Kaisernetwork.org (Washington, DC)
31 March 2008
Politics and Policy
House To Consider PEPFAR Reauthorization Bill Wednesday
[Mar 31, 2008]
The House on Wednesday is scheduled to consider a bill (HR 5501) that would reauthorize the President's Emergency Plan for AIDS Relief, CQ Today reports (Vadala/Ethridge, CQ Today, 3/27).
The measure, which was approved in February by the House Foreign Affairs Committee, would allocate $50 billion for PEPFAR over the next five years. President Bush had called on Congress to authorize a $30 billion, five-year extension of PEPFAR. The bill also would remove a requirement that at least one-third of HIV prevention funds that focus countries receive through PEPFAR be used for abstinence-until-marriage programs. It also would require "balanced funding" for abstinence, fidelity and condom programs based on evidence in each PEPFAR focus country. In addition, the bill would retain the requirement that PEPFAR recipients pledge opposition to commercial sex work.
The bill would allow groups to use PEPFAR funding for HIV testing and education in family planning clinics but not for contraception or abortion services. The bill also would require reports to Congress if abstinence and fidelity programs compose less than half of country-level spending on programs aimed at preventing sexual transmission of the virus. In addition, the bill would allocate about $9 billion to fight tuberculosis and malaria, which often affect HIV-positive people in Africa. That amount also would underwrite food supplements for people living with HIV/AIDS. The bill would provide loans to women widowed by the disease or ostracized because of their HIV-positive status (Kaiser Daily HIV/AIDS Report, 2/29).
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Across The Nation
CDC Releases Surveillance Report on U.S. 2006 HIV/AIDS Cases
[Mar 31, 2008]
CDC last week released its annual HIV/AIDS surveillance report, which found that the number of reported HIV cases in 2006 was higher compared with previous years, the Wall Street Journal reports. According to the Journal, the higher number of reported HIV cases reflects CDC's "improved surveillance system rather than a rise in the epidemic" (Wall Street Journal, 3/31).
According to the report, the number of reported HIV cases based on data from 45 states and five dependent territories with confidential name-based reporting was 52,878 in 2006. Five states -- Hawaii, Maryland, Massachusetts, Montana and Vermont -- were not included in the data. The 2006 data for the first time included the seven states -- California, Delaware, Illinois, Maine, Oregon, Rhode Island and Washington -- which have now implemented confidential, name-based reporting. The comparable number of HIV cases reported in 2005 was 35,537 based on data from 38 states and five territories (CDC release, 3/27). The number of HIV/AIDS cases in the 33 states and five areas with long-standing reporting has remained stable from 2003 to 2006, according to the report (Wall Street Journal, 3/31).
"No matter how the CDC tries to spin these numbers, the fact remains that the numbers they've been reporting for years have been inaccurate and have incorrectly portrayed the U.S. epidemic as static at roughly 40,000 new infections per year," Whitney Engeran, director of the AIDS Healthcare Foundation's Public Health Division, said, adding, "We missed a crucial opportunity to work with Congress to adjust the budget to better reflect the needs of the populations affected because of the CDC's delay in reporting these numbers" (AHF release, 3/27). Robert Janssen, director of CDC's Division of HIV/AIDS Prevention, said that the report does not "show an increase in HIV/AIDS diagnoses." He added, "The higher number of reported HIV diagnoses in 2006 ... is due to the fact that this table includes data from states that have newly implemented confidential name-based HIV reporting as of 2006, including highly populous states like California, Illinois and Washington" (CDC release, 2/28).
The report is available online (.pdf).
A Kaiser Family Foundation fact sheet with the 2006 data is available online. Several state indicators also have been updated on statehealthfacts.org.
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Report Finds That HIV Cases in Baltimore Increasing Among People Ages 20-29, Calls on City To Do More To Fight Spread of Virus
[Mar 31, 2008]
The number of HIV cases recorded in Baltimore among people ages 20-29 increased by 10% annually between 2000 and 2006, and blacks account for 90% of new cases in the city, according to a report released Thursday by the Baltimore City Commission on HIV/AIDS Prevention and Treatment, the Baltimore Sun reports.
According to the Maryland AIDS Administration, almost 16,000 city residents were living with HIV/AIDS as of September 2006, the last date for which data are available. Although the rate of new cases has been declining by about 2% annually, the decline has not been as fast as other U.S. cities, the administration found. Baltimore has the second-highest rate of new AIDS cases in the nation, according to a federal report. The commission's report called on the city to begin measuring results of its prevention efforts to ensure that people who test HIV-positive receive treatment access. The report also said that Baltimore should increase HIV/AIDS education in the city's public school system. In addition, it recommended a citywide advertising campaign to increase awareness about the disease and programs to provide homeless people living with HIV/AIDS with housing and treatment.
"Baltimore as a whole is not doing well," William Blattner, head of the commission, said, adding, "We need to have a strategic plan so we can move ourselves out of the top 10 in a coordinated way." Blattner said he is disturbed by the increase of HIV cases among people in their 20s, adding that it is a trend that the school system could address through "age-appropriate" classes starting in grade school.
City health commissioner Joshua Sharfstein said his top priority is to develop a "coherent prevention plan." He added the city still lacks an inventory of what public and not-for-profit groups are doing and what they have accomplished. "There's no public accounting," Sharfstein said, adding that one problem is the assortment of public and private agencies making grants. "If there were a single funding agency, it would be easier," Sharfstein said. The Health Department is creating a program, called "HIV stat," that will ask agencies to report their activities on a quarterly basis, the Sun reports. Sharfstein said the health department also is planning new methods to fight the spread of the disease among people who engage in commercial sex work to support their drug habits (Bor, Baltimore Sun, 3/28).
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Global Challenges
Ugandan Vice President Bukenya Calls for Research on Country's HIV Prevention Strategies
[Mar 31, 2008]
At Uganda's fifth National AIDS Conference last week, Ugandan Vice President Gilbert Bukenya called for research into the country's primary HIV/AIDS prevention strategies to understand why prevalence of the disease has increased in the country, Uganda's Monitor reports.
Bukenya said that research is needed to "establish what has worked and what has not worked." Although the ABC approach -- which stands for abstinence, be faithful and use condoms -- has been credited with curbing the spread of HIV in Uganda in the past, HIV prevalence in the country has increased in recent years, according to the Monitor. "Researchers should be able to carry out operational research to know why there is an increase in infections, yet we still have in place this policy that has worked very well," Bukenya said.
Alex Coutinho, executive director of the country's Infectious Diseases Institute, said that Uganda has conducted research that could help slow the spread of the virus but has not used the research in designing new policies. "Uganda has research that is really important," Coutinho said, adding that other countries have taken Ugandan research and are "making good use of it." He said the country tends to "stagnate when it comes to putting into practice most of this research that promotes prevention."
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