At the end of 2006, an estimated 1,106,400 persons within the United States were living with HIV infection, with 21% undiagnosed. This number increases by approximately 60,000 per year, with approximately one new case every 10 minutes. The U.S. medical system is ill-prepared to cope with the number of Americans now infected with HIV, however steps are being taken under President Obama’s new Healthcare policies.
More than 200,000 people living with HIV/AIDS in the United States do not know they are infected. Increased HIV testing may help identify these individuals, reducing the chance that they will spread HIV to others and improving their health outcomes. But many may not receive the care they need because the health care system may not have the capacity to care for them.
Paul Cleary, dean of the Yale School of Public Health in New Haven, Conn., said in a news release from the National Academy of Sciences:
“There will be numerous challenges as the nation begins implementing the [Obama administration’s] new National HIV/AIDS Strategy. Many practical suggestions from the research literature and experts about how to address and overcome the obstacles to a more effective and efficient HIV/AIDS strategy are available.”
Specifically, too few health care providers are adequately trained and experienced in providing the care these patients need, the report authors indicate.
The Office of National AIDS Policy’s (ONAP) website states:
“Our vision for a national strategy is a concise plan for moving the country forward is predicated on building on what we are currently doing, and will identify a small number of high payoff action steps that need to be taken to achieve each of the President’s goals. We envision the strategy being a document that provides a roadmap for policymakers and the general public. We anticipate that the strategy will clearly describe the areas that require the most immediate change, the specific action steps that must be taken by the Federal Government and a variety of stakeholders, and specific targets for measuring our progress toward achieving the President’s goals.”
This strategy aims to bring about a drop in the rate of HIV infection while at the same boosting access to care among those already infected.
Given the widening gap between HIV-care supply and demand, the independent report emphasizes the need for health-care provider flexibility, in order to overcome the constraints under which many providers labor. Collaboration across facilities should be encouraged, in order to better allocate and share sparse resources among multiple providers. However, at times such task-sharing may run afoul of state regulations, which can limit the ability of providers to share caseload responsibilities.
Currently there is a lack of a clear federal policy regarding HIV testing, statewide differences regarding how testing is implemented, obstacles to the provision of rapid HIV testing and discrimination against HIV-positive individuals.
ONAP began engaging the community on the NHAS development in the summer of 2009. Since that time they have also engaged in broad public outreach, traveling the country listening to Americans recount their experiences with HIV and their strategic recommendations for achieving the President’s goals. More than 4,200 people attended 14 HIV/AIDS community discussions.
The Office also sought other opportunities to engage with the community and a variety of stakeholders. This included meeting with representatives of the American Indian/Alaska Native communities, people living with HIV in rural communities in the South and northeast, Asian and Pacific Islander Americans, African immigrants, business and philanthropic leaders, and others. ONAP staff also participated in additional community discussions and expert meetings organized by outside parties all working toward the development of a National HIV/AIDS Strategy.
Sources: Institute of Medicine of the National Academies and The Office of National AIDS Policy
Written by Sy Kraft, B.A.