Miller School Hosts White House Forum on National HIV/AIDS Strategy

Local and state health leaders, providers and other stakeholders in the fight against HIV/AIDS who gathered at the Miller School this week for the first White House forum on implementation of the National HIV/AIDS Strategy expressed pride over how far AIDS management has come over the past three decades, but raised concerns over who will care for people living with the once-fatal disease in the future.

Addressing the audience during a panel discussion at the December 18 forum held in the Lois Pope LIFE Center, Michael A. Kolber, M.D., Ph.D., Director of the Miller School’s Comprehensive AIDS Program, said he was particularly concerned that the existing lack of specialty and sub-specialty care that HIV/AIDS patients need will be exacerbated as the Affordable Care Act increases heath care access to more individuals.

“I think this is a major question that everybody in this room and the audience needs to concern themselves with,” Kolber said. “Right now our patients already wait considerable amounts of time to get specialty and sub-specialty care. To increase the number of individuals in the system … and not increase the sub-specialty network that these individuals have … is going to be a major problem as we move forward.”

Kolber made his comments during an afternoon forum hosted by the Miller School and convened by the White House’s Office of National AIDS Policy to discuss ongoing challenges and successes of implementing the National HIV/AIDS Strategy with the Affordable Care Act. Launched by the Obama administration in July 2010, the nation’s first integrated response to the AIDS epidemic has specific targets for reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities by 2015.

In his welcome remarks, Miller School Dean and UHealth CEO Pascal J. Goldschmidt, M.D., noted that Miami-Dade County is an epicenter of the epidemic, ranking first in the nation for new AIDS cases per capita, in a state that ranks third nationwide in the number of people living with AIDS.

“There is no question that one of the challenges we face is to improve the ‘treatment cascade’ in our community. We need to provide a continuum of care from diagnosis of HIV infection, link to treatment and retain those infected in care, which I understand remains a significant problem in our community,” the Dean said. “In Miami-Dade we have about 34,000 people who are infected with HIV, and unfortunately, fewer than 9,500 remain on their medication long enough to have a suppressed viral load. That’s just 27 percent. So we must find ways to keep these patients engaged in the system, getting care, and virtually eliminating the virus.”

Added Mario Stevenson, Ph.D., Chief of the Division of Infectious Diseases and co-director of the administrative core of UM’s Center for AIDS Research, in his welcome, “Despite the impressive progress made in the management of HIV infection and antiretroviral therapy, it is clear that we are not going to drug our way out of HIV. For that reason there has been a move toward prevention, treatment as prevention, and Miami is really on the front lines.”

Outlining the goals of the national strategy, Grant Colfax, M.D., Director of the Office of National AIDS policy, said that a coordinated response is the only way they will be achieved. “This meeting is part of that,” he said. “We realize that an integrated federal response is critically important. But a federal response alone is not sufficient. We need to have a response at the state level and community level to really meet the goals.”

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