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Kaisernetwork.org (Washington, DC)

Africa: Daily HIV/Aids Report

27 November 2007

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Election 2008

Clinton To Release HIV/AIDS Policy

[Nov 27, 2007]

Sen. Hillary Rodham Clinton (N.Y.), who is running for the Democratic presidential nomination, on Tuesday while campaigning in South Carolina is expected to announce a plan to fight HIV/AIDS domestically and abroad, the New York Times reports. Clinton's "two main rivals" for the Democratic nomination -- Sen. Barack Obama (Ill.) and former Sen. John Edwards (N.C.) -- already have released HIV/AIDS plans, the Times reports. The three plans are "similar in terms of spending, goals and differences with President Bush's AIDS policy," according to the Times.

Clinton's plan, like Edwards' and Obama's, will propose spending at least $50 billion by 2013 on initiatives to fight HIV/AIDS worldwide. The Bush administration has allocated $30 billion for the same time period. Clinton's plan also will propose doubling funding for HIV/AIDS research at NIH to $5.2 billion annually. Edwards' plan, which was released in September, pledges to "strengthen" spending for such research, while Obama, who released parts of his plan at different times throughout the year, said he would "expand" research funding.

According to the Times, the three plans would not focus HIV prevention strategies on abstinence-only education. A paper provided by Clinton's campaign that outlines her plan says that she supports providing young people with "age-appropriate information about HIV/AIDS and how to protect themselves against it." Clinton, Edwards and Obama also all support federal funding for needle-exchange programs.

In addition, the paper outlining Clinton's plan says that she would work to "significantly" reduce the number of new HIV cases in the U.S. each year, as well as to establish measureable targets and timelines for expanding prevention and treatment services. Obama's plan for reducing new cases is "almost identical to what [Clinton] proposes," the Times reports. Edwards has said that his plan for reducing new cases includes holding his HHS secretary "accountable" for releasing an annual HIV/AIDS report that demonstrates progress toward Edwards' targets. Edwards also has said that he would appoint a "strong" director for the White House Office of National AIDS Policy.

Clinton, Edwards and Obama all pledge to provide HIV-positive people with improved medical care, primarily through health insurance programs that the three candidates have proposed this year. According to Clinton campaign advisers, she thinks that the current federal plan to combat HIV/AIDS is "diffuse and uncoordinated," according to the Times.

Although HIV/AIDS plans have not been a primary topic among the leading Republican presidential candidates, some have spoken about how increased efforts are needed, according to the Times. Former New York City Mayor Rudy Giuliani, who is running for the Republican presidential nomination, has said that he would increase funding for Bush's HIV/AIDS programs in Africa. He added that he would provide aid to fight malaria in Africa, as well as aim to bolster trade between the U.S. and the continent (Healy/Altman, New York Times, 11/27).

Link to this story.

Across The Nation

Washington, D.C., Mayor Fenty Pledges Increased HIV Testing, No-Cost Condom Distribution in Response to Report

[Nov 27, 2007]

Washington, D.C., Mayor Adrian Fenty's administration on Monday pledged to triple within one year the number of no-cost condoms distributed by the city, as well as to work with hospitals to increase HIV testing in emergency departments, in an effort to curb the spread of the virus, the Washington Post reports (Nakamura, Washington Post, 11/27).

The announcement follows the release of a report that called HIV/AIDS a "modern epidemic" in the district with "complexities and challenges that continue to threaten the lives and well-being of far too many residents." According to the report, almost 12,500 district residents were known to be living with HIV/AIDS in 2006. Thirty-seven percent of HIV cases were transmitted through heterosexual contact, compared with 25% that were transmitted among men who have sex with men.

The number of HIV cases in the district began declining in 2003, but the decrease likely is the result of underreporting or delayed reporting, the report said. One in 20 district residents is HIV-positive and one in 50 is living with AIDS, according to Shannon Hader, head of the city's HIV/AIDS Administration. The city's cumulative number of AIDS cases is more than 17,400.

More than two-thirds of AIDS cases in the district during the past 10 years were among people who progressed to AIDS within one year of being diagnosed with HIV, compared with 39% of AIDS cases nationwide, the report found. The report also found that more people ages 40 to 49 were being diagnosed with HIV than any other age group. In addition, all of the 36 children in the district who tested positive for HIV since 2002 contracted the virus during birth (Kaiser Daily HIV/AIDS Report, 11/26).

Hader said the HIV/AIDS Administration plans to scale up several initiatives that began before she started at the administration in October, the Post reports. Hader also said that she hopes to increase the number of no-cost condoms distributed by the city to three million by 2009 to help prevent the spread of HIV. She added that she wants to "challenge" all hospital EDs to offer "rapid HIV testing" to help diagnose the virus in earlier stages. George Washington University Medical Center and Howard University Hospital have the only EDs that currently offer HIV testing, Hader said. In addition, Hader said she plans to collaborate with the city's seven birthing centers to draft guidelines and set up outreach and testing sites to help prevent mother-to-child HIV transmission.

"These things have already been started, but we want to use the report to build on them," Hader said, adding, "We're using all the tools in the tool kit, and we're also looking at all of our tool kits, figuring out where there are gaps." Hader said she does not plan to request more HIV/AIDS funding in the coming year but added that if early testing and treatment rates are increased, the programs could become more costly (Washington Post, 11/27).

Related Editorial

The figures in the report are "harrowing," but "with a new director of HIV/AIDS administration, plenty of funding and, now, data, the district stands a chance of beating back this killer that has no cure," a Post editorial says. According to the editorial, doctors and hospitals need to routinely test pregnant women for HIV, and prevention and treatment efforts "must be accelerated." The Post adds that Fenty and Hader have committed themselves to this goal, but "their efforts will be useless if people think they are somehow immune to the epidemic." The editorial concludes that "AIDS is an equal-opportunity killer" (Washington Post, 11/27).

NPR's "The Bryant Park Project" on Tuesday included a discussion with Larry Bryant, an outreach and advocacy worker in the district, about the report ("Bryant Park Project," NPR, 11/27). Audio of the segment is available online.

In addition, WAMU's "The Diane Rehm Show" on Tuesday is scheduled to include a discussion with Anthony Fauci, director of the National Institute of Allergy and Infectious Disease at NIH, about the report and other issues related to HIV/AIDS ("The Diane Rehm Show" Web site, 11/27). A broadcast schedule and additional details about the segment are available on the program's Web site. Audio of the segment will be available online about one hour after the broadcast.

Link to this story.

Palm Beach Post Examines HIV/AIDS in Florida

[Nov 27, 2007]

The Palm Beach Post on Sunday examined HIV/AIDS in Florida, which has the third-highest caseload nationwide. More than 105,000 people have been diagnosed with AIDS since the start of the epidemic in the U.S., and the rate of HIV/AIDS among children in the state is second only to New York, according to the Post. In addition, about 80% of pediatric HIV/AIDS cases occur among black children. Palm Beach and St. Lucie counties have recorded the highest HIV/AIDS rates among black residents statewide, the Post reports. Black residents, who make up 15% of Palm Beach county's population, comprise 65% of people living with HIV/AIDS in the area.

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