Committee Holds Hearing on Domestic HIV Epidemic

We’re here today to discuss some alarming developments in the fight against HIV and AIDS in the United States.

The Centers for Disease Control and Prevention (CDC) recently announced that the HIV epidemic in the U.S. is growing at a rate far greater than was previously thought. The new figures are a stark reminder that the HIV epidemic is far from over, and that we must take new and urgent steps to strengthen our national HIV prevention efforts.

The first cases of what later came to be identified as AIDS were reported in Los Angeles in 1981. Over the next two years, the case reports accumulated, and we learned that a distinct syndrome was being diagnosed in different populations all across the country. By the mid-1980s, there were an estimated 130,000 new infections every year in the United States.

As infections increased, so did our investment in HIV prevention efforts. Even before the virus called HIV was identified as the cause of AIDS, CDC’s experts had figured out the transmission routes and issued early recommendations for the prevention of infection. The federal government started investing significant amounts of funding in prevention and education efforts nationwide.

These investments paid off, and the infection rate dropped dramatically.

But this is a job that is never done. This was recently demonstrated in dramatic fashion when CDC reported that the real infection rate is much higher than we thought.

Over the past ten years, CDC’s official estimate for annual new infections has been about 40,000. But last month, CDC announced that in fact there were over 56,000 new HIV infections in 2006.

The higher figure was due to improved counting methods, not to an actual jump in infections. But it tells us that the epidemic in the United States is — and has been — growing faster than we had thought.

The message these new findings send is clear: we’re not doing enough to limit the spread of this deadly disease.

What’s more, we’re still seeing severe disparities in HIV’s impact on different populations. Men who have sex with men constitute 57% of new infections. Blacks, who make up about 12% of the total population, account for 45% of new HIV infections. Hispanics are also disproportionately affected.

Part of the problem is that the federal government has not been doing enough for HIV prevention in the United States. In adjusted dollars, the CDC’s HIV prevention budget has dropped more than 20% since 2002. This year, the Administration actually asked for a million-dollar decrease in HIV funds.

This didn’t make sense to me. So I asked CDC to prepare a budget that reflects not what the White House wanted but rather the agency’s professional scientific judgment of what it would take to fully implement effective HIV prevention in the United States.

As we will hear today, the Administration asked for less than half of what the CDC’s scientific professionals estimate is necessary for effective HIV prevention. Instead of listening to its own experts, the Administration requested that Congress fund HIV prevention programs at far lower levels.

What’s even more senseless is that by underfunding prevention, the nation will incur greater treatment costs down the road. It is indisputable that evidence-based HIV prevention saves money in addition to saving lives by avoiding the high costs of medical care and lost productivity. But on this issue, the Administration apparently prefers to be penny-wise and pound-foolish.

We’re here today to learn from some of the nation’s top HIV prevention experts what a truly robust national HIV prevention program would look like. We will hear from leaders at CDC and NIH about how they are attempting to roll out effective programs and research potential new ones.

We will discuss barriers to evidence-based HIV prevention, like the federal needle exchange ban and this Administration’s stubborn and irrational focus on abstinence-only programs. And because HIV infections don’t occur in a vacuum, we will hear recommendations from all of our witnesses on how the federal HIV prevention response should address societal factors that contribute to risk, including poverty, homelessness, racial and gender inequality, homophobia, and stigma related to HIV status.

I look forward to a constructive discussion of these questions today.

But one point should be clear from the outset: the status quo simply isn’t acceptable. We undermine public health and betray some of America’s most vulnerable citizens — and allow the further spread of a deadly and still-incurable disease — by failing to invest in proven prevention methods.

We aren’t doing everything we can and should, and I hope this hearing will be the first step in returning the necessary spotlight, resources, and political will to HIV prevention efforts in the United States.