on HIV care continuum outcomes. Various experts from the field engaged in robust dialogue with the PACHA members and the information shared will continue to inform recommendations made by the Council.
For additional details, the summary of the meeting will be posted on the PACHA page of HIV.gov in the near future.