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National HIV Prevention Conference -- Highlights of Day 1

By Ronald Valdiserri, M.D., M.P.H.

August 15, 2011

Dr. Ronald Valdiserri.

Dr. Ronald Valdiserri.

This article was cross-posted from the AIDS.gov blog.

With this post we launch a series of daily re-caps from the National HIV Prevention Conference underway now in Atlanta.

More than 3,000 public health, medical and AIDS community leaders are gathered here to share the latest research and discuss innovative strategies to drive down the number of new HIV infections in the United States. The meeting, organized by the Centers for Disease Control and Prevention (CDC) and co-sponsored by 40 other public and private agencies, including my office, is the only major U.S. conference dedicated exclusively to HIV prevention. Conference sessions and scientific presentations will focus on strategies to advance the ambitious goals of the National HIV/AIDS Strategy (NHAS).

The theme of the conference is: "The Urgency of Now: Reduce incidence. Improve access. Promote equity." This theme was chosen to reinforce and reflect the urgent need to quickly and efficiently scale-up proven interventions and to improve the coordination of our nation's response at the national, state, and local levels in order to achieve the maximum reduction of HIV incidence, improve the health of people living with HIV, and reduce HIV-related health disparities.

After reflecting on 30 years of leadership in AIDS, today's opening plenary turned our attention to implementing the NHAS with engaging and thought-provoking remarks from several panels.


Reflections on the First Year of Pursuing the National HIV/AIDS Strategy

In his remarks, Mr. Jeffrey Crowley, Director of the White House Office on National AIDS Policy (ONAP), recalled being at the last NHPC in 2009 and kicking off community dialogues that came to inform the development of the National HIV/AIDS Strategy. He thanked the audience for that input and reflected on the results of the first year of having the Strategy as a roadmap to guide our collective efforts. Jeff observed that among the accomplishments of this first year have been both a reinvigorated national response to HIV/AIDS and greater government-wide collaboration. The latter was evidenced during the opening session, which also featured not only Dr. Kevin Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, and several of his CDC colleagues from the Division of HIV/AIDS Prevention (DHAP), but also Dr. Deborah Parham Hopson, Associate Administrator, HIV/AIDS Bureau, Health Resources and Services Administration; Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health; and Mr. David Vos, Director of the Office of HIV/AIDS Housing at the U.S. Department of Housing and Urban Development.

Kevin echoed Jeff's observations, noting that the Strategy has been a "game changer" in the nation's response to HIV, serving as a roadmap to guide our collaborative efforts as well as a tool to specifically strengthen prevention efforts at the federal, state, and local levels.

CDC also highlighted that throughout the conference a number of sessions will share lessons learned to date from the experiences of the 12 jurisdictions that have received grants for Enhanced Comprehensive HIV Prevention Planning (ECHPP), which is a key element of the HHS 12 Cities Project.

CDC's Dr. Jonathan Mermin, Director of CDC's Division of HIV/AIDS Prevention, provided an overview of the U.S. HIV/AIDS epidemic and introduced the concept of "High Impact Prevention" (HIP) -- namely supporting cost-effective prevention interventions that have been shown to work, at a scale that will achieve significant reductions in HIV incidence.

Paul Kawata

Paul Kawata

Mr. Paul Kawata, Executive Director the National Minority AIDS Council (NMAC) even wondered aloud, "Is this the beginning of the end of HIV?" Paul also shared his thoughts on some guiding principles for putting into practice the promising recent findings about treatment as prevention from the HIV Prevention Trial Network study 052. The study demonstrated that starting HIV-positive individuals in a treatment regimen early and reducing their viral load to undetectable levels can cut the risk of HIV transmission to an uninfected partner by as much as 96 percent. Paul's principles stressed the essential nature of leadership by persons living with HIV in any efforts to advance treatment as prevention.

Without minimizing positive outcomes, several presenters -- federal and non-federal alike -- acknowledged that these are challenging times for HIV prevention activities in light of a federal discretionary spending freeze and state and local budget cuts that have resulted in the loss of an estimated 45,000 public health jobs and serious reductions in a variety of public health programs. Other panelists, including the Executive Director of the National Alliance of State and Territorial AIDS Directors (NASTAD), Ms. Julie Scofield, shared concerns about the impact of growing ADAP waiting lists on our nation's ability to achieve the NHAS goals. Julie also urged federal partners to think carefully about the intricacies of implementation as we take bold policy steps to re-align HIV/AIDS resources to match the epidemiology -- and the needs of -- today's U.S. epidemic.


Concern Regarding the High Burden of HIV Among Young Black MSM

Last, but certainly not least, the alarming increases in new HIV infections among young African American men who have sex with men (MSM) reported earlier this month by CDC drew the attention of several presenters, including Secretary of Health and Human Services Kathleen Sebelius in her video message to conference attendees. CDC shared information on several initiatives underway to expand prevention efforts for this population. These include a major new campaign being developed to increase HIV testing among black MSM -- called "Testing Makes Us Stronger" -- as well as the new grant program to provide effective HIV prevention services for young MSM of color, for which applications are now under review.

Elsewhere at the conference yesterday, colleagues from the Office of HIV/AIDS Policy (OHAP) and the AIDS.gov team opened their exhibit booths and interacted with dozens of conference attendees. The OHAP team fielded questions from participants about the Strategy as well as the recently released Action Plan for the Prevention, Care and Treatment of Viral Hepatitis, which is an important issue at this conference since HIV and hepatitis share common modes of transmission and persons with HIV also are disproportionately affected by viral hepatitis and related adverse health conditions. At the AIDS.gov booth, the team fielded questions about the website, offered "tours" of the content, and heard ideas from participants about the content available and ideas for the enhancing the site.

Tune in tomorrow for another daily conference wrap. Following the conference we'll provide some posts reflecting on the main themes and lessons from this important gathering.

Ronald Valdiserri, M.D., M.P.H., is the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services. (Cross-posted from White House Office of National AIDS Policy Blog.)

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