Federal health officials are preparing to study the “test and treat” strategy in an effort to curb the spread of HIV in high-incidence communities, the New York Times reports. The three-year study will focus on Washington, D.C., where as many as 5% of adults are HIV-positive, and the Bronx, which has the highest rate of AIDS-related deaths of any New York City borough. Both communities have some of the highest HIV/AIDS rates in the U.S. According to Centers for Disease Control and Prevention data, 20% to 25% of people in the U.S. are unaware of their HIV-positive status. CDC recommends voluntary HIV testing as part of regular medical care for people ages 13 to 64, but experts say that many hospitals, clinics and medical practices are not following the recommendations.

According to the Times, the test and treat strategy involves routinely testing nearly every adult in a community and immediately beginning treatment for those found to be HIV-positive. The goal of the study’s first phase is not to determine if the strategy can slow an epidemic, but rather if it can be carried out effectively given the number of barriers to HIV testing and treatment, the officials said. For example, only about 50% of Washington, D.C., residents who tested HIV-positive in 2006 saw a physician about the diagnosis within six months (Okie, New York Times, 10/27).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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The U.S. Department of Housing and Urban Development (HUD) on Wednesday announced that it will provide several housing assistance grants to help low-income families living with HIV/AIDS, the Boston Globe reports (7/23). “A record $310 million will assist 58,000 U.S. households annually, officials said,” KITV.com reports. The grants were distributed based on the number of AIDS cases reported nationwide. The Gregory House Programs of Honolulu, a nonprofit that provides housing assistance, substance use and other services, will receive $1.3 million (KITV.com, 7/22). The Frannie Peabody Center in Portland, Maine, will receive $1.3 million; the city of Portland will receive $1.4; New Hampshire will receive over $716,000; and the Burlington Housing Authority in Vermont will receive over $392,000, the Globe reports (7/23).

This information was reprinted from dailyreports.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily U.S. HIV/AIDS Report, search the archives and sign up for email delivery at dailyreports.kff.org.

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“HIV infection rates among babies are significantly cut when mothers are given prolonged ARV treatment during breastfeeding,” according to findings released at the International AIDS Society conference in Cape Town, South Africa on Wednesday, Reuters reports. According to Reuters, “Key findings from the study showed that a stronger drug cocktail administered over a longer period reduced the risk of mother-to-child HIV transmission compared with the current WHO-recommended short-course ARV regimen.” Tim Farley, project leader for the “Kesho Bora” study - which was conducted at five sites in Burkina Faso, Kenya and South Africa by the WHO in partnership with several other international agencies - said, “The results of this study show an almost two-fold reduction in the risk of HIV transmission during the breastfeeding period and also [show] there is no short-term toxicity (to mothers or infants).” The WHO “is reviewing its 2006 recommendations on the use of ARVs in pregnant women, including during the breastfeeding period. New guidelines are expected to be published by the end of 2009 and will take into account emerging data,” Reuters reports (Roelf, 7/21).

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Newly nominated Surgeon General Regina Benjamin has a “tall order” ahead of her being “[c]hief health educator” of the U.S., “and, if confirmed, she will have to talk to us all in terms we plainly understand,” Lorraine Teel, executive director of the Minnesota AIDS Project, writes in a Minneapolis Star Tribune opinion piece. She adds, “But when it comes to unintended pregnancies, sexually transmitted diseases and AIDS, the message becomes more difficult” than messages related to nutrition and obesity. Teel says that “former Surgeon Generals tried to educate us,” on HIV/AIDS, such as Surgeon General C. Everett Koop, but he “was prevented from speaking frankly.” Teel continues, “Let’s hope that this Surgeon General’s administration sounds the alarm, loud and clear, about HIV. A major factor in why we are not winning the battle against AIDS is because we have been forced to only politely talk about risk” (7/1).

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The Latino HIV Task Force in Houston will offer free HIV testing as part of National HIV Testing Day on June 27, the Houston Chronicle reports. According to the Houston Department of Health and Human Services (HDHHS), Hispanics comprise 21 percent of the more than 16,000 HIV cases reported to the agency over the last 10 years and 17 percent of the nearly 26,000 AIDS cases since 1981. Porfirio Villarreal, HDHHS’s public information officer and media chair for the Task Force, said that HIV prevention is challenging among Hispanic communities because of stigma and difficulties in talking openly about sex. He added, “People who are undocumented in this country do not go test because they fear they may be deported, which is wrong.” The task force was established in 2002 and has brought together several local health agencies and community-based organizations that offer medical treatment or programs focused on HIV/AIDS, according to the Chronicle (Lamkahouan, Houston Chronicle, 6/22).

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The Senate on Friday confirmed President San Francisco Chronicle reports. Goosby - who “served previously in the Clinton administration as director of HIV/AIDS policy in the Department of Health and Human Services and as chief adviser to the president on HIV-related issues” - will now “head the U.S. strategy for addressing HIV around the world, and oversee the implementation of the President’s Emergency Plan for AIDS Relief” (PEPFAR), the newspaper writes. Goosby “has more than 25 years of experience treating HIV/AIDS,” and most recently served as chief executive officer and chief medical officer of the Pangaea Global AIDS Foundation, which is affiliated with the San Francisco AIDS Foundation, according to the San Francisco Chronicle (Doyle, San Francisco Chronicle, 6/20).

Mark Cloutier, CEO of the San Francisco AIDS Foundation, said in a written statement, “The world’s most vulnerable populations will benefit from Dr. Goosby’s guidance through greater access to HIV treatment and prevention programs based on sound science” (San Francisco AIDS Foundation release, 6/19). “What’s unusual about Eric is that he already comes into the arena with a lot of global experience,” Cloutier added (San Francisco Chronicle, 6/20).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

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The New York Times recently examined a campaign that aims to promote HIV awareness and prevention through several media outlets. The campaign was created by 17 students ages 16 to 23 as part of a Youth AIDS Media Institute program. The institute was formed by Cable Positive, an HIV/AIDS telecommunications organization that receives support from the Motorola Foundation. The students are from four community-based HIV/AIDS service groups in the Northeast, according to the Times.

The campaign — called “There’s no LOL in HIV” — features television commercials, a Web site, and pages on the social networking sites Facebook, MySpace and Twitter, as well as on the video sharing site YouTube. In addition, the campaign features text messages and print advertisements. Cable Positive will distribute the TV commercials to cable channels and local cable systems. The ads feature the students who created the campaign acting as students who are misinformed or in denial about HIV/AIDS. The ads “use humor to focus them back on responsibility,” Sean Strub, president and chief executive at Cable Positive, said. Cox Communications, Suddenlink Communications and Time Warner Cable have requested the commercials, Rob Feinberg — who works in account services at the Watsons, a New York-based marketing firm that worked with the students on the campaign.

The students participating in the campaign “were given a mandate to create a multi-platform, peer-to-peer education campaign for Cable Positive, which was their client,” Strub said. The idea behind the campaign is that “when you go to the communities you want to educate and give them the tools, you get a much better product,” Strub said. Paul Orefice, partner and creative director at the Watsons, said that the students wanted the campaign to be “funny.” Orefice said, “They said, ‘We look at so much media all day, you have to pull out all the stops to get our attention,’” adding that the humor gets students’ attention “in a fun and engaging way” (Elliott, New York Times, 5/11).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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Access To Second-Line Antiretrovirals In India

The successful scale-up of services for people living with HIV (PLHIV) in India “is now at risk,” write Loon Gangte, president of the Delhi Network of Positive People, and Leena Menghaney, projects manager in India for Medecins Sans Frontieres’ Campaign for Access to Essential Medicines, in a livemint.com editorial.

Although “[t]he need for access to newer combinations of ARVs has been evident from the beginning of the government treatment programme,” the authors write that “the government held back from introducing second-line ARVs in the national AIDS treatment programme on concerns about the spiralling prices of second-line ARVs.” While ten ARV centers have begun to administer second-line ARVs, there are restrictions on who can access the drugs.

“The refusal to treat spells immense hardship for PLHIV and their families, who are forced to purchase second-line ARVs themselves from pharmacies at prices significantly higher than those obtained by the government through bulk purchases directly from the generics producers,” say the authors, adding, “Many will not be able to sustain this expensive treatment, leading inevitably to further drug resistance, continuous ill health, AIDS, and death.”

The authors conclude, “The battle to start providing ARV therapy in India has been won. The battle to provide lifelong treatment to all is just beginning” (Gangte/Menghaney, livemint.com, 6/8).

Obama’s PEPFAR Funding Level, ‘Unwise,’ But ‘Understandable’ Choice

“Though President Obama’s trip to Africa [last week] focused on the Muslim world, by looking South from Egypt across the Sahara to the rest of the continent he could have seen the dramatic impact” of former President George W. Bush’s HIV/AIDS policies in Africa, columnists Cokie Roberts and Steven Roberts write in a Billings Gazette opinion piece. PEPFAR’s “efforts to deal with HIV/AIDS in Africa have saved more than a million lives; Obama needs, even in these tough times, to continue them.”

PEPFAR’s investments are “impressive” throughout the “15 focus countries of the program, where more than 2 million people have received lifesaving antiviral drugs free of charge,” according to the authors. But the “bad news is that the number of infections has not decreased and there are still millions of children who have been either orphaned or made vulnerable to a life of desperate deprivation due to HIV/AIDS,” according to Roberts and Roberts.

The opinion piece includes details about Cokie Roberts’ recent Africa trip to see how Save the Children, where she is a trustee, uses PEPFAR money. One of the group’s projects focuses on improving “the lives of [children's] caretakers” by working with local charities to teach women how to save money, according to the authors. They also describe a youth center where young boys talk about “how much they like coming to a place where adults pay attention to them and try to teach them how to make good choices.”

According to Roberts and Roberts, these are some of the “best way[s] to reduce the incidence of AIDS in the long run.” They conclude that although Obama’s budget proposal decreases PEPFAR somewhat, it’s “an understandable choice in recessionary times, but an unwise one given the success of the program” (Roberts/Roberts, Billings Gazette, 6/5).

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Rep. Barbara Lee (D-Calif.) introduced legislation that seeks to encourage state and local governments, as well as media organizations, to recognize June 8th as National Caribbean American HIV/AIDS Awareness Day, the American Chronicle reports. The legislation also supports the development of a national AIDS strategy that aims to reduce new HIV infections in the U.S., particularly among minorities (American Chronicle 6/9).

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Declining private and public financial support has forced Vital Life Services, an Oakland, Calif.-based nonprofit that provided support, case management, mental health counseling and other services to roughly 400 low-income and homeless clients with HIV, to shut down, the Oakland Tribune reports. According to the Tribune, the 25-year-old center — which also provided “unique” services such as daily meals and emergency housing assistance — “has become a victim of the recession” (Burt, Oakland Tribune, 5/30).

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