Christopher Bates

During this February’s observance of Black History Month, we have observed National Black HIV/AIDS Awareness Day (NBHAAD) and heard about efforts to eliminate viral hepatitis disparities among the African American community.  We must also take note of the importance that the National HIV/AIDS Strategy places on addressing HIV/AIDS and its disproportionate impact on African American communities in the United States.

The Strategy recognizes that Blacks comprise the greatest proportion of HIV/AIDS in various groups across the U.S., including women, heterosexual men, injection drug users, and infants. It also notes the extent to which the HIV epidemic among African Americans remains concentrated among Black gay men, who comprise the single largest group of African Americans living with HIV. As such, the NHAS affirms that efforts to reduce HIV among Blacks must forcefully confront the epidemic among Black gay and bisexual men..

The Strategy calls for efforts to respond to HIV/AIDS in the African American community in order to achieve its goals. For example, to achieve the first goal of reducing new HIV infections we are asked to refocus our HIV prevention efforts, targeting resources appropriately to communities that bear a heavy burden of HIV, including African Americans.  In a podcast this month, our colleague Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, spoke about CDC’s efforts to do just this.

The Strategy also established as a measure of progress toward its third goal –reducing HIV-related health disparities — increasing by 2015 the proportion of HIV diagnosed Blacks with undetectable viral load by 20 percent.

All Americans will benefit the implementation of the actions detailed in the Strategy—from intensifying targeted prevention efforts, to establishing seamless systems to immediately link people to continuous and coordinated quality care when they learn they are infected with HIV, as well as efforts to reduce stigma and discrimination against people living with HIV. This month’s observance of NBHAAD is a reminder of the importance of persevering in these efforts.

James Albino

On Monday, President Obama sent his Fiscal Year 2013 budget proposal to Congress.  The budget proposal clearly demonstrates his determination to help the Nation achieve the goals of the National HIV/AIDS Strategy (NHAS) and renews the President’s commitment to ending the AIDS pandemic. To address HIV/AIDS in the U.S., the 2013 Budget:

• Supports HIV/AIDS research.
• Expands investments in prevention and care.
• Funds cross-cutting innovative efforts for care and prevention.
• Expands the Ryan White HIV/AIDS Program.
• Increases funding for HIV/AIDS prevention and service integration.
• Modernizes the Housing Opportunities for Persons with AIDS (HOPWA) Program.
• Fights the stigma of HIV/AIDS.

Read more about the Fiscal Year 2013 budget’s HIV/AIDS elements in this fact sheet from the White House: Fighting the HIV/AIDS Epidemic and Supporting People Living with HIV/AIDS.

The President’s budget proposal advances our domestic HIV/AIDS agenda, strengthens programs, and supports our continuing efforts to achieve the National HIV/AIDS Strategy goals of reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities—bringing us closer to the goal of an AIDS-free generation.

The term podcast is used to describe a series of online audio or video files that audiences can subscribe to and download regularly. As part of our effort to promote the use of new media and emerging technologies to extend the reach of HIV messaging, we have been producing audio podcasts since 2006. In 2008, we began adapting and recording our new media blog posts for syndication, and added posts on the National HIV/AIDS Strategy to our audio recordings in 2010.  Since then, we have produced over 200 audio podcasts, many of which you can find on our blog beneath the title of its corresponding post.

AIDS.gov has been rethinking how we schedule and market our posts for 2012. It’s given us a chance to revisit our process and identify what has worked and the challenges we experienced. So what have we learned from our years of audio podcasting?

Promote. Audio podcasts are ideal for busy people with busy lives. They can be listened to during a commute, while multitasking, or on-the-go. For 2012, AIDS.gov is developing a new landing page for our audio podcasts, updating our iTunes feed, and planning bi-weekly promotion of the podcasts to let our busy audiences know when the week’s audio is up and where to find them.  Letting your audience know where to look and how to subscribe quickly, easily, and regularly is key to extending the range of your message.

Schedule content regularly. We launched our blog over four years ago with a new media post every Tuesday (and haven’t missed a Tuesday since).  When you begin to build an audience, your audience expects updated content, stories, and information regularly. For AIDS.gov, 2012 will be the year of the Thursday audio podcast. A workplan that will help adhere to that schedule and maintain that continuity will help add to our current regular listeners.

Be timely, but take your time. When we started recording adaptations of our new media posts, our initial goal was to have the audio up the same day as its corresponding post.  What we learned was that it’s okay to allow time for the things that matter, (i.e. quality assurance for the post, time for the web team to upload the audio to iTunes and the podcast gallery, thinking through promotion for each post, gathering audio from guest posters, etc.). Allowing two days between a post and an accompanying audio podcast will keep the information timely, while not rushing the process.

Listen to the people.  Before you start podcasting, or using any new media tool for that matter, check in with your audience and continue to listen along the way. Podcasting takes time– make sure this is the tool your users want, need, and use.

In the weeks to come, we’ll be highlighting our new podcast releases for both new media and the National HIV/AIDS Strategy. We’re also looking into creating more topic-specific podcast series featuring interviews and more in-depth information. So stay tuned!

Do you listen to any podcasts regularly?  What sort of topics would you find interesting for our upcoming series?  Leave your thoughts in the comment section below.

Today, the Obama Administration issued the President’s budget request for fiscal year (FY) 2013. It demonstrates that the United States remains fully committed to the fight against global AIDS, and will meet the President’s ambitious targets for HIV/AIDS treatment and prevention announced on World AIDS Day 2011. I am so proud that, even in a challenging budget environment with strict budget caps, the Administration has continued to make this work a priority.

This budget will enable PEPFAR to achieve the President’s stated goals for the program, including on prevention and supporting 6 million people on treatment by the end of 2013. As we move towards creating an AIDS-free generation, President Obama and Secretary Clinton are focused on improving and saving lives — these outcomes are the most important metric of success. The results to date speak for themselves:

• We have more than doubled the number of individuals on lifesaving antiretroviral treatment (nearly 4 million in FY 2011, up from 1.7 million in FY 2008).
• We averted 200,000 infant HIV infections in FY 2011, through increased commitment to prevent mother-to-child transmission.
• We supported care services for almost 13 million people (including 4 million orphans and vulnerable children) in FY 2011, a 55 percent increase from FY 2008.

Under this Administration, PEPFAR has matured. We’ve become more efficient, increasing the impact of our work. The FY 2013 request reflects this focus on finding efficiencies and continuing to drive down costs. By using generic drugs, shipping commodities more cheaply, task-shifting to nurses and community health workers as appropriate, and linking AIDS services to other programs (such as maternal and child health), we have dramatically decreased the per-patient cost of providing treatment and other services. We have reduced PEPFAR treatment costs per person from $1,100 to $335 per person and costs continue to fall — every dollar we invest is going farther.

The growth in country ownership of programs is another critical piece of the story. Middle income countries with PEPFAR programs have begun to increase their investments in health programs, further reducing our direct costs. South Africa is the leading example of a country that has ramped up its investment (now over $1 billion) and indicates that it will continue to do so — a key development, as it has the largest number of people living with HIV in the world.

As the PEPFAR program matures, we are able to maximize our impact based on new prevalence data and assessments of absorptive capacity. We focus resources on countries where we can have the largest impact on the HIV epidemics, and we carefully review our levels of support in countries with low HIV prevalence or where significant other resources are available. For example, we are freeing up resources by reducing programs in lower HIV prevalence countries like Ethiopia, and are eliminating support to countries like Russia (which has stated its intention to become a donor country). Kenya is an example of a mature program focused on sustainable country systems for program implementation and building up the capacity of local implementers. As a result, we are able to adjust Kenya funding to better match its capacity to absorb funds through these new mechanisms.

The President’s budget for FY 2013 requests $1.65 billion for a contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria , fulfilling his pledge to seek $4 billion over three years for the Fund. As the President has stated, the response to the global AIDS pandemic is a shared responsibility. The Global Fund is the vehicle for others to step up and increase their investments. In fact, each dollar we invest in the Fund leverages $2.50 from other donors, and we will continue to seek to leverage our donations with other partners.

In October 2010, the U.S. tied our historic multi-year pledge to the Global Fund to successful implementation of reforms that increase the impact of grants. The Fund took decisive action in adopting comprehensive reforms last year, and we are encouraged by the appointment of the Fund’s new General Manager, Gabriel Jaramillo, who has promised to advance the reform agenda as rapidly as possible. As a sign of support, the Gates Foundation has recently announced a $750 million commitment to the Fund, and Saudi Arabia has stepped up and contributed to the Fund for the first time.

I want to address any concern that our increased investment in the Global Fund may interfere with PEPFAR’s ability to reach its bilateral goals. I can say with conviction that if this was the case, we would not be doing it. Our Global Fund investment is critical to the ability of our bilateral PEPFAR program to reach its goals. These two U.S.-supported efforts on global AIDS are now truly interdependent and collaborative. We are jointly funding many country programs and specific service sites, and as we review our country PEPFAR programs, again and again we see that the success of Global Fund grants is a critical factor in the success of our work.

Saving lives is the bottom line, and to reach it, we need a strong PEPFAR and a strong Global Fund.

In their remarks in late 2011, President Obama and Secretary Clinton put forward the inspiring vision of an AIDS-free generation. With this budget, the United States will keep our commitments, and we will meet our ambitious targets.

Dr. J. Nadine Gracia

During February’s observance of African American History Month, please join us in working to end the unfortunate history of viral hepatitis’ disproportionate impact on the African American community.  This Administration is working hard to reduce and eliminate health disparities and achieve health equity.

Unfortunately, viral hepatitis is a health problem that is often overlooked by the public as well as healthcare providers. This, despite the fact that viral hepatitis is a leading infectious cause of death, claiming the lives of 12,000–15,000 Americans each year. As many as 5.3 million Americans are living with viral hepatitis, though most do not know that they are infected. This places them at greater risk for severe, even fatal, complications from the disease and increases the likelihood that they will spread the virus to others.

What Is Hepatitis?
“Hepatitis” means inflammation of the liver. It is most often caused by a virus.  In the U.S., the most common types are hepatitis A, hepatitis B, and hepatitis C.  All of these viruses cause acute, or short-term, viral hepatitis. But the hepatitis B and C viruses (HBV and HCV) can also cause chronic hepatitis, in which the infection is prolonged, sometimes lifelong. Chronic hepatitis can lead to cirrhosis, liver failure, and liver cancer.  In fact, viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.

Viral Hepatitis Disparities
Within the African American community, significant hepatitis-related health disparities exist. For example:

Hepatitis B

• Hepatitis B can be prevented by a vaccine; however, African American children have lower HBV vaccination rates than non-Hispanic white children.
• Since 2004, rates of hepatitis B have remained steady among all racial/ethnic populations. However, new infections of hepatitis B remain the highest among African Americans, with 2.3 cases per 100,000 people.

Hepatitis C

• African Americans are twice as likely to be infected with hepatitis C when compared with the general U.S. population and chronic liver disease, often hepatitis C-related, is a leading cause of death among African Americans ages 45-64.
• While African Americans represent only 12% of the U.S. population, they make up about 22% of the chronic hepatitis C cases. In fact, African Americans have a substantially higher rate of chronic hepatitis C infection than do Caucasians and other ethnic groups.

Viral Hepatitis Action Plan
My Federal colleagues and I are committed to ensuring that new cases of viral hepatitis are prevented and that persons who are already infected are tested; informed about their infection; and provided with counseling, care, and treatment. In fact, last year we issued Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care & Treatment of Viral Hepatitis (PDF 672KB), which outlined robust and dynamic steps that are now underway across the government to increase viral hepatitis awareness and knowledge among health care providers and communities, and improve access to quality prevention, care, and treatment services for viral hepatitis. (Read more about the Action Plan.)

In addition, the Viral Hepatitis Action Plan is both supported by and complements several other initiatives unfolding within HHS and across the Federal government, including the:

• The National HIV/AIDS Strategy, which helps us address the significant rates of HIV-HCV coinfection;
• The National Prevention Strategy, which calls for us to enhance early detection of HIV, viral hepatitis, and other sexually transmitted infections and improve linkage to care;
• The U.S. National Vaccine Plan, which will help us reduce the incidence of vaccine-preventable hepatitis A and B;
• The HHS Action Plan to Reduce Racial and Ethnic Health Disparities; and
• The infectious disease and immunization objectives of Healthy People 2020, which specifically seek to reduce new hepatitis A, B, and C infections and increase viral hepatitis awareness among infected persons.

Your Help Is Essential
These are all part of our response to the silent epidemic of viral hepatitis. But we need your help, too. So, during African American History Month, please help by learning more about viral hepatitis, educating family and friends about this silent killer in the African American community, and encouraging conversations with healthcare providers about vaccinations for hepatitis A and B and screening for hepatitis C for those who may have been exposed.

Together, we can make viral hepatitis history.

We want to draw your attention to an important deadline for the upcoming International AIDS Conference (AIDS 2012). The deadline for submitting abstracts for the conference is Wednesday, February 15. We encourage authors to visit the conference website to review submission guidelines .

For U.S. authors, please note: the strict midnight deadline applies to Central European Time (CET), or 6:00 PM (ET). After that time, the online submission system will close and no further submissions will be accepted by the conference secretariat.

All submissions must be made online through an individual’s conference profile. If you have never attended the International AIDS Conference before, you will need to create a profile . If you have been a delegate to a previous conference, you can sign into your existing profile.

Wednesday, February 15, is also the deadline for submissions related to other activities at the conference. For more information, visit www.aids2012.org .

Miguel Gomez is the Director of AIDS.gov and Senior Communications Advisor to the  Office of HIV/AIDS Policy, U.S. Department of Health and Human Services. Kelley Lennon is the AIDS 2012 Program Liaison at the Office of the Global AIDS Coordinator, U.S. Department of State.

The HHS Office of Global Affairs will host an educational forum for Federal staff with Dr. Elly Katabira, President of the International AIDS Society  (IAS) and International Chair of the XIX International AIDS Conference  (AIDS 2012), on Friday, February 10, from 1:00–2:00 p.m. Dr. Katabira will discuss the historic nature of AIDS 2012 during the forum, “AIDS 2012 and Beyond.”

The biennial conference, which is convened by the IAS in partnership with international and local (U.S.) organizations, including the U.S. government, will take place in Washington, DC, from July 22-27, 2012. The forum will be live-streamed to the public at: http://videocast.nih.gov/live.asp?live=10999.

To stay up-to-date on U.S. Government conference activities, please visit the USG @ AIDS 2012 webpage.

Christopher Bates

The Presidential Advisory Council on HIV/AIDS (PACHA) will convene February 28 and 29 in Washington, DC. Among the many items on the agenda for the 45th meeting of the PACHA, two are of particular note:

• A conversation with Secretary of Health and Human Services Kathleen Sebelius on a variety of issues, including the implementation of the National HIV/AIDS Strategy across HHS.
• PACHA will devote much of the first day of this meeting to an examination of the state of HIV/AIDS among women and girls in the U.S. and the nation’s response. A number of speakers have been invited to address PACHA on issues including HIV/AIDS research, prevention, and access to care and treatment.

Other items on the agenda for the two-day meeting include HOPWA modernization, implications of health care reform on mental health and substance abuse services for people at risk for or living with HIV, and follow-up to discussions at the prior PACHA meeting on HIV and youth.

The meeting will be held at the White House and will be the first to be led by the newly appointed chairperson, Nancy Mahon. Ms. Mahon is Senior Vice President of M·A·C Cosmetics and Executive Director of the M·A·C AIDS Fund .

For more information, follow PACHA’s activities via its website.

Last month, we attended the 9th Annual National African American MSM Leadership Conference on HIV/AIDS and other Health Disparities (AAMSM) in New Orleans, LA,  to encourage the use of new media in HIV/AIDS programs. Over 350 federal, state, and local health officials, community based organizations (CBOs), HIV/AIDS service providers, and community leaders gathered to share and learn from their peers’ experiences in facing the HIV/AIDS epidemic in the African American MSM (men who have sex with men) community.

We spoke with Kalyani Sanchez, On-site Supervisor at the David Geffen Testing Center at Gay Men’s Health Crisis (GMHC ) of New York City about a social networking outreach program it has piloted called the Leaders in Networking and Knowledge (L.I.N.K.) Project. The program uses social applications such as Facebook, instant messaging, Facetime, Skype, and more to promote and encourage HIV testing. The L.I.N.K. project also provides clients with the resources they need to extend the reach of HIV information to their social networks.

“It’s community taking care of community, getting individuals to get their friends, family, sexual partners, drug-using partners tested, and identifying those individuals that are newly diagnosed and linking them to care,” said Sanchez.

Not only is the project using social networks to deliver the message of getting tested, but it is  using mobile testing sites to remove some of the barriers to HIV testing. “We know that there’s a stigma surrounding testing centers,” said Sanchez, “so what we do is bring testing to them in places like parties or even video game challenges…It’s just making testing part of the norm.”

During the pilot of the program, they tested over 900 young MSM — many of whom did not know their status beforehand. To learn more about the L.I.N.K. project view our interview with Mr. Sanchez below.