Public-health officials and AIDS advocates are looking forward to a renewed interest in domestic HIV/AIDS issues in the USA as a result of Barack Obama’s election to the White House. Obama pledged to develop a national HIV/AIDS strategy that would better coordinate federal efforts against the disease and enhance programmes to reduce infections, increase access to care and address health disparities.The President-elect also promised to target HIV/AIDS resources to minority communities, fund housing programmes for HIV positive individuals and expand research for HIV/AIDS prevention.

A key element of the plan is improved access to health care coverage as part of Obama’s goal of reforming the US health-care system. “His plan will ensure that people living with HIV have access to lifesaving treatment and care”, campaign documents indicate.

The US is grappling with an HIV annual incidence rate of 56 300—a number that is 40% higher than previously thought. The new figure is the result of new incidence testing methodologies developed by the Centers for Disease Control (CDC) that more accurately determine when an infection was contracted.

CDC officials say they hope the new tool can help pinpoint growth in the epidemic so resources can be marshaled more efficiently to where they are needed most. The test also is being tried in Africa under the PEPFAR programme.

Increased testing is likely to be among the key features of enhanced prevention strategies. Although routine HIV screening is recommended for Americans aged 13-64 years, compliance is uneven. A recent study showed that only about 5% of patients with serious illness are screened in hospital emergency rooms, one of the sites CDC recommends for the tests.

In Washington, DC, the US city with the highest HIV/AIDS rate, officials are working with physicians to improve testing compliance. Shannon Hader, director of the HIV/AIDS Administration for the city, calls physician reluctance the  ”core barrier” to more universal screening. “We’ve spent 25 years telling medical providers that HIV testing was something special….something they had to be very careful about and really not their job,” she said. DC is changing that message by encouraging providers to offer HIV tests as part of routine exams, something she says many patients thought already was happening. “When you’ve been going to the doctor and getting your pap smear and getting your mammogram and getting checked out for your heart disease and your doctors say ‘hey you check out well,’ it doesn’t occur to [patients] that they didn’t bother to check you for the number one cause of premature death in your city”, Hader commented.

See the World Report in this week’s print issue for more on this topic.

Nellie Bristol

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This entry was posted on Thursday, November 27th, 2008 at 1:05 pm and is filed under US Election, Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can trackback from your own site.