Primary Care Leaders Visit HRSA

Dr. George Sigounas welcomed state primary care officials to HRSA on June 18.
Dr. George Sigounas welcomed state primary care officials to HRSA on June 18. Representing state and regional nonprofits, they provide training and technical assistance to health centers and play a vital role in HRSA's health center program -- helping to improve clinical practice and bolstering financial performance and operations among their members.

 

HRSA programs are critical to achieving the federal government's bold new objective to dramatically reduce new HIV/AIDS infections within 10 years, Administrator Dr. George Sigounas told a gathering of state Primary Care Association officials Tuesday.

Announced in February, the Administration's “Plan for America” aims to end the AIDS epidemic by limiting new infections to fewer than 3,000 people per year by 2030. The massive undertaking would involve multiple federal agencies, focused on 48 U.S. counties (PDF - 75 KB), Washington, DC, San Juan (PR), and seven states with entrenched HIV burdens -- principally in rural communities and across the American South.

 

A busy year ahead: BPHC Associate Administrator Jim Macrae briefed association leaders on the agency's plans for the coming year. Senior agency leaders walked the group through strategic plans for bureaus and offices throughout HRSA over two days.
A busy year ahead: BPHC Associate Administrator Jim Macrae briefed association leaders on the agency's plans for the coming year. Senior agency leaders walked the group through strategic plans for bureaus and offices throughout HRSA over two days.

 

HRSA's many "boots on the ground" -- funded through the storied Ryan White HIV/AIDS Program and 1,400 Community Health Centers, along with the 340B prescription drug initiative -- arguably make the agency "the primary player" in fulfilling the ambitious goals of the plan, said HRSA Administrator Dr. Sigounas. "HRSA will play a leading role in diagnosing, treating, preventing, and responding to end the HIV epidemic."

Reaching people who are HIV-positive but not in treatment remains a formidable challenge, which will rely heavily on the associations and their member health centers.

 

"You know your communities," Dr. Sigounas told the attendees.  "You know how to reach those people.  Give us your ideas, give us your plans. Tell us how to reach those people who need our support." Above (fifth from right, to left) Jim Macrae; BPHC Chief Medical Officer Dr. Judy Steinberg; and Deputy Associate Administrator Tonya Bowers.
"You know your communities," Dr. Sigounas told the attendees.  "You know how to reach those people.  Give us your ideas, give us your plans. Tell us how to reach those people who need our support." Above (fifth from right, to left) Jim Macrae; BPHC Chief Medical Officer Dr. Judy Steinberg; and Deputy Associate Administrator Tonya Bowers.

 

Stigma is a major factor that keeps people out of HIV care and unwilling or unable to use PrEP, HAB's Dr. Laura Cheever said.

PrEP, or pre-exposure prophylaxis, is a simple, daily pill that protects at-risk people who do not have HIV from acquiring the virus. When taken consistently, it reduces the risk of HIV infection by up to 92 percent. Well known and widely prescribed in U.S. urban areas, research has shown that it is not generally available in many rural communities -- partly because patients are reluctant to talk to their doctors about it for fear of being "outed."

Meanwhile, HAB's historic leap forward in HIV care of recent years continues. Among people who've received Ryan White-delivered HIV care at least once, the increase in suppression rates in recent years has been "huge," Cheever said: an estimated 70 percent were virally suppressed in 2010. By 2017, the figure rose to 86 percent.

"Viral suppression is key," Cheever said. "They're not cured of their HIV, but the virus is undetectable in their blood.  And people with an undetectable viral load live a near-normal lifespan … and they effectively have no risk of transmitting HIV to someone else." That distinction is key to the success of the Administration's plan. By preventing new infections, through PrEP or viral suppression, the virus could be all-but-eliminated across broad swaths of the country within 10 years.

Date Last Reviewed:  June 2019