IDSA 2011: Improving HIV Care

HIV/AIDS was a big topic at the 49th Infectious Diseases Society of America Annual Meeting, as it is every year. In the Saturday morning session, “Improving HIV Care: Access, Reform, and the National AIDS Strategy,” the three speakers discussed the importance of developing a national strategy, the impact of the Affordable Care Act, and the financial sense and burden of caring for people with HIV. After each speaker gave his 20 minute presentation, there was a loud round of applause. Obviously all in attendance understand how important these topics are and understand the potential repercussions of the 2012 Presidential election.

Ronald Valdiserri, MD, MPH, Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services, focused his talk on the progress and challenges of the National HIV/AIDS Strategies. Dr. Valdiserri started off by saying that the National HIV/AIDS Strategies was what he was invited to talk about, not the Affordable Care Act, although clearly the two need to interface; Valdiserri received a big laugh.

HIV/AIDS Statistics: Diagnosis and Prevalence

• A couple of years ago, the CDC updated its estimate that there are 50,000 new HIV cases, even after being “relatively stable” the last couple of years.
• It is estimated that there are 1.2 million people living with HIV or AIDS, but approximately 20% of those infected are unaware that they are infected. This was something that Valdiserri kept emphasizing and reemphasizing during his discussion.
• Approximately 1/3 of all new, late diagnoses of HIV cases will develop AIDS within a year of diagnosis. Valdiserri commented, “This means that these people have been infected for years and have gone undiagnosed.”
• Between 40-50% of patients who know they are infected with HIV do not receive regular care by physicians.
• In 2008, there were more than 17,000 deaths attributed to HIV/AIDS.

The National HIV/AIDS Strategy

In July 2010, the National HIV/AIDS Strategy was launched. It is the first comprehensive attempt to develop a national strategy; this is not a federal strategy. Valdiserri said that the strategy is “meant to be a plan for all of us to get together to help.”

There are three goals that make up the strategy:

1. Reduce new HIV infections
2. Increase access to care and improve health outcomes for patients living with HIV
3. Reduce HIV-related disparities and health inequalities (this is across the board)

Valdiserri included a fourth goal on his own which focuses on achieving more coordinated national response to HIV epidemic. Yes, there is a need to coordinate with the federal government, but not exclusively; there are a lot of areas to help improve coordination across all sectors of society, public and private.