Early-May, 2018

 

In Brief is NEAETC's news service covering the latest developments and educational resources about HIV, hepatitis, health disparities, and related topics. To subscribe, please click HERE.

 

More News from the 25th Conference on Retroviruses and Opportunistic Infections (CROI)

 

Global HIV Spending Peaked at About $50 Billion in 2013, According to Health Financing Network

Between 2000 and 2015, global HIV spending totaled approximately $563 billion, according to a recent report in the journal Lancet from the Global Burden of Disease Health Financing Collaborator Network.  Annual funding tripled from about $16.3 billion in 2000 to a peak of about $49.7 billion in 2013, and then decreased to about $48.9 billion by 2015.  During 2015 – the latest year covered by the study – approximately 19% ($9.3 billion) of total HIV funding was spent on prevention, and 56% ($27.3 billion) was dedicated to HIV care and treatment. 

“Despite the considerable domestic response to HIV/AIDS, many low-income and middle-income countries remain dependent on development assistance for health to fund HIV/AIDS programmes,” according to the report. “Development assistance for health made up most of the total spending on HIV/AIDS in high prevalence (1–5%) countries in 2015. In extremely high prevalence (>5%) countries, development assistance for health comprises half of HIV/AIDS spending. Low-income countries make up half of high-prevalence countries and a third of extremely high-prevalence countries.” 

The report authors conclude that, “High-prevalence countries reliant on development assistance for health must plan strategically so that decreases in external financing do not alter trajectories towards ending the transmission of HIV and sustaining HIV-positive populations with antiretroviral therapy . . . Potential ways to offset declines in external HIV/AIDS funding include reallocating more government resources to the health sector, reallocating more government health resources to HIV/AIDS, or reallocating government HIV/AIDS resources to focus on the most effective approaches to HIV/AIDS prevention or treatment.”

The Center for Strategic and International Studies and the Kaiser Family Foundation recently hosted a forum, “Global HIV/AIDS Financing Amidst Uncertainty,” in which experts discussed key findings of the funding report and their implications for global efforts to end the HIV pandemic.  An audio recording of the forum is available here.

 

IAS Annual Letter Outlines Policy Questions and Commitments for 2018

In its recent 2018 annual letter, AIDS Is (Still) Political, the International AIDS Society (IAS) notes that, despite recent global scientific advances and increased sharing of best practices to prevent, diagnose, and treat HIV infection, progress toward ending the HIV pandemic varies widely across the globe.  While the number of new HIV infections was cut nearly in half worldwide, in parts of Eastern Europe, new infections have risen 60% since 2010. IAS contends that politics – and, in particular, harmful political choices – explain why progress in some nations and regions has faltered. The IAS letter addresses four “uncomfortable questions” about the epidemic: 1) Who are we ending AIDS for? 2) Why is prevention falling behind? 3) How should donor nations support the response to HIV in low- and middle-income countries outside of Southern and Eastern Africa? and 4) How ready are we, as the HIV community, to embrace other approaches to managing the epidemic?

The IAS letter then goes on to present the following organizational commitments to its members for 2018:

  • to link HIV with the broader global health agenda; 
  • to Push science to drive policy;
  • to Unite interdisciplinary scientists, community advocates. and frontline healthcare workers at AIDS 2018;
  • to Invest in prevention prioritization; 
  • to make groundbreaking HIV research available; and  
  • to make the money work for people-centered healthcare.

 

Viral Hepatitis

 

Latest CDC Surveillance Data Show 22% Increase in Reported Acute Hep C Cases

Reported cases of acute hepatitis C virus (HCV) infection increased about 3.5-fold from 2010 through 2016 (from 850 to 2,967 cases), according to recently published viral hepatitis surveillance data from the U.S. Centers for Disease Control and Prevention (CDC).  Reported HCV cases rose each year throughout this period, with about a 22% increase between 2015 and 2016 alone. “The increase in acute HCV case reports reflects new infections associated with rising rates of injection-drug use, and, to a lesser extent, improved case detection,” the CDC report notes. “Several early investigations of newly acquired HCV infections reveal that most occur among young, White persons who inject drugs and live in non-urban areas (particularly in states within the Appalachian, Midwestern, and New England regions of the country); trends in these states likely indicate an overall increase in HCV incidence throughout the country.” The report also notes that the great majority of acute HCV infections are not reported, since few HCV-infected adults and adolescents have symptoms, and only a minority of them are subsequently diagnosed and reported to health authorities.  CDC estimates that, after adjusting for under-ascertainment and under-reporting, approximately 41,200 new HCV infections occurred in 2016.

Chronic hepatitis infection continues to affect millions of Americans, of which about 3.5 million are infected with HCV.  In 2016, a total of 14,847 reports of chronic hepatitis B virus (HBV) infection and 148,932 reports of chronic HCV infection were submitted to CDC through the National Notifiable Diseases Surveillance System. CDC’s mortality data from 2016 indicate that certain socio-demographic groups are disproportionately dying with these infections, specifically 1) persons over 55 years old for hepatitis A (HAV); 2) persons over 55 and Asians/Pacific Islanders for HBV; and 3) persons between 55 and 64 years old and American Indians/Alaska Native for HCV.  In 2016, viral hepatitis mortality rates were highest among persons infected with HCV (4.45 deaths per 100,000 population), followed by HBV (0.45 deaths per 100,000 population) and HAV (0.02 deaths per 100,000 population).

“CDC and state health departments rely on surveillance data to track the incidence of acute infection, guide development and evaluation of programs and policies to prevent infection and minimize the public health impact of viral hepatitis, and monitor progress towards achieving goals established for these programs and policies,” according to the hepatitis surveillance report. “Effective systems for conducting surveillance for chronic HBV and HCV infections are critical to ensure accurate reporting of all cases and to support prevention programs that interrupt transmission of viral hepatitis and improve the health of those who are currently infected.”

 

Health Communication and Social Media

 

Latest Digital Marketing Tips from HIV.gov

In the past few weeks, the HIV.gov blog has published three new posts on digital marketing as part of its ongoing series to help agencies and organizations make better use of digital tools for HIV communication.  These recent posts are:

  

Fact Sheets and Other Resources

 

U.S. HIV Incidence and Prevalence Slide Set from CDC

Last month, CDC posted the slide set, Estimated HIV Incidence and Prevalence in the United States, 2010-2015, in its online HIV library.  The 32-slide set includes a series of graphs and maps summarizing National HIV Surveillance System data reported through June 2017 for adults and adolescents aged 13 years and older in all 50 states and the District of Columbia.  The data focus on: 1) HIV incidence; 2) HIV prevalence – persons living with both diagnosed and undiagnosed HIV infection; and 3) the percentage of total HIV infections that are diagnosed.  The slides include trends in HIV incidence and percentage diagnosed infection, with breakdowns by age, gender, race/ethnicity, transmission category, and region of residence. A map showing estimated prevalence in 2015 by region is also provided.

 

Now Available: Comprehensive PrEP Provider Database and Locator Widget

CDC’s National Prevention Information Network (NPIN) and Emory University have developed a comprehensive, national directory of U.S. health service providers offering pre-exposure prophylaxis (PrEP) to prevent HIV infection. The database, which is now maintained by NPIN, includes over 1,800 public and private PrEP providers from all 50 states, as well as U.S. territories. For each health service provider, the database includes information about the key services rendered and whether a provider offers PrEP access assistance and/or PrEP to uninsured patients at a low cost. To simplify access to information in the database, NPIN has also released a new PrEP locator widget that allows users to obtain a list of nearby PrEP providers by simply entering their zip code.

 

Fact Sheets on HIV Medications and Affected Populations 

Earlier this year, the U.S. Food and Drug Administration (FDA) approved three fixed-dose combination medications for the treatment of HIV infection: Cimduo, Symfi, and Symfi Lo. Both Symfi and Symfi Lo are complete regimens for the treatment of HIV infection. Cimduo is not a complete HIV regimen; it is always used in combination with other medications.  The Department of Health and Human Services AIDSinfo site has published fact sheets about each of these new medications in both English and Spanish, as well as an updated version of its fact sheet listing all approved HIV medications.

In addition, AIDSinfo recently published updated versions of several consumer fact sheets focusing on the effects of HIV on different population groups. Each fact sheet includes a summary of key issues and links to additional information and resources. 

In conjunction with the observance of National Youth HIV and AIDS Awareness Day and National Transgender HIV testing Day last month, CDC also published updated versions of their fact sheets HIV Among Youth and HIV Among Transgender People.  

 

Recent Minority Health Forums and Videos from HHS 

April was National Minority Health Month, and the theme for 2018 was “partnering for health equity.” In recognition of the month, the HHS Office of Minority Health (OMH) recently conducted two minority health forums that were live-streamed, videoed, and later uploaded to Youtube.  OMH’s National Minority Health Month Observance, held on April 17, focused attention on partnerships at the federal, state, local, tribal, and territorial levels to reduce disparities in health and health care. At this year’s event, key HHS officials from across the Department highlighted public and private sector collaborations for increasing health equity. 

On April 25, the Centers for Medicare & Medicaid Services Office of Minority Health and the Substance Abuse and Mental Health Administration’s Office of Behavioral Health Equity hosted the Forum on Opioids: Strategies and Solutions for Minority Communities. At the forum, a panel of public health leaders, health care professionals, and community members discussed opioid use and behavioral health, with an emphasis on minority communities. Participants received updates on strategies for the prevention, diagnosis, intervention, and treatment/recovery of persons with opioid addiction, and for increasing access to behavioral health services. 

  

 

 

 

 

 

 

 

 

 

 

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