Washington Blade - April 11, 2008
Brent Minor, btminor@bellatlantic.net.

REGARDLESS OF WHO is elected the next president of the United States, he or she will come into office facing a persistent and increasingly complex AIDS crisis here at home.

The Centers for Disease Control recently estimated that approximately 1.2 million people are living with HIV in the United States and new infection rates are on the rise yet again.

While President Bush deserves credit for his approach to the global epidemic, his response to AIDS here in the U.S. has been somewhat disappointing. Here are six suggestions that the next president should consider to fight AIDS here at home.

• Appoint a surgeon general and AIDS czar. It's hard to believe that we have been without these two key health policy positions for more than three years. Bush's surgeon general nominee, Dr. James Holsinger, is at best a nominal candidate and should be rejected at his upcoming Senate hearing. Bush appointees like the Global AIDS Coordinator, Mark Dybul, demonstrate that this administration has the capacity to select strong candidates when it chooses. We need and deserve better in this sensitive position.

The lack of a permanent Director of National AIDS Policy certainly explains why there has been such little public activity or any new initiatives in domestic AIDS programs. While the White House is quick to point out that it did not eliminate the position (as was once suggested in internal discussions), it has become virtually invisible, which in some ways is worse.

• Lift the HIV travel ban policy. After years of an embarrassing and biased ban against people with HIV being able to travel or immigrate to the U.S. without first securing a waiver, there is finally realistic activity on Capitol Hill to remove this requirement. Not only does this policy reinforce the negative stigma of HIV, it is an impractical approach and discourages honesty while offering a false sense of security. The United States should abandon this misguided policy that only such "progressive" nations like North Korea, Sudan and Iran have in place.

• Fund domestic care and treatment programs sufficiently. No matter where a person with HIV lives in this country, he or she should have equal access to life-saving medications and therapies. Programs like the Early Treatment of HIV Act (ETHA) would be a tremendous step forward to expand funding instead of continuing the barbaric practice of divvying up the same shrinking pie of available federal dollars. Every major study has demonstrated that early treatment has proven to be cost-effective and actually reduces the spread of HIV.

• Allow science to guide prevention efforts. Why AIDS prevention programs are still treated like a political football is baffling and dangerous. While AIDS education should be age-appropriate, it should not be so compromised as to be ineffective. Recent studies showing how roughly 25 percent of all teenage girls have been diagnosed with a sexually transmitted disease is clear evidence that adolescent sex is alive and well - just like when all of us were growing up.

THE MORE WE talk openly and truthfully about HIV, the better chance we will have to encourage safe behavior, reduce stigma about getting tested, address touchy issues like substance abuse, syringe exchange, and "down low" behavior, which should ultimately reduce new infections.

• Continue research efforts. Recent failures in vaccine trials have prompted some to call for such efforts to be abandoned. The expansion of the medical knowledge base over the last 20 years is extraordinary and would have never happened without such research. The idea of stopping such efforts is ludicrous. I'm sure glad the people calling for the elimination of these programs weren't around when the Wright Brothers, Louis Pasteur or Thomas Edison failed in their initial efforts.

• Host a White House summit on domestic HIV/AIDS. When I served on the Presidential Advisory Council on HIV/AIDS, we unanimously passed a motion in 2003 encouraging President Bush to hold such a meeting. It didn't happen.

We have lost our focus about AIDS in this country and operate under a "if it ain't broke, don't fix it" mentality. HIV is 100 percent preventable and, yet, we still have more than 40,000 new infections in the United States every year. We need to address the new challenges of the AIDS epidemic in this country and a White House Summit would offer the kind of commitment and visibility from the very top that is needed.

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Brent Minor was a member of the Presidential Advisory Council on HIV/AIDS from 2000-2005.

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