In the document ‘National HIV/AIDS Strategy for the US: Updated to 2020’, the Office of the National AIDS Policy (ONAP) outlines the country’s updated strategy for addressing the HIV/AIDS epidemic. It notes that the plan was first released in 2010 and that it has helped in the realization of significant achievements. They include groundbreaking work such as the HIV Prevention Trials Network study by the National Institute of Health (NIH), the introduction of pre-exposure prophylaxis (PrEP), and significant efforts by the Centers for Disease Control and Prevention (CDC) (ONAP, 2015, p. 1). Others are substantial increases in funding for the AIDS Drugs Assistance Program (ADAP) and collaboration across the Federal government. The current update has four primary goals, which are a reduction in new HIV infections, increased access to care and improved health outcomes for HIV/AIDS patients, reduction in HIV-related disparities and health inequities, and achievement of more coordination in national response to the epidemic.
The first goal, which is reducing new HIV infections, is based on the fact that the epidemic does not impact the country equally but is instead concentrated in certain populations and geographic areas. It aims at ensuring that funding is allocated to areas of most effective interventions, such as scientific research and the dissemination of accurate information about the spread, transmission, and prevention of the disease (ONAP, 2015, p. 4). The document outlines and discusses the steps necessary to realize the goal. They are the intensification of prevention efforts in communities mostly affected by the disease, the use of practical, evidence-based approaches to expand prevention efforts, and the educating people through the dissemination of scientifically accurate information about the risks, prevention, and spread of the disease (ONAP, 2015, p. 8). ONAP states that indicators of the achievement of the goal would include an increased percentage of HIV/AIDS patients who know their statuses, reduced number of new diagnosis, and a reduction in the proportion of people who engage in HIV-risk behaviors (ONAP, 2015, p. 16).
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The second goal is based on three factors, which are the importance of health care coverage to HIV/AIDS patients, the importance of improving outcomes of all the stages of the HIV care continuum, and the importance of the development of care models that treat the HIV/AIDS patients and the virus (ONAP, 2015, p. 5). ONAP identifies two steps that are crucial to the realization of the goal. They are the establishment of systems that link newly diagnosed patients to health care and support to suppress the virus and reduce the risk of transmission, increasing the capacity of the systems and the number and diversity of health care providers, and promoting comprehensive and coordinated patient-centered care for HIV/AIDS patients (ONAP, 2015, p. 9). The identified indicators of progress in the realization of the goal include an increase in the percentage of patients linked to health care one month after diagnosis, increase in the proportion of patients who are retained in HIV medical care, and an increase in the percentage of patients with a suppressed viral load (ONAP, 2015, p. 30). Others are a reduction in the percentage of homeless HIV/AIDS patients and a decrease in death rate among HIV/AIDS patients.
The third goal is also based on three principles. They are the need for the nation to reduce disparities to meet goals of the strategy, the importance of structural approaches to lessen the risk of transmission of the disease in communities and societies, and the importance of eliminating stigma and discrimination to diminish prevention, testing, and care barriers (ONAP, 2015, p. 6). ONAP identifies three steps critical to the realization of the goal. They are the reduction of HIV-related disparities in HIV high-risk communities, the adoption of structural approaches to reduce infections and improve health outcomes in such communities, and the reduction of stigma and elimination of the discrimination associated with the disease (ONAP, 2015, p. 10). The indicators identified to measure the progress of the realization of the goal include a reduction in disparities by at least fifteen percent and an increase in the percentage of virally suppressed patients who inject drugs (ONAP, 2015, p. 38).
The fourth goal is based on the potential for and importance of greater coordination in response to the epidemic (ONAP, 2015, p. 7). ONAP identifies two steps that are necessary to the realization of the goal (ONAP, 2015, p. 11). They are increased coordination of programs across the Federal Government and between the agencies of the Federal, State, territorial, Tribal, and local governments, and the development of improved mechanisms for monitoring and reporting the progress of the achievement of national HIV goals.