The Importance of HIV Treatment Education, Health Literacy, and Wellness Programming

by Moisés Agosto-Rosario

 

I returned to NMAC in 2011 to develop our treatment education, adherence and mobilization division (TEAM). As some of you might remember, 20 years ago, I joined NMAC with the same goal and we were able to develop policies and programs that served as the basis for strong community based HIV treatment education initiatives. All the work accomplished during those years helped thousands of people living with HIV make informed and adequate treatment decisions, enhancing their capacity to adhere to complicated protease based regimens.

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Combination therapy was the driving force behind HIV treatment education back then, but today we add other areas that are equally important in not only helping us treat the disease but also prevent transmission. Treatment as prevention has been proven to decrease community viral load and transmission risk, while pre- and post-exposure prophylaxis are effective tools at preventing new infections. All together these biomedical interventions create a path to end AIDS in America. This time around we know that the concept of treatment education must be expanded to include HIV health literacy, but also educate around issues related to comorbidities, aging and overall wellness.

The implementation of the National HIV Strategy and the Affordable Care Act, highlight the growing need for strong programmatic infrastructure and policies to improve HIV health literacy and wellness in communities of color. We believe that for successful implementation, it will be vital to reexamine and reimagine treatment education. As such, on April 3 and 4, the NMAC convened a diverse group of stakeholders ranging from researchers and community based organizations, to government and private funders to participate in the National HIV Treatment Education, Health Literacy and Wellness Think Tank, with the ultimate goal of developing a treatment education plan for the 21st century.

The objectives of the Think Tank were to:

• Understand the current HIV treatment education landscape
• Expand the potential of HIV treatment education/wellness programming
• Identify the challenges social determinants of health pose to successful HIV treatment education programming
• Identify HIV treatment and health literacy guidelines
• Understand the role of patient navigation in ACA and its impact on NHAS goals
• Identify roles of HIV treatment education/wellness in the public, private and NGO sector

Our desired outcomes of the Think Tank were to:

• Establish a blueprint for HIV health literacy and wellness inclusive of social determinants of health
• Identify available funding sources for HIV treatment education/health literacy
• Identify themes for follow-up (i.e., special meetings on a topic, additional think tank, etc.
• Develop recommendations on the role of the public, private and NGO sectors

The think tank consisted of three pillars: assessing and identify the landscape for HIV treatment education, developing a road map on how to transform the field, and developing a framework or blueprint to create an infrastructure responsive to the health literacy needs of people living with HIV and those that serve them.

The result was a robust conversation about the future of treatment education and how it can best be implemented to help bring the HIV epidemic to an end. There were a number of compelling presentations on topics of significance, including an in-depth review of NMAC's paper, "How To Ends AIDS in The united States: community oriented HIV service delivery, treatment education", and mobilization As well as a presentation from Harold Phillips of HRSA, who sought to clarify what the ACA's navigators can and cannot do, what resources are available to implement the program, and recommendations for how the community should re-think Ryan White service categories used for outreach, enrollment, and benefits counseling in light of the ACA.

The enthusiastic exchange of ideas demonstrated that there is renewed energy around treatment education and the development of a plan that can effectively improve health literacy, outcomes, and overall quality of life.

As a result of the think tank we created four working groups to refine the details of the blueprint. Those four working groups are content, policy, social determinants of health, and HIV-positive leadership. As part of the action plan the four working groups will be charged with providing the content or criteria of the future blueprint which will be revealed in draft form at USCA in September and presented to the larger HIV community on World AIDS Day 2013. Stay tuned for updates! And be sure to register for this year’s USCA in New Orleans to learn the latest about our treatment education efforts and how they can help bring an end to this epidemic.

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About NMAC
The National Minority AIDS Council (NMAC) builds leadership within communities of color to end the HIV/AIDS epidemic. Since 1987, NMAC has advanced this mission through a variety of programs and services, including: a public policy education program, national and regional training conferences, a treatment and research program, numerous publications and a website: http://www.nmac.org/.

For more information, contact NMAC directly at (202) 483-NMAC (6622) or communications@nmac.org.

Visit the agency online at http://www.nmac.org/

President of Nigeria Joins Global Fund Efforts to Broaden Fight Against HIV, TB and Malaria

ABUJA –Nigeria’s President, Goodluck Jonathan, agreed to help lead the Global Fund’s efforts to raise funds this year, a critical role in the partnership to fight AIDS, tuberculosis and malaria all over the world.
 

President Jonathan met with Mark Dybul, Executive Director of the Global Fund, on Monday to discuss joint efforts to control these deadly infectious diseases in Africa’s most populous nation and globally.

Dr. Dybul praised President Jonathan’s effective leadership and personal commitment to expanding health services, embodied by Nigeria’s “Save One Million Lives” initiative that is aiming to dramatically increase access to basic quality health services, particularly for women and children. 

President Jonathan accepted an invitation be a Co-Chair in this year’s replenishment efforts by the Global Fund. Other Co-Chairs include UN Secretary-General Ban Ki-moon and heads of state from developed countries, emerging economies and the private sector.

“Working together, we can make tremendous gains,” said Dr. Dybul. “With the existing science, our understanding of the epidemiology and our collective experience in combating the diseases, we now have an opportunity to control them. If we do not, the long-term costs will be incalculable.”

During his first visit to Nigeria as Executive Director of the Global Fund, Dr. Dybul also met with the Minister of Health, Prof. Chukwu Onyebuchi and Minister of State for Health, Dr. Muhammad Pate, and other key stakeholders, partners and implementers to discuss opportunities to further strengthen collaboration.  

Mr. Aig-Imoukhuede, Chairman of Friends Africa, said: "The upcoming replenishment of the Global Fund is its most critical replenishment and ought to be given the highest levels of support for the fight against these diseases to be won."

Dr. Dybul announced that the Global Fund is providing up to US$ 288 million in additional funding to help accelerate programs to prevent and treat HIV and malaria in Nigeria. This new funding is being made available under a new funding model, and Nigeria is one of 47 countries accessing new funding through renewals, grant extensions and redesigned programs in 2013.

The Global Fund’s latest HIV grants are targeting pregnant women and “most-at-risk” populations such as women and girls, sex workers, people who use drugs, men who have sex with men, while the TB grants support expansion of diagnosis and treatment capacity including treatment of multidrug-resistant TB. 

Malaria grants are aiming to achieve nationwide coverage of mosquito nets through mass campaigns and routine distribution, while at the same time increasing availability of antimalarial medicines and diagnostic tests.   

Despite promising advances in recent years, such as declining AIDS and TB mortality and a sharp increase in the use of insecticide-treated nets, Nigeria faces serious health challenges. Over the last 12 months, Nigeria and the Global Fund signed agreements in worth a total of US$ 560 million to support programs that will help significantly expand prevention, diagnosis and treatment of the three diseases.

Dr. Dybul appealed to President Jonathan to expand domestic investment in health even further. Nigeria has the second-largest number of people living with HIV in the world after South Africa. But only 30 percent of those needing treatment are on antiretroviral therapy and only 16 percent of pregnant HIV-positive mothers are getting prophylactic treatment to prevent them from passing on the virus to their babies.  

The country also has the second-highest child and maternal mortality in the world, in absolute numbers, and accounts for nearly one-third of deaths from malaria globally. While TB mortality has fallen significantly since 2003, case detection rates are still among the lowest in the world.

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The Global Fund is an international financing institution dedicated to attracting and disbursing resources to prevent and treat HIV and AIDS, TB and malaria. The Global Fund promotes partnerships between governments, civil society, the private sector and affected communities, the most effective way to help reach those in need. This innovative approach relies on country ownership and performance-based funding, meaning that people in countries implement their own programs based on their priorities and the Global Fund provides financing where verifiable results are achieved.

Since its creation in 2002, the Global Fund has supported more than 1,000 programs in 151 countries, providing AIDS treatment for 4.2 million people, anti-tuberculosis treatment for 9.7 million people and 310 million insecticide-treated nets for the prevention of malaria. The Global Fund works in close collaboration with other bilateral and multilateral organizations to supplement existing efforts in dealing with the three diseases.

For more information, please contact:

                                                                                    

ANDREW HURST

Head of Media and Translations

Mobile: +41795616807

E-mail: Andrew.hurst@theglobalfund.org

Information on the work of the Global Fund is available at www.theglobalfund.org

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