National HIV/AIDS Policy Priorities

National HIV/AIDS Policy Priorities

National HIV/AIDS Policy Areas

Currently, the Housing Works national advocacy strategy is focused in the following HIV/AIDS policy areas:

  • Health Care Reform
  • Ryan White HIV/AIDS Program
  • Federal Budget Advocacy
  • HIV Criminalization
  • Hepatitis C
  • Syringe Access

Health Care Reform

The Affordable Care Act (ACA) was signed into law in March 2010. Several provisions have already been implemented, however a number of provisions will be implemented in 2014 as Marketplaces go live and new insurance policies take effect. Provisions disallowing lifetime spending limits and denial of coverage due to preexisting conditions have already proven beneficial to people living with HIV/AIDS (PLWHA). We are monitoring ongoing implementation to ensure protections and identify opportunities for PLWHA, and support advocacy efforts for one of the most critical elements of the ACA—Medicaid expansion in all 50 states.

Ryan White HIV/AIDS Program

The Ryan White Program provides funding for HIV medication, medical care, and support services for those who are unable to access these services for lack of adequate insurance coverage or financial support. Although originally intended as an emergency program to fill gaps in service coverage, the Ryan White Program has proven essential to comprehensive and accessible HIV care nationwide. If implemented successfully, the ACA will eclipse the Ryan White Program in HIV treatment coverage. That does not mean, however, that the Ryan White Program has been made obsolete—to the contrary. We continue to be strong advocates for the continuation of the Ryan White Program, structured as needed to operate seamlessly with the ACA. As about half of states continue to refuse Medicaid expansion, the Ryan White Program remains crucial to quality care for PLWHA.

Federal Budget Advocacy

National staff is focused on working to ensure that Non Defense Discretionary (NDD) funding affecting PLWHA is maintained at the highest levels during the annual appropriations process, in partnership with the AIDS Budget Advocacy Coalition (ABAC)—a work group of the Federal AIDS Policy Partnership. Programs that are federally funded through NDD appropriations include the Ryan White HIV/AIDS Program; CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention; the Substance Abuse and Mental Health Services Administration; Housing Opportunities for Persons with AIDS; and National Institutes of Health research initiatives.

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HIV Criminalization

“HIV Criminalization” statutes exist in over 30 U.S. states, enacted in a climate of panic and fear before we fully understood the science behind HIV transmission. These HIV-specific laws create penalties for exposure to or transmission of HIV, or simply for status nondisclosure. Some laws stand alone; others create sentencing enhancements for other crimes. We support advocacy to put an end to such discriminatory and highly punitive laws, based on outdated science, which only serve to discourage community prevention efforts and foster mistrust between local health departments and community.

Hepatitis C

Routes of transmission for hepatitis C are similar to those for HIV, and approximately 25 percent of people living with HIV are also co-infected with hepatitis C. Because each of these viruses exacerbates the effects of the other, affordable, accessible, and effective treatment for both HIV and hepatitis C is critical. Currently, hepatitis C screening has no dedicated funding stream. National staff advocates for increased funding for viral hepatitis prevention and care initiatives, and an appropriately robust and fully implemented Viral Hepatitis Action Plan (initiated by HHS in 2011).

Syringe Access

Despite the continued prevalence of HIV and hepatitis C, Congress prohibits states from using their existing federal funds for one of the most effective and cost-saving prevention tools available—Syringe Services Programs (SSPs). SSPs nationwide do far more than provide sterile syringes to people who inject drugs; they are a nonjudgmental source for HIV and hepatitis C testing, linkage to medical care, safe disposal of used syringes, and referrals to drug treatment. Although this ban was lifted in 2009 for two beneficial years, Congress senselessly reinstated it in 2011 despite overwhelming benefit. We continue to work in coalition to once again lift the federal funding ban on syringe exchange, urging Congress to base policy on science rather than ideology.

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