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ONAP Town Halls in Oakland, San Francisco Identify Challenges, Progress on HIV

bay area Editor’s note: This week we continue our look back at some of the summer’s HIV/AIDS community highlights. Today we share reflections from our colleague Dr. Andrew Forsyth on two listening sessions held by the White House Office of National AIDS Policy in the San Francisco Bay area earlier this summer.

On June 24 and 26, The Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) participated in two town halls in Oakland and San Francisco, California that were hosted by the White House Office of National AIDS Policy Director (ONAP) Douglas Brooks. With local organizational assistance from the San Francisco AIDS Foundation, the events were part of a summer series that took place around the country to permit updates on and discussion of federal, state, and local progress toward achieving the goals of the National HIV/AIDS Strategy (NHAS) and the HIV Care Continuum Initiative (HCCI).

With welcoming comments by Deputy Mayor Sandré R. Swanson and with moderation by United Church of Christ Bishop Yvette Flunder, the Oakland meeting included highlights of federal NHAS implementation by Mr. Brooks and myself, and provided an update on the HIV epidemic in Alameda County by Public Health Director Muntu Davis. A panel discussion followed that explored the prevention and treatment needs of transgender women and other high priority populations, improving clinical care outcomes, and addressing the needs of Latino men who have sex with men, with participation from AIDS Healthcare Foundation’s Lisha Wilson, Alameda County Medical Director Kathleen Clanon, Grupo Fremont Executive Director Ron Chavez, and Women Organized to Respond to Life-threatening Diseases’ Robin Crawford.

Key issues raised by participants in the Oakland meeting included challenges securing employment and stable housing for persons living with HIV infection, concerns about the optimal allocation of state HIV resources to meet local demographic and epidemiological needs (e.g., young Black men who have sex with men; Oakland vs. other cities), the importance of mental health and substance use treatment, better integration of community input into state HIV planning processes, and additional guidance needed from federal partners to inform investments necessary to optimize state and local resources in HIV prevention and treatment programs and services.

According to ONAP Director Brooks, “these town hall meetings, which we concluded in August with visits to Chicago and New York City, were opportunities for federal and non-federal partners to take stock of the progress we’ve made, explore remaining gaps and opportunities, and share ideas about how the federal government can assist state, local, and tribal governments to achieve the goals of the NHAS and bring about an AIDS-free generation.”

The San Francisco town hall on June 26 followed a similar format and was opened with welcoming comments by city Health Commissioner and PACHA member Cecelia Chung and HHS Region IX Health Director Herb K. Schultz, and was moderated by former ONAP director and PATH’s HIV and Tuberculosis Program Leader Grant Colfax. In addition to NHAS implementation updates by federal partners, California Department of Public Health’s Karen Mark provided a statewide epidemiological overview that depicted California’s progress toward achieving the NHAS goals [PDF 175KB]. Additionally, San Francisco General Hospital’s Mary Lawrence Hicks discussed her team’s successes realizing extraordinarily high HIV care continuum outcomes, and advocate Tez Anderson discussed efforts to define and respond to “AIDS survivor syndrome.”

As with the Oakland town hall, attendees were very concerned about the lack of housing support for persons living with HIV infection, and expressed dismay about the current congressional ban on the use of federal funds for syringe exchange programs and called for guidance to states on comprehensive sexual education in schools. Recent accomplishments by the U.S. Department of Justice in fighting HIV-discrimination cases were highlighted but states’ own legal environments were acknowledged as key points of opportunity to reduce stigma and dscrimination for persons living with HIV infection, as the recent efforts to modernize Iowa’s HIV criminalization laws will attest.

As hoped, these town halls provided opportunities for increased dialogue between and among attendees, and suggested important considerations for focusing and sustaining our combined efforts to achieve the goals of the NHAS at the national, state, local, and tribal levels. Sidebar discussions touched on how the federal government might inform local policies to optimize resource allocation to address the local epidemiology, particularly as it pertains to geographic and demographic need; and how regional and non-regional federal partners can work to improve collaboration and coordination at the local level.

“A range of factors affecting local epidemics will influence implementation of the Strategy,” notes Ronald Valdiserri, MD, MPH, Deputy Assistant Secretary for Health, Infectious Diseases. “By improving within-HHS coordination and collaboration between headquarters and the regions, we can enhance tailoring of our regional HIV response to geographic locations and subgroups where HIV is most concentrated, such as MSM. Only then will we achieve the goals of the Strategy.“

Slides from several of the presentations from the Bay Area listening sessions are available:

ONAP also held listening sessions and site visits over the summer in Jackson, Mississippi; Columbia and Charleston, South Carolina; Atlanta, Georgia; Chicago, Illinois; and New York, New York.