In continued efforts to combat the spread of AIDS/HIV President Obama has signed an executive order (EO) called the HIV Care Continuum Initiative. This EO will “coordinate Federal efforts in response to recent advances regarding how to prevent and treat HIV infection. The Initiative will support further integration of HIV prevention and care efforts; promote expansion of successful HIV testing and service delivery models; encourage innovative approaches to addressing barriers to accessing testing and treatment; and ensure that Federal resources are appropriately focused on implementing evidence-based interventions that improve outcomes along the HIV care continuum.”
The EO appears to to mandate HIV testing for “all individuals ages 15 to 65 years”, by suggesting that all clinicians screen for it:
Based on these and other data, recommendations for HIV testing and treatment have changed. The U.S. Preventive Services Task Force now recommends that clinicians screen all individuals ages 15 to 65 years for HIV, and the Department of Health and Human Services Guidelines for Use of Antiretroviral Agents now recommends offering treatment to all adolescents and adults diagnosed with HIV.
The Initiative directs Federal agencies to prioritize addressing the continuum of HIV care by accelerating efforts and directing existing federal resources to increase HIV testing, services, and treatment, and improve patient access to all three.
To ensure we succeed in this effort, the President’s Executive Order establishes an HIV Care Continuum Working Group. The group will coordinate federal efforts to improve outcomes nationally across the HIV care continuum, and will be co-chaired by the White House Office of National HIV/AIDS Policy and HHS’s Office of the Assistant Secretary for Health. The working group will provide annual recommendations to the President on actions to take to improve outcomes along the HIV care continuum.
Second, today HHS announced a new multi-year demonstration project that brings together OASH, CDC, and the Health Resources and Services Administration (HRSA) in a collaboration to expand the capacity of community health centers, local health departments, and their grantees to better integrate HIV prevention and treatment across the continuum of care. HHS will invest $8-10 million a year to support health centers and local health departments in integrating public health practice, and clinical care. The project will target areas with high numbers of racial and ethnic minorities, who are disproportionately affected by the epidemic, and communities with a substantial unmet need for comprehensive HIV services.
These two actions complement many of the ways we are already addressing the importance of continuum of care now.
The National Strategy shares its third anniversary with the Affordable Care Act, landmark legislation that is vital to our fight against HIV/AIDS.
Already, the law has expanded access to HIV testing, and ends the practice of putting lifetime caps on care when patients need it the most. Beginning in 2014, it will bring to an end to insurance practices like denying coverage for pre-existing conditions, including HIV infection.
Beginning this October, when the online Health Insurance Marketplaces open for enrollment, millions more Americans will have the opportunity to enroll in affordable coverage that includes HIV testing and other preventive care, with coverage set to begin January 1, 2014.
And the health care law also allows states to expand their Medicaid programs. Many people living with HIV will no longer have to wait for an AIDS diagnosis to become eligible for Medicaid.
The law aligns with the National HIV/AIDS Strategy’s overall goals to reduce new infections, improve access to care, and reduce HIV-associated health disparities.
This includes fighting HIV stigma and discrimination. It includes advocating for the health of communities at greatest risk for HIV, including young, black, gay men and transgender people. It includes supporting research, in order to find more prevention and treatment breakthroughs.
And it means making smarter, more coordinated investments to fight the epidemic. That’s why the president’s Executive Order is so important.
Read the HIV Care Continuum fact sheet here.