HIV: Domestic HIV/AIDS

Domestic HIV/AIDS

Through the Elizabeth Glaser Scientist Award, the International Leadership Award, and other research and training grants, the Foundation maintains its commitment to cutting-edge research with the goal of ultimately eradicating pediatric AIDS. While great strides have been made since the early days of the epidemic, the special needs of children and youth with HIV/AIDS are still too often overlooked. To give them the best possible chance for a healthy future, we must ensure that their specific prevention, care, and treatment needs are appropriately addressed.

The Ryan White CARE Act

The Foundation has long supported prevention, care, and treatment programs aimed at women, children, and families affected by HIV/AIDS. Innovative initiatives like these were included in the groundbreaking Ryan White CARE Act, which was passed in 1990. Since the Act was successfully passed, one of the Foundation's main domestic advocacy goals has been to maintain congressional support for the funding of these programs within the CARE Act.Next to the Medicaid program, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act is the largest federal investment in the care and treatment of people living with HIV/AIDS in the United States, providing services to approximately 533,000 low-income, HIV-positive individuals. First enacted in 1990, the CARE Act supports a wide range of community-based services, including primary and home health care, case management, substance abuse treatment, mental health services, and nutritional services.

As part of the creation of the CARE Act, the Foundation successfully advocated for the inclusion of a program to help women and children with HIV/AIDS participate in clinical trials of new therapies. This program would later become part of Title IV of the CARE Act during the reauthorization of the legislation in 1996.

Today, Title IV provides medical care, support services, case management, outreach, and other services to women, children, and families affected by HIV/AIDS. Through its family-centered approach to providing care and treatment, Title IV is saving lives, improving quality of life by keeping people healthier, and saving money by reducing hospitalizations. Title IV projects have also led the way in reducing mother-to-child transmission of HIV from more than 2,000 babies born HIV-positive each year to fewer than 200 per year. In addition, Title IV programs help link women and children to opportunities to participate in cutting-edge HIV/AIDS clinical research.

 

HIV Testing of Pregnant Women and Newborns

Currently, more than 3,700 children and youth in the United States under the age of 13 are living with HIV and AIDS. Of the 40,000 Americans newly infected with HIV every year, half are under 25 years of age. While the discovery of effective drug therapies for preventing mother-to-child transmission of HIV has reduced the number of infected babies born in the United States to less than 200 a year, each infection represents a tragedy that could have been averted.Without medical intervention, an HIV-infected woman has about a one-in-four chance of giving birth to an HIV-infected baby. However, as a direct result of HIV testing and preventative therapies, the risk of HIV transmission from mothers to their infants in the United States has been dramatically reduced to less than two percent. The Foundation strongly believes we must continue to work toward further reductions in mother-to-child transmission of HIV. As recommended by the Centers for Disease Control and Prevention (CDC) and the Institute of Medicine (IOM), the Foundation endorses the voluntary, routine, and universal HIV testing of pregnant women as a means of increasing testing rates and further reducing transmission from a mother to her newborn. 
 
Pediatric HIV/AIDS Research
In keeping with Elizabeth Glaser’s legacy, the Foundation advocates for a strong U.S. commitment to domestic pediatric HIV/AIDS research programs, including those funded at the National Institutes of Health (NIH).
From its inception, the Foundation has had a long history of advocating for increased funding for pediatric HIV/AIDS research. In October 1989, the Foundation advocated for and secured $10 million for basic pediatric HIV/AIDS research at the National Institutes of Health (NIH) – marking the first time government funds were ever specified for basic biomedical pediatric HIV/AIDS research. The following year, the FY 1991 Labor-HHS appropriations bill included $20 million for pediatric HIV/AIDS basic research, an increase of $10 million over the previous year. An additional $23.8 million was also appropriated for important pediatric clinical trials.

Building on this legacy of achievement, critical pediatric HIV/AIDS research remains a priority for the Foundation. As we marvel at the progress that has been made in pediatric AIDS, it is important to remember the long battle ahead for the young people infected with HIV. The unique medical and social challenges that these young adults face is highlighted in a June 2005 New York Times article, "Their Unexpected Adolescence."

Many adolescents and young adults are already resistant to existing medications and are waiting for new drugs that can keep the virus in check. These young people are also entering uncharted medical territory with potential problems unknown to even the most experienced AIDS researchers. Additional research is needed into the long-term health implications of drug treatment on these children and young adults, including their psychological and social needs, and appropriately targeted prevention services. In addition, through the use of preventive drug regimens, many children born to HIV-positive mothers were uninfected. As this population of HIV-exposed children grows, more research is needed into the long-term health effects of the exposure of these children to preventive drug regimens