CDC - NCHHSTP Director's Blog - HIV Testing, Celebrating Life and World AIDS Day

Well, it has been a busy November and things are moving at a rapid pace as we approach the end of the year. I hope you all had a wonderful Thanksgiving holiday and wish you well in your activities for World AIDS Day 2008.

I have been doing a lot of thinking about the role and importance of HIV testing in our continued efforts to fight this virus. I recently attended the 2008 National Summit on HIV Diagnosis, Prevention and Access to Care and had a chance to hear first hand of progress since the 2006 release of CDC’s revised recommendations on HIV testing. I was pleased to see some of the great energy and innovation around implementing and promoting routine HIV testing in many parts of the country. Local medical settings, city and county health departments, insurance companies and other federal agencies are showing great leadership, and aligning policies and practice to support routine HIV testing.

However, it was clear that more remains to be done. Despite having tackled key policy, legislative, and in many areas fiscal barriers to routine HIV testing, we have lots of work ahead of us to scale up coverage. Too many Americans have never been HIV tested, and too many people are testing too late in the course of their disease. Perceived or real barriers to testing remain – including concerns about reimbursement for HIV testing; local prioritization, leadership, and accountability; and sustaining HIV testing activities. Two years after the implementation of the CDC revised recommendations, we now need to dramatically accelerate steps to ensure that more Americans know their HIV status.

Let’s not forget the urgency of this situation. There are more than 1.1 million Americans living with HIV of whom 1 in 5 is unaware of their HIV status and nearly 1 in 2 is not in care. People who do not know they are HIV infected are responsible for transmitting most of the more than 56,000 new HIV infections which occur each year – the majority of whom are men who have sex with men of all races, African Americans and Hispanics and Latinos. HIV testing is a gateway to effective treatment and care, and those who test HIV positive benefit greatly from the effective antiretroviral treatments and supportive services, and are able to take proactive steps to reduce the risk of onward transmission of HIV.

In the absence of a cure for HIV, we must use all available tools at our disposal to end this epidemic. HIV testing and linkage to care is one crucial tool, and recent studies highlighting the importance and promise of earlier diagnosis and treatment in getting ahead of the epidemic, should inspire us to do more. As we pause to commemorate World AIDS Day, it is important to acknowledge our success and to keep our focus on what still needs to be done to end this epidemic. In so doing, today we focus on two themes: "Lead - Empower - Deliver" in the United States and for PEPFAR, the President's plan for global AIDS relief, "Celebrate Life." These themes work in tandem. We are committed to keeping the promise and to celebrating the lives saved and the healthier lives of those living with this disease. We have the tools, we have the policies, we have the test, and we have the know-how. Let us recommit ourselves to doing more to pushing through the barriers to bring an end to this epidemic.

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We have a problem here in Australian as with many other countries that people are still passing on the virus. In large part, the negative person is negating the alterations to their life when they become Positive. Things like, loss of insurance, permanency in some positions, rejection by many organisations for a position and the long term affects of medications of their bodies (I have been Pos since 1984). These issues are not promulgated by our HIV/AIDS bodies in their advertising which is all about using condoms and not these other issues. They will also not describe, or indeed illustrate, the affects of anti retroviral on ones body over the long term. They use the excuse that if they try this direct approach, they will stigmatise HIV folk, but most long termers like me, are quite relaxed about a more aggressive warning approach. These organisations are a disgrace in my opinion.

Regards,
Bob Newey
Port Melbourne, Australia

Received from Bob Newey, on Thursday, December 11, 2008 at 5:30 am ET

Comment

The U.S. HIV epidemic continues to evolve with increased diagnoses being reported in cities and states where HIV is traditionally has been more common. Earlier this month, officials at the Idaho Department of Health and Welfare announced that the number of HIV infections in their state have increased by 23 percent since last year. Over a dozen of those newly diagnosed were under 25 years of age.

Today marks the first day of the new fiscal year for our programs. This is a time well suited to reflection on what we’ve accomplished and a look forward to the year ahead. So I would like to share with you some of my thoughts on the past, present, and future of our work.

On Tuesday, CDC Director Dr. Julie Gerberding and I participated in a Congressional hearing titled, “The Domestic Epidemic is Worse than We Thought: A Wake-Up Call for HIV Prevention,” held by Congressman Henry A. Waxman. Dr. Tony Fauci, Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, took part in the hearing.

I have been reflecting on my experiences at the XVII International AIDS Conference

in Mexico City, which concluded close to three weeks ago. As I walked the conference hall, I could feel the amazing energy, passion and commitment that this event brings together. Once again, I was humbled and invigorated by the selfless dedication of those committed to fighting the global HIV pandemic.