On March 16, the White House released the Report by the President's Task Force on Puerto Rico's Status. That report contained a number of recommendations related to Puerto Rico's political status and economic development; it also addressed the need for HIV outreach and education, especially for Puerto Rico's veterans.
In July 2011, the President released the National HIV/AIDS Strategy (NHAS), which contains specific recommendations for responding more effectively to the domestic HIV epidemic. HHS has an Operational Plan for the NHAS, and one element of that plan is the 12 Cities Project. These cities represent 44% of the nation's AIDS cases, and San Juan, Puerto Rico is one of them. The 12 cities have been chosen to actively coordinate Federally funded programs at the local level, and the project involves collaboration between HHS agencies that could have huge payoffs and propel progress toward the Strategy's goals of reducing HIV incidence, increasing access to care and improving outcomes for people diagnosed with HIV, and reducing HIV-related health disparities.
In Puerto Rico, those goals are particularly important, because the HIV incidence rate on the Island (45.0 cases per 100,000 population) is twice what it is on the mainland (22.8). The Puerto Rico epidemic also differs from the mainland in that the most common form of HIV transmission in Puerto Rico is through injection drug use, rather than male-to-male sexual contact, and that those diagnosed with HIV tend to be older (30-39).
Given these differences, military veterans have been identified as one of Puerto Rico's populations at greatest risk for HIV, and the President's Task Force on Puerto Rico recognized a particular challenge in meeting their HIV-related needs. The Task Force made the following recommendation:
HIV Outreach and Education Initiative for Veterans: [The Department of Veterans Affairs] VA should continue raising Island-wide HIV/AIDS awareness and providing onsite clinic testing to ensure that veterans living in high-risk population areas are afforded an opportunity to be tested, treated, and enrolled into the VA health care system. The targeted outcome of this initiative should be 100 percent testing of veterans who consent to be tested and enrollment in health care services for any HIV-positive veteran residing in Puerto Rico who is eligible for services.
The Task Force noted that VA participated in awareness events on November 17 and 22, 2010, and that information from those events is being analyzed to inform future events. The Task Force also encouraged VA and HHS to work together in the coming year to expand this program beyond veterans, where possible. This recommendation aligns with the goals of the 12 Cities Project, and provides even broader support for collaborative Federal efforts to address HIV.
Finally, the Task Force recommended that Puerto Rico work to develop a National Center for the Treatment and Care of Chronic Illnesses, which would include facilities for the care and treatment of Puerto Ricans living with HIV/AIDS.
You can download a copy of the report here (PDF 15MB).
James Albino is a senior program manager at the Office of National AIDS Policy.