The National HIV/AIDS Strategy and the Patient Protection and Affordable Care Act

In the context of the continuing challenges posed by HIV, the White House Office of National AIDS Policy (ONAP) released a National HIV/AIDS Strategy (NHAS) for the United States in July 2010. The primary goals of the NHAS are to

  • reduce HIV incidence;
  • increase access to care and optimize health outcomes for PLWHA; and
  • reduce HIV-related health disparities.

Federally run HIV programs traditionally have been administered in a siloed fashion due to differences in the missions of the agencies within which they originate or in funding stream requirements. Meeting the NHAS objectives will require increased synergy of HIV programs across federal agencies, and among federal agencies, states, and other jurisdictions. As such, the NHAS includes a fourth objective to increase coordination of HIV program activities across levels of government. Subsumed within this objective is the development of improved mechanisms to monitor progress in achieving the NHAS goals. In the agency operational plans for the NHAS, this Institute of Medicine (IOM) report is named as one of the activities that ONAP is undertaking to address existing gaps in the collection, analysis, and integration of data on the care and treatment experiences of PLWHA.

The NHAS is intended to build upon the Patient Protection and Affordable Care Act (ACA), which—if implemented as originally planned—is expected to bring millions of uninsured individuals, including many PLWHA, into the health care system. Examples of provisions of the ACA that may increase access to care for PLWHA include changes in eligibility requirements for public (e.g., Medicaid) and private health insurance, reduced out-of-pocket costs for Medicare Part D prescription drugs, expansion of coverage for preventive health services, and increased care capacity in community health centers.


ONAP requested that the IOM convene a committee to identify critical data and indicators related to continuous HIV care and access to supportive services, as well as to monitor the impact of the NHAS and the ACA on improvements in HIV care. In addition, the committee was tasked with identifying public and private data systems that capture the data needed to

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