AIDS Conference is a Wrap, U.S. Still Has Much Work To Do

August 7, 2012

By Jane Norman, CQ HealthBeat Associate Editor

The XIX International AIDS Conference drew to a close Friday without the physical presence of President Obama but with a full cast of other high-profile U.S. politicians who expressed their commitment to ending the disease.

The notables at the conference included Secretary of State Hillary Rodham Clinton; former President Bill Clinton; former first lady Laura Bush; Minority Leader Nancy Pelosi, D-Calif., and other members of Congress, both Democratic and Republican. Also prominent through the week were Health and Human Services Secretary Kathleen Sebelius, White House AIDS adviser Grant Colfax and Global AIDS Coordinator Eric Goosby, all stressing the president’s AIDS strategy.

Good news abounded, too, such as the announcement of a new study of a small group of HIV-positive patients who, when treated early and then taken off antiretroviral drugs, showed no signs that the infection had recurred. Charlene Bacchus, lead researcher of the study at the French National Agency for Research on AIDS and Viral Hepatitis, said the results showed the value of beginning treatment as soon as possible after the infection is detected. More than 20 antiretroviral drugs are on the market, and when used in combination they not only prolong people’s lives for decades, but also reduce transmission to others.

Diane Havlir, one of the U.S. organizers of the conference and chief of the HIV/AIDS division and Positive Health Program at San Francisco General Hospital, said in closing remarks that it was the first time a cure for AIDS has been suggested at a conference, and that there was “renewed enthusiasm” for a vaccine.

At the sprawling conference, headquartered at the convention center in Washington, D.C., the problems of HIV among the aging and women were discussed, protesters interrupted speeches to shout for additional global funding and “sex workers” lobbied for their work to be recognized like any other and practiced in a safe and regulated way so as to reduce the possibility of HIV transmission.

Yet the heartbreaking message for U.S. efforts heard over and over is that only a quarter of the 1.1 million U.S. residents who have the HIV infection are receiving consistent drug treatment and health care. The problem was underlined with the release Friday of an analysis by the Centers for Disease Control and Prevention (CDC) that found that among people who are HIV-positive, 21 percent of black Americans have a suppressed viral load, compared to 30 percent of white Americans and 26 percent of Latinos. Thirty-four percent of black Americans are receiving ongoing care, compared to 37 percent of Latinos and 38 percent of whites.

The analysis also found that just 15 percent of people between 25 to 34 with the HIV infection have suppressed viral loads, compared to 36 percent of people between 55 to 64, who may have been living with HIV for decades thanks to treatment. National data wasn’t available on people younger than 25, though the CDC said statistics suggest that teens and young adults are not diagnosed as often as older adults.

AIDS activists from the United States warned that the success promised by the research presented at the conference would not come to fruition if the health care law (PL 111-148, PL 111-152) is not fully implemented and Medicaid is not extended to childless adults earning less than 138 percent of the federal poverty level.

The Supreme Court ruling in June that upheld the law allowed states to opt out of the Medicaid expansion, raising fears among AIDS activists that Southern states with large numbers of HIV-infected people will choose not to expand the federal-state health program for the poor.

Carl Schmid, deputy executive director of the AIDS Institute, warned that “we risk losing the progress that’s within reach.” Federal funding for AIDS care faces funding cuts due to sequestration and the House Labor-HHS-Education fiscal 2013 appropriations bill, activists said. Julie Scofield, executive director of the National Alliance of State & Territorial AIDS Directors, said sequestration could take $500 million out of anti-AIDS programs.

Pelosi, who represents San Francisco, a city that was at the center of the beginning of the pandemic in the early 1980s, said at the conference’s closing session that even in difficult times, cutting back on AIDS funding is a “false economy” that will cost more in the future.

“HIV/AIDS is a challenge that knows no borders, and the United States must continue to invest in treatments and prevention at home while working to restore a future of hope and health to communities around the world,” said Pelosi.

The next conference will be in Melbourne, Australia, in July 2014. This year’s event, the first in the United States since 1990, was made up of 194 sessions and drew 24,000 people from 183 nations, according to the sponsor, the International AIDS Society.

Jane Norman can be reached at jnorman@cq.com.