July 15, 2010WASHINGTON (The New York Times News Service) -- The White House on Tuesday announced the nation's most sweeping national strategy ever for fighting HIV/AIDS, an effort that aims to cut infection rates by 25 percent in five years by shifting money to help gay and African American men who are at highest risk of contracting the disease.
The plan marks the first time that the disproportionate scale of the disease's effects on gay and African American men has been recognized at the national policy level. It does not, however, call for additional funding, which drew criticism from some AIDS activists.
About 1.1 million Americans are living with HIV and 56,000 are newly diagnosed each year.
The Obama administration's plan, 15 months in the making, would focus resources on the nation's most vulnerable communities, shifting money away from areas such as the Midwest that have a comparatively low incidence of HIV infection.
The administration's goal is to reduce the number of new cases, improve access to care and give greater help to poor people who are less able to afford antiretroviral drugs.
Gay or bisexual men and African American men are two of the highest-risk groups for HIV/AIDS. More than half of all transmissions stem from male-to-male sexual contact, and African Americans are seven times as likely to contract the disease as other races. Latinos are also named as a priority by the plan.
Experts said gay men and African Americans men tend to live in communities with higher rates of the disease and engage more frequently in such risk behaviors as male-to-male intercourse and intravenous drug use.
In San Francisco, 87 percent of new infections occur among gay men.
"For the Bay Area and San Francisco, the plan allows a more coordinated effort between communities and federal agencies," said Jason Riggs, deputy director at the Stop AIDS project, a grassroots prevention group in San Francisco.
The plan asks key federal agencies -- the Centers for Disease Control, the Department of Health and Human Services and the Health Resources and Service Administration -- to redirect funding to high-risk populations, assigns goals to each agency and holds them accountable for the results.
Health Secretary Kathleen Sebelius said $30 million of the funds appropriated under the new health care reform law will go toward the new HIV/AIDS strategy.
In addition to reducing the rate of new transmissions, the strategy aims to increase the number of sick people who get treatment within three months of diagnosis, from the current 65 percent to 85 percent.
Supporters of the new plan hope the administration's focus on coordinating the local, state, and federal response will clear up the disjointed array of resources available to patients, providing a simple, streamlined plan of treatment, education, and counseling.
The strategy calls for the lead federal agencies to re-evaluate prevention programs in high-risk areas and use social media campaigns to educate the public about risk behaviors and the importance of getting screened.
"We have a phrase that knowing your HIV status should be as common as knowing your home address," said Barbara Kimport, interim chief executive of the San Francisco AIDS Foundation.
Some gay rights groups and AIDS activists said the new strategy took too long to develop and should have more funding, given the 2,200 Americans who are currently on waitlists for antiretroviral drugs as states struggle to cover the costs of treatment.
Last week, the administration reallocated $25 million for the foundering AIDS Drugs Assistance Program to help states pay for HIV drugs in an attempt to eliminate the waitlists. Critics said drug waitlists are a disincentive for getting tested for the disease.
The AIDS Healthcare Foundation in Los Angeles, one of the nation's largest providers of community based AIDS health care, held a news conference Tuesday in Washington to protest the president's plan.
"This strategy is a day late and a dollar short: 15 months in the making, and the White House learned what people in the field have known for years," said president Michael Weinstein. "There is no funding, no 'how to,' no real leadership."
The creation of a national HIV initiative comes after a promise Obama made during the 2008 presidential election. At the behest of advocates for a national AIDS policy, Obama promised to create a federal strategy for fighting the disease if he was elected.
The absence of new funding for HIV/AIDS may avert Republican criticism over deficit spending, but the strategy could open the administration to charges that it favors gay and black men over others.
"From the very early days of the epidemic, the fear that ... some people will stop caring about AIDS if it seems to happen mostly to people who are in their eyes 'not like them' has been there," said Keith Humphreys , a professor at Stanford Medical School. "I think the country has come a long way since the epidemic started in terms of compassion and inclusiveness."
Two million people died worldwide from AIDS in 2008. In the U.S., the disease has killed 580,000 people in the past three decades.
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