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National HIV/AIDS Strategy (NHAS). What’s Next?

Article / Review by on November 2, 2011 – 11:07 pmNo Comments

National HIV/AIDS Strategy (NHAS). What’s Next?

To accomplish the Strategy’s goals, we must undertake a more coordinated national response to the epidemic. This will require increasing the coordination of HIV programs across the Federal Government and between Federal agencies and state, territorial, tribal, and local governments, as well as developing improved mechanisms to monitor and report on progress toward achieving national goals. But to be effective, our national response will require that others join in these efforts to build on and refocus our existing efforts to deliver better results. Government can’t do this alone, nor should it. Success will require the participation of businesses, faith communities, philanthropy, the scientific and medical communities, educational institutions, people living with HIV, and others.

Reducing Infections

Action steps

  • Intensify HIV prevention efforts in the communities where HIV is most heavily concentrated
  • Expand targeted efforts to prevent HIV infection using a combination of effective, evidence-based approaches
  • Educate all Americans about the threat of HIV and how to prevent it

By 2015

  • By 2015, lower the annual number of new infections by 35% (from 56,300 to 42,225).
  • Reduce the HIV transimission rate, which is a measure of annual tranmissions in relation to the number of people living with HIV, by 30% (from 5 person infected per 100 people with HIV to 3.5 persons infected per 100 with HIV).
  • By 2015, increase from 79% to 90% the precentage of people living with HIV who know their serostatus (from 948,000 to 1,080,000 people).

Increasing Access

Action steps

  • Establish a seamless system to immediately link people to continous and coordinated quality care when they learn they are infected with HIV
  • Take deliberate steps to increase the number and diversity of available providers of clinical care and realted services for people living with HIV
  • Support people living with HIV with co-occuring health conditions and those who have challenges meeting their basic needs, such as housing

By 2015

  • Increase the proportion of newly diagnosed patients linked to clinical care within three months of their HIV diagnosis from 65% to 85% (from 26,824 to 35,078 people).
  • Increase the proportion of Ryan White HIV/AIDS Program clients who are in continous care (at least 2 visits for routine HIV medical care in 12 months at least 3 months apart) from 73% to 80% (or 237,924 people in continous care to 260,739 people in continous care).
  • Increase the number of Ryan White clients with permanent housing from 82% to 86% (from 434,000 to 455,800 people). (This serves as a measurable proxy of our efforts to expand access to HUD and other housing supports to all people living with HIV.

Reducing HIV-Related Disparities

Action steps

  • Reduce HIV-related mortality in communites at high risk for HIV infection
  • Adopt community-level approaches to reduce HIV infection in high-risk communities
  • Reduce stigma and discrimination against people living with HIV

By 2015

  • Improve access to prevention and care services for all Americans.
  • Increase the proportion of HIV diagnosed gay and bisexual men with undectable viral load by 20%.
  • Increase the proportion of HIV diagnosed Blacks with undetectable viral load by 20%.
  • Increase the proportion of HIV diagnosed Lations with undectectable viral load by 20%.
National HIV/AIDS Strategy

Federal Implementation Plan


Implementing the National HIV/AIDS Strategy
July 7, 2011
AIDS.gov spoke with community and Federal partners about how they were implementing the National HIV/AIDS Strategy and how they were encouraging others to do so as well.

This document is a companion to the National HIV/AIDS Strategy for the United States and presents the Administration’s views on the measures it will use to assess progress toward meeting the Strategy’s goals, and includes immediate, short-term, and longer-term Federal actions that are intended to move the National toward meeting the President’s goals.

The job of implementing the National HIV/AIDS Strategy, however, does not fall to the Federal Government alone, nor should it. It will be the collective responsibility of all members of society. In fact, we hope that the Strategy is a catalyst for States and local government developing their own implementation plans for achieving the goals in the National HIV/AIDS Strategy, and for working with other partners to better coordinate responses to HIV/AIDS at the state and local levels.

Reducing New HIV Infections

  1. Step 1: Intensify HIV prevention efforts in communities where HIV is most heavily concentrated.
  2. Step 2: Expand targeted efforts to prevent HIV infection using a combination of effective, evidence-based approaches.
  3. Step 3: Educate all Americans about the threat of HIV and how to prevent it.

Increasing Access to Care and Improving Health Outcomes for People Living with HIV

  1. Step 1: Create a seamless system to immediately link people to continuous and coordinated quality care when they are infected with HIV.
  2. Step 2: Take deliberate steps to increase the number and diversity of available providers of clinical care and related services for people living with HIV.
  3. Step 3: Support people living with HIV with co-occurring health conditions and those who have challenges meeting their basic needs, such as housing.

Reducing HIV-Related Health Disparities

  1. Step 1: Reduce HIV-related mortality in communities at high risk for HIV infection.
  2. Step 2: Adopt community-level approaches to reduce HIV infection in high risk communities.
  3. Step 3: Reduce stigma and discrimination against people living with HIV.

Achieving a More Coordinated National Response to the HIV Epidemic in the United States

  1. Step 1: Increase the coordination of HIV programs across the Federal Government and between federal agencies and state, territorial, local, and tribal governments.
  2. Step 2: Develop improved mechanisms to monitor, evaluate, and report on progress toward achieving national goals.

President’s Memorandum to Federal Agencies

Read the President’s memo to the heads of Federal agencies regarding implementation of the Strategy.

  • Section 1. Role of the White House Office of National AIDS Policy (ONAP)
  • Section 2. Lead Responsible Agencies
  • Section 3. Role of the Secretary of Health and Human Services
  • Section 4. Responsibilities of Other Agencies
  • Section 5. General Provisions
  • Section 6. Publication
National HIV/AIDS Strategy

President’s Memorandum to Federal Agencies

On July 13, 2010, President Barack Obama issued this memorandum to the heads of Federal agencies and departments regarding the implementation of the National HIV/AIDS Strategy.

As we approach thirty years from the onset of the HIV/AIDS epidemic in the United States, new actions are needed to prevent HIV infection and better serve people living with HIV. The actions we take now will build upon a legacy of global leadership, national commitment, and sustained efforts on the part of Americans from all parts of the country and all walks of life to end the HIV epidemic in the United States and around the world. I am committed to renewing national leadership to fight HIV/AIDS here at home, as we continue our efforts to fight HIV/AIDS around the world. My Administration has engaged in an extensive process to engage Americans and listen to their ideas for improving our national response to HIV/AIDS.

Today, I am releasing a National HIV/AIDS Strategy for the United States (Strategy) and a National HIV/AIDS Strategy Federal Implementation Plan (Federal Implementation Plan), which identifies specific actions to be taken by Federal agencies to implement the Strategy’s goals.  While agencies already undertake many actions to address HIV/AIDS, successful implementation of the Strategy will require new levels of coordination, collaboration, and accountability. This will require the Federal Government to work in new ways across agency lines, as well as in enhanced and innovative partnerships with State, tribal, and local governments. Government cooperation at all levels, moreover, is not enough. Success will require the commitment of all parts of society, including businesses, faith communities, philanthropic organizations, scientific and medical communities, educational institutions, people living with HIV, and others. It is also necessary to sustain public commitment to ending the epidemic, and this calls for regular communications between governments at all levels to identify the challenges we face and report the progress we are making.

To these ends, I hereby direct the following:

Section 1. Role of the White House Office of National AIDS Policy (ONAP)

(a) The Director of ONAP, in consultation with the Office of Management and Budget (OMB), shall be responsible for setting the Administration’s domestic HIV/AIDS priorities and monitoring the implementation of the Strategy. The Director of ONAP shall convene regular meetings with representatives of executive departments and agencies (agencies) to coordinate HIV/AIDS-related policies, programs, and activities.

(b) The Director of ONAP shall annually report to the President on the implementation of the Strategy, including progress in meeting key targets and taking key actions identified in the Strategy and the Federal Implementation Plan.

Section 2. Lead Responsible Agencies

While the Strategy requires a government-wide effort in order to succeed fully, certain agencies have primary responsibilities and competencies in implementing the Strategy.

(a) Designation of Lead Agencies

Lead agencies for implementing the Strategy shall be:

  1. the Department of Health and Human Services;
  2. the Department of Justice;
  3. the Department of Labor;
  4. the Department of Housing and Urban Development;
  5. the Department of Veterans Affairs; and
  6. the Social Security Administration.

(b) Lead Agency Implementation Plans

Within 150 days of the date of this memorandum, the head of each lead agency shall submit a report to ONAP and OMB on the agency’s operational plans for implementing the Strategy. The plans shall assign responsibilities to agency officials, and designate reporting structures for actions identified in the Federal Implementation Plan and identify other appropriate actions to advance the Strategy. The plans shall also include steps to strengthen coordination in planning, budgeting for, and evaluating domestic HIV/AIDS programs within and across agencies. Lead agencies are encouraged to consider, and reflect in their plans, steps to streamline grantee reporting requirements and funding announcements related to HIV/AIDS programs and activities.

(c) Ongoing Responsibilities of Lead Agencies

The head of each lead agency shall:

  1. designate an official responsible for coordinating the agency’s ongoing efforts to implement the Strategy;
  2. develop a process for sharing progress reports, including status updates on achieving specific quantitative targets established by the Strategy, with relevant agencies submitting agency reports to ONAP on an annual basis, or at such other times as ONAP requests; and
  3. in consultation with the OMB, use the budget development process to prioritize programs and activities most critical to meeting the goals of the Strategy.

Section 3. Role of the Secretary of Health and Human Services

The Secretary of Health and Human Services (Secretary) shall designate a lead official for improving coordination of domestic HIV/AIDS programs and activities across the Federal Government.

(a) Coordination within the Department of Health and Human Services

The Secretary, or the Secretary’s designee, shall develop and implement specific plans and procedures for improving intra-departmental coordination and collaboration on HIV/AIDS care, research, and prevention services.

(b) Coordination with Other Agencies

The Secretary, or the Secretary’s designee, shall be responsible for convening interagency efforts to improve coordination of HIV/AIDS programs and activities. This may include collaboration with governmental and nongovernmental entities to achieve the Federal Government’s implementation and research priorities in the areas of highest impact.

(c) Presidential Advisory Council on HIV/AIDS (PACHA)

PACHA, which was established by Executive Order 12693 of June 14, 1995 (Presidential Advisory Council on HIV/AIDS), as amended, shall monitor the implementation of the Strategy and make recommendations to the Secretary and to the Director of the ONAP, as appropriate, concerning implementation.

Section 4. Responsibilities of Other Agencies

All agencies that support HIV/AIDS programs and activities shall ensure that, to the extent permitted by law, they are meeting the goals of the Strategy.

(a) Department of Defense

Within 150 days of the date of this memorandum, the Secretary of Defense shall submit to ONAP and OMB a plan for aligning the health care services provided by the Department of Defense with the Strategy, to the extent feasible and permitted by law. The plan shall address, in particular, HIV/AIDS prevention, care, and treatment.

(b) Department of State

Within 150 days of the date of this memorandum, the Secretary of State shall submit to ONAP and OMB recommendations for improving the government-wide response to the domestic HIV/AIDS epidemic, based on lessons learned in implementing the President’s Emergency Plan for AIDS Relief (PEPFAR) program.

(c) Equal Employment Opportunity Commission (Commission)

Within 150 days of the date of this memorandum, the Chair of the Commission shall submit to ONAP and OMB recommendations for increasing employment opportunities for people living with HIV and a plan for addressing employment-related discrimination against people living with HIV, consistent with the Commission’s authorities and other applicable law.

Section 5. General Provisions

(a) The heads of executive departments and agencies shall assist and provide information to the Director of ONAP, consistent with applicable law, as may be necessary to implement the Strategy. Each agency shall bear its own expense for carrying out activities to implement the Strategy.

(b) Nothing in this memorandum shall be construed to impair or otherwise affect:

  1. authority granted by law to an agency or the head thereof, or to other Executive Branch officials; or
  2. functions of the Director of the OMB relating to budgetary, administrative, or legislative proposals.

(c) This memorandum shall be implemented consistent with applicable law and subject to the availability of appropriations.

(d) This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

Section 6. Publication

The Secretary is authorized and directed to publish this memorandum in the Federal Register.

National HIV/AIDS Strategy


Agency Operational Plans

……………

Overview of Agency Operational Plans

Overview of Agency Operational Plans

……………

Department of Health and Human Services

Department of Health and Human Services Operational Plan

……………

Department of Housing and Urban Development

Department of Housing and Urban Development Operational Plan

……………

Department of Justice

Department of Justice Operational Plan

……………

Department of Labor

Department of Labor Operational Plan

……………
……………

Social Security Administration

Social Security Administration Operational Plan

……………

Accompanying Documents

The lead federal agencies for implementing the Strategy—Health and Human Services, Housing and Urban Development, Department of Justice, Labor, Veterans Affairs, and the Social Security Administration submitted to the Office of National AIDS Policy (ONAP) and the Office of Management and Budget (OMB) detailed operational plans for implementing the Strategy within their agencies.

These operational plans complement the Federal Implementation Plan that was released with the Strategy. The Federal Implementation Plan details action steps that specific agencies would meet the goals of the Strategy in 2010 and 2011.

Each agency’s operational plan addresses not only its approach to implementing the actions assigned in the Federal Implementation Plan but also details additional intra- and inter-agency activities and initiatives.

The White House provided an overview of the agency operational plans: Implementing The National HIV/AIDS Strategy: Overview of Agency Operational Plans (PDF, 1.2 Mb).

ONAP and OMB also received from the Secretary of Defense a plan for aligning the health care services provided by the Department of Defense with the Strategy; and the Secretary of State submitted recommendations based on lessons learned in implementing the President’s Emergency Plan for AIDS Relief (PEPFAR); and the Chair of the Equal Employment Opportunity Commission (EEOC) submitted recommendations for increasing employment opportunities for people living with HIV and a plan for addressing employment-related discrimination against people living with HIV.

National HIV/AIDS Strategy

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