On October 13, 2016, amfAR, the Foundation for AIDS Research, released a new report, “Curbing the HIV Epidemic by Supporting Effective Engagement in HIV Care: Recommendations for Health Plans and Health Care Purchasers,” which highlights the critical role of health plans and health care purchasers, including Medicaid and Medicare programs, marketplaces, and employers, in moving the nation toward ending the domestic HIV epidemic. The report was written by Jeffrey S. Crowley of the O’Neill Institute for National and Global Health Law, Dr. Rivet Amico of the University of Michigan, and Dr. Michael Mugavero of the University of Alabama at Birmingham.
In the United States, 1.2 million people are living with HIV, and an estimated 44,000 new infections occur annually. In recent years, the share of people with HIV who are aware of their status has risen to record levels. However, according to the Centers for Disease Control and Prevention, almost half of all people diagnosed with HIV in the U.S. are not receiving regular HIV care, and account for roughly seven in ten HIV transmissions. Moreover, while more people with HIV in the U.S. are on effective antiretroviral treatment, only 30 percent remain in care and are virally suppressed.
The report outlines a relatively small number of actionable and meaningful steps that health plans and health care purchasers can take that will improve health outcomes, reduce preventable HIV-related health spending, and contribute to the development of more tightly integrated systems of care. These steps fall within three primary domains: 1) better monitoring of engagement in HIV care; 2) intervening to support continuous and sustained engagement in care and HIV viral suppression; and 3) supporting policy changes at all levels of government to strengthen engagement in HIV care.
The report is intended to be one more tool to help the U.S. health system adopt proven measures to strengthen monitoring, engage people in care, and re-engage people after an interruption in care so that all people living with HIV are supported in maintaining viral suppression. The O’Neill Institute’s National HIV/AIDS Initiative continues to work with an array of policymakers and stakeholders, including the White House, federal agencies, state and local officials, and community members and advocates, to support effective engagement in HIV care and treatment. In addition to its collaboration on the amfAR report, the Initiative’s reports, policy briefs, and guides provide information, research, technical analysis, and recommendations so that policymakers and health officials can streamlines policies and services to better support people living with HIV and so community stakeholders have the tools they need to advocate for the health and quality of life of people living with HIV.