National HIV/AIDS Strategy Feed

May 02, 2011


HHS Region VIII Agencies Convene to Discuss National HIV/AIDS Strategy Implementation

By CAPT Zachary Taylor, M.D., M.S., Regional Health Administrator – Region VIII, U.S. Department of Health and Human Services

Zachary Taylor

With efforts to implement the National HIV/AIDS Strategy (NHAS) unfolding across the country, we thought it would be valuable to gather our Federal colleagues in this region to identify ways to coordinate and collaborate in our HIV/AIDS-related activities. After all, the NHAS calls for a more coordinated national response to the epidemic. To realize the goals of the NHAS, this coordination must take place not just at the Federal level, but also at the regional, state and community levels.

As the senior Federal public health official in the region for the Department of Health and Human Services (HHS), my responsibilities encompass four major areas: prevention, preparedness, health equity, and agency-wide coordination. In this capacity, I work closely with the Office of the Assistant Secretary for Health (OASH), which has taken a lead role in forging collaborations across HHS and with other Federal departments to implement the NHAS. Borrowing from that example, we planned a joint meeting of regional staff from HHS and other Federal departments for a discussion about implementing the NHAS in this region. The HHS Region VIII encompasses Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming.

The level of enthusiasm from our partners was impressive. Joining in this conversation were regional representatives of numerous HHS agencies including the Health Services and Resources Administration (HRSA), Administration on Aging (AoA), Administration on Children and Families (ACF), Office for Civil Rights (OCR), Office of Population Affairs (OPA), Office of Minority Health (OMH), and Office on Women’s Health (OWH). In addition, representatives from the Departments of Agriculture, Education, Housing and Urban Development (HUD), Justice (DOJ), Labor (DOL), and Veterans Affairs (VA), and the Social Security Administration (SSA) joined the discussion (this list includes all of the agencies tasked by the White House with lead responsibility for implementing the Strategy as well as several other welcome additions). The broad organizational diversity of the partners, along with their collective depth of experience and perspective made for a very rich discussion.

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Perspectives from Missouri

By Christopher Bates, M.P.A., Executive Director, Presidential Advisory Council on HIV/AIDS, and Senior Advisor to the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services

Christopher Bates

Earlier this month, I had the opportunity to spend time in Missouri speaking with audiences about the National HIV/AIDS Strategy (NHAS) and learning about what they are doing to support implementation of the Strategy locally. As in other communities across the country, the folks I spoke to in Kansas City and Jefferson City are eager to contribute locally to the nationwide efforts to achieve the Strategy’s goals.

In Kansas City, I spoke to the Campaign to End AIDS Exit Disclaimer (C2EA) Annual Summit. C2EA is a diverse coalition of people living with HIV and AIDS, their advocates, colleagues, friends, and loved ones. The panel discussion in which I participated was entitled “National HIV/AIDS Strategy Implementation: Federal to State to Community.”

NHAS In Action

The title captures the importance of engaging all sectors of society in implementing the Strategy if we are to achieve its important and life-saving goals. Joining me on that panel was Missouri’s State AIDS Director, Michael Herbert, who shared some of the approaches his agency is taking to align programs and activities with the Strategy’s goals to reduce new HIV infections, increase access to care, and reduce HIV-related health disparities. I provided an overview of what is underway at the Federal level and also encouraged the participants to ground their efforts in science, conduct assessments so they know what works best in their community in terms of prevention and treatment, and scale up those efforts sufficient to meet demand in the communities most impacted.

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April 26, 2011


SAMHSA, Behavioral Health and the National HIV/AIDS Strategy (Part II)

By Gretchen Stiers, PhD, HIV/AIDS Policy Lead, Office of Policy, Planning and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services

Gretchen Stiers

Gretchen Stiers, SAMHSA

As the HIV/AIDS policy lead at the Substance Abuse and Mental Health Services Administration (SAMHSA), I am pleased to return to the blog to discuss more of the activities that SAMHSA is engaged in to support the National HIV/AIDS Strategy (NHAS). In my last post, I discussed SAMHSA’s commitment to addressing the behavioral health problems that can put individuals at greater risk for HIV infection, co-occur with HIV infection, and hinder access to treatment and maintenance in care for mental and substance use disorders as well as for primary medical services. I also discussed SAMHSA’s efforts to examine the funding criteria that allow States to use five percent of the Substance Abuse Prevention and Treatment Block Grant funds for HIV/AIDS services, and our support of the 12 Cities Project. Today, I would like to provide an overview of how some of our current behavioral health activities are aligned with each of the three goals of the NHAS. Behavioral health refers to emotional health in general and the choices/actions that affect wellness. Behavioral health problems include substance abuse or misuse, alcohol and drug addiction, serious psychological distress, suicide, and mental and substance use disorders.

Goal 1: Reducing New HIV Infections

To reduce the number of new HIV infections, the NHAS calls for us to re-orient our prevention efforts by realigning resources to serve the populations at highest risk of acquiring or transmitting HIV including those with mental and substance use disorders1. The NHAS recommends that HIV testing and other comprehensive HIV prevention services be coupled with treatment and services for individuals with mental and substance use disorders. To help assess the need for additional services, SAMHSA is conducting a needs assessment to determine the distribution and frequency of HIV testing in SAMHSA-funded substance abuse and mental health treatment clinics. We will use the results from the assessment to determine areas for expanding HIV testing capacity in SAMHSA-funded clinics and centers. While many behavioral health service providers are not HIV specialists, their patient populations may be engaging in behaviors that put them at higher risk for HIV infection or hinder access to HIV treatment and maintenance in care. SAMHSA will develop resources, technical assistance and training to help substance abuse and mental health treatment providers offer HIV prevention services (such as access to rapid testing) and to increase their capacity to link people with HIV/AIDS to primary care in a timely manner.

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April 20, 2011


Illinois Commences Development of Statewide HIV/AIDS Plan

By David Ernesto Munar, President and CEO, AIDS Foundation of Chicago Exit Disclaimer

In a recent article Exit Disclaimer, my colleague at AIDS Foundation Chicago Exit Disclaimer, Keith R. Green, profiled efforts underway in Illinois to develop a statewide operational plan aligned with the National HIV/AIDS Strategy. Keith frankly observes that “coordinated efforts at the national level will only produce small results without similar coordination within local jurisdictions.”

I thought it was particularly timely to share his article given that on Tuesday I participated in a meeting that the U.S. Department of Health and Human Services (HHS) convened to discuss the development of state HIV/AIDS plans. Joining me at this meeting were representatives from the community, the National Alliance of State and Territorial AIDS Directors Exit Disclaimer(NASTAD) and the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS), several state AIDS directors, local health department representatives, and others. The National HIV/AIDS Strategy is, afterall, a national and not merely a federal strategy. So the strategy counts on contributions to this national effort from all sectors, including state and local governments.  In recommending that the States develop individual HIV/AIDS plans, the Strategy suggests:

The purpose of State plans would be to enhance coordination between planning and resource allocation activities, which are often siloed in a way that separates prevention and care…In developing their plans, States will also be encouraged to identify all Federal, State, and local resources, and to the extent feasible, private and nonprofit resources to ensure that all HIV/AIDS resources are allocated in the most efficient manner to address the full range of prevention, care, and social service needs. talked with James Albino, the Senior Program Manager in the White House Office of National AIDS Policy about this post and he told us that “. . . shortly after the launch of the National HIV/AIDS Strategy I began visiting communities from LA to Dover, DE to encourage them to look at ways to implement the Strategy at the local level.  I am pleased that Illinois is in the forefront of this important effort and hopeful that their efforts might serve to inform and inspire other States to pursue similar plans.”

April 19, 2011


Justice Department Issues Letter Regarding Illegal Exclusion of Individuals with HIV/AIDS from Occupational Training and State Licensing

By Allison Nichol, JD, Deputy Chief, Disability Rights Section, Civil Rights Division, U.S. Department of Justice


Allison Nichol, U.S. DOJ

The Justice Department has issued letters to the attorneys general of all 50 states, as well as U.S. territories to request their assistance in addressing the illegal exclusion of individuals with HIV/AIDS from occupational training and state licensing. Persons with HIV and persons with AIDS are covered by the Americans with Disabilities Act (ADA), which gives federal civil rights protections to persons with disabilities in public accommodations, employment, and state and local government services. 

The Justice Department has learned that public and private trade schools for barbering, cosmetology, massage therapy, home health care work and other occupations, as well as state licensing agencies, may be illegally denying individuals with HIV/AIDS admission to trade schools and/or occupational licenses because of their HIV status.  However, because HIV cannot be transmitted by casual contact or by the circumstances present in these occupations, HIV-positive status is irrelevant.

In his letter to the attorneys general, Assistant Attorney General for the Civil Rights Division Thomas E. Perez asked that they review their respective jurisdictions’ admission and licensing criteria for trade schools and licensing agencies to identify the existence of any criteria that unlawfully exclude or discriminate against persons with HIV/AIDS, and to take the steps necessary to bring all such programs into compliance with the ADA. 

The department recently entered into a settlement agreement with a private cosmetology school in Bayamón, Puerto Rico, for delaying the admission of an HIV-positive individual.  That settlement agreement requires the school to remove questions about applicants’ HIV/AIDS status and to promptly enroll the aggrieved individual in its cosmetology program.  The department has also addressed related issues in its guidance entitled “Questions and Answers: The Americans with Disabilities Act and the Rights of Persons with HIV/AIDS to Obtain Occupational Training and State Licensing.”

This action supports the National HIV/AIDS Strategy’s call to reduce stigma and discrimination experienced by people living with HIV.  Even today, some people living with HIV still face discrimination in many areas of life including employment, housing, provision of health care services, and access to public accommodations.  This undermines efforts to encourage all people to learn their HIV status, and it makes it harder for people to disclose their HIV status to their medical providers, their sex partners, and even clergy and others from whom they may seek understanding and support.  Vigorous enforcement of the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act, and other civil rights laws is vital to establishing an environment where people will feel safe in getting tested and seeking treatment.  So the National HIV/AIDS Strategy calls upon the Department of Justice and Federal agencies to strengthen enforcement of these civil rights laws.


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