Feds Release Updated National HIV/AIDS Strategy

The federal government announced last week that it will push for universal access to pre-exposure prophylaxis (PrEP) as well as full viral suppression of all persons living with HIV by 2020.
Health officials in Michigan said they are scaling up programming to match the new national goals. They also announced a new online directory of Michigan health care providers who are willing to prescribe PrEP.
The state announcement came in conjunction with the release of the updated National HIV/AIDS Strategy. The strategy was first published and released by the White House in 2010. That strategy laid out goals to 2015. The new strategy lays out plans to address the epidemic until 2020, well into the next presidential term.
Viral suppression, commonly referred to as undectable viral loads, are a measure of the activity of antiretroviral medication. When a person living with HIV is on successful treatment, the viral load is less than 28 viral particles per milliliter of blood. That in turn, scientists have found, reduces the risk of transmission of the virus significantly. Studies have found no cases of transmission of HIV from suppressed persons living with HIV to their HIV-negative sex partners.
"To achieve viral load suppression and improved health outcomes, Michigan is focusing on strategies to support people with HIV at each stage of the treatment cascade from diagnosis to viral suppression; build HIV Care Networks in underserved communities; and integrate HIV care expertise into the mainstream health care system," said Jennifer Smith, a spokesperson for the Michigan Department of Health and Human Services.
In 2013, the most recent year available, MDHHS reported that viral suppression goals across the state had been surpassed in three target categories: Latinos living with HIV, African-Americans living with HIV and men who have sex with men living with HIV.
According to state reports, of 5,604 African-Americans living with HIV, 64 percent had received a viral load test in the previous year, and 4,185 of the 5,604 (75 percent) were virally suppressed. In 2013, there were 832 Latinos living with HIV, and of those, 451 (54 percent) received a viral load test in the previous year and 337 of the 451 (84 percent) were virally suppressed. That same year, 8,950 men who have sex with men were living with the virus, and of those, 5,822 (65 percent) received a viral load test and 4,780 of the 5,822 (82 percent) were virally suppressed.
PrEP is a relatively new prevention method. In this intervention, a person at high risk for HIV takes an anti-HIV drug originally developed to treat the virus. The drug, known by the brand name Truvada, is taken daily. Studies show the drug is at least 92 percent effective in preventing a person who is HIV negative from being infected. A National Institutes of Health model predicts daily use of the drug would result in a 99 percent reduction in risk of infection.
"We will scale up universal access to PrEP and PrEP adherence support services by addressing and mitigating barriers that are commonly seen as roadblocks to PrEP services. To that end, a PrEP provider directory for the state of Michigan has been compiled and posted online at www.michigan.gov/hivstd," Smith said. "We are developing supplementary tools for other areas such as cost (Medicaid, Healthy Michigan and Gilead co-pay assistance tool kit) and adherence (readiness assessment to determine if PrEP is right for a given client). Another important component is training and education of key personnel such as HIV test counselors, disease intervention specialists, STD clinic staff and medical professionals. These populations will be reached through activities by MDHHS and its collaborations with educational entities such as the Midwest AIDS Training & Education Center."
The strategy also committed the federal government to focus on HIV in men who have sex with men, as well as transgender communities. Both have a higher incidence of HIV infection.