An AIDS-Free Generation is Within Our Reach: Hillary Clinton’s Plan to Tackle HIV and AIDS Together

The Briefing

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The AIDS crisis in America began as a quiet, deadly epidemic—and because of discrimination and disregard, it remained that way for far too long. When many in positions of power turned a blind eye, health care providers, activists, scientists, and ordinary, heroic people fought with courage and compassion for a national commitment to address the disease. Due to their efforts, the AIDS crisis looks very different today: more options exist for treatment and prevention than ever before, and more people with HIV are leading long and productive lives. But HIV and AIDS are still with us. More than 1.2 million people live with HIV in the United States, and about 50,000 people are newly diagnosed each year. Globally, HIV afflicts a total of 37 million people, including a staggering 25.6 million in sub-Saharan Africa. Yes, we have made progress, but so much work remains. Hillary Clinton believes we have to tackle this work together.

As Secretary of State, Clinton began an ambitious campaign to usher in an AIDS-free generation, and as president she’ll put us on an ambitious path to end the epidemic. Clinton will:

• Convene an “End the Epidemic” working group to adopt aggressive and attainable timelines for ending AIDS as an epidemic in the United States and globally. An AIDS-free generation is within our grasp, and now is the time to adopt aggressive, attainable, and concrete goals. That’s why, as president, Clinton’s Office of National HIV/AIDS Policy will immediately convene an “End the Epidemic” working group to engage a wide range of experts, advocates, and stakeholders to adopt ambitious and attainable timelines for ending AIDS as an epidemic in the United States and globally.

• Work to fully implement and strengthen the National HIV/AIDS Strategy to meet these timelines. The National HIV/AIDS Strategy provides an important roadmap in our march towards an AIDS-free generation in the United States. Clinton’s Office of National HIV/AIDS Policy will work to fully implement the National HIV/AIDS Strategy, and strengthen it to align with the timelines developed for ending AIDS as an epidemic.

As part of Clinton’s effort to end AIDS as an epidemic in the United States and globally, she will fight to expand critical programs, remove disparities and barriers to accessing care, and end stigma and discrimination:

Expand Critical Programs Needed to Reach and Sustain an AIDS-free Generation

• Dramatically increase the number of people on HIV treatment worldwide, through programs like PEPFAR. We have made significant progress in our fight against global HIV and AIDS. Since 2000, the number of new HIV infections has decreased by 35 percent and since the peak of the global epidemic in 2004, deaths due to AIDS-related causes have decreased by roughly 42 percent. Programs like the President’s Emergency Plan for AIDS Relief (PEPFAR) have played a significant role in driving this progress. However much work remains. Today, roughly 37 million people are living with HIV across the globe, including roughly 6 million children. As president, Clinton will work with members of Congress and engage leaders around the world to increase global funding for HIV/AIDS treatment and prevention.

• Increase our investment in HIV and AIDS research to continue United States leadership. Due to our nation’s commitment to scientific research, most people diagnosed with HIV today can live longer lives with consistent treatment. Researchers at the National Institutes of Health and elsewhere are poised to make even more progress in the years to come towards developing long-acting treatments and a cure for HIV. As president, Clinton will expand our investment in research to accelerate this progress and ensure that significant study questions related to HIV and AIDS are identified, funded, and answered.

• Expand utilization of HIV prevention medications, including pre-exposure prophylaxis (PrEP). As we continue to increase HIV and AIDS research, we should also invest in the promising innovations that research is producing. For example, PrEP and other medications, when properly used, have proven effective in preventing HIV infections. As a result, both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have recommended widespread use of PrEP, particularly among members of at-risk groups. The CDC has funded grants to state and local health departments to increase knowledge about and uptake of PrEP. Clinton will increase the CDC’s investment to ensure populations at greatest risk of infection have access to preventive medicines.

• Expand access to quality, affordable health care. The Affordable Care Act (ACA) has insured over 20 million Americans, providing quality, affordable health coverage to those living with HIV and AIDS all across our country. Thanks to the ACA, insurance companies can no longer deny coverage based on a pre-existing HIV diagnosis, thousands of HIV patients are now eligible for Medicaid, and Americans living with HIV or AIDS can now count AIDS Drug Assistance Program (ADAP) costs towards their Medicare Part D out-of-pocket spending limit. In addition, under the ACA, most new health insurance plans must cover lab tests, preventive services such as HIV screenings, and chronic disease management tools. Clinton will defend the ACA and build on its progress to ensure universal, quality, affordable health care for everyone in America. As president, Clinton will:

• Fight to extend Medicaid coverage. Of the 70,000 people living with HIV who were uninsured before the Affordable Care Act, roughly 47,000 should have been newly eligible for Medicaid. However, the refusal of some states to expand Medicaid coverage has left many without the coverage they need. That’s unacceptable. Clinton will fight until every state expands Medicaid coverage and provides life-saving health care to people living with HIV.

• Expand Medicare by allowing people 55 years or older to opt in while protecting the traditional Medicare program. Currently, Medicare is an important source of health coverage for an estimated 100,000 people 65 and over living with HIV. Clinton believes we should expand Medicare to allow those 55 and over to opt-in. This could benefit the nearly 4,000 Americans between 55 and 65 who are newly diagnosed with HIV each year, and provide critical coverage for a population that is more likely to be diagnosed with HIV late in the course of the disease.

• Expand our system of community health centers. A key component of achieving universal primary care, Federally Qualified Health Centers (FQHCs) serve 25 million people in the United States each year. FQHCs are core safety net providers for vulnerable populations, including those living with HIV/AIDS. As president, Clinton will double funding for FQHCs over the next decade, which will expand access to millions of people. In addition, Clinton will nearly triple the size of the National Health Service Corps, which includes HIV and AIDS providers in underserved areas.

• Lower the price of prescription drugs for those living with HIV and AIDS. It is unacceptable that in America, a pharmaceutical company can raise the price of life-saving medicine for HIV and AIDS patients by more than 5,000 percent. Clinton believes it’s time to hold the pharmaceutical industry accountable and lower the cost of prescription drugs for Americans, including medications that help to prevent and treat HIV and AIDS. As president, Clinton will:

• Cap monthly and annual out-of-pocket costs for prescription drugs at $250. Clinton will require health insurance plans to place a monthly limit of $250 on covered out-of-pocket prescription drug costs to provide financial relief for patients living with HIV and AIDS.

• Provide a new, progressive refundable tax credit of up to $5,000 per family for excessive out-of-pocket costs. For families that still struggle with prescription drug costs even after out-of-pocket limits on drug spending, Clinton will provide progressive, targeted new relief. Americans with health coverage will be eligible for a new refundable tax credit of up to $2,500 for an individual, or $5,000 for a family, available to those with substantial out-of-pocket health care costs. The credit will be available to insured Americans with qualifying out-of-pocket health expenses in excess of five percent of their income, and who are not eligible for Medicare or claiming existing deductions for medical costs. This refundable, progressive credit will help middle-class Americans who may not benefit as much from currently available deductions for medical expenses. This tax cut will be fully paid for by demanding rebates from drug manufacturers and asking the most fortunate to pay their fair share.

• End subsidies drug companies receive for direct-to-consumer advertising and invest that money in research. Almost every country in the industrialized world bans or severely restricts direct to consumer advertising because it increases prescription drug costs. As president, Clinton will crack down on the practice by eliminating tax breaks for direct-to-consumer advertising, saving the government billions of dollars over the next decade. She will invest these savings in research to promote the development of new drugs, including better therapies for HIV and AIDS.

• Empower Medicare to negotiate lower drug prices. Clinton has long believed that Medicare should use its leverage with more than 50 million enrollees to negotiate and drive down drug and biologic prices for seniors and others in the program. Today, drug prices in Medicare are negotiated by a disparate set of benefit managers, rather than using the full bargaining power of the program. Clinton believes that we should drive the best bargain for Americans by allowing Medicare to negotiate drug prices, notably for high-cost drugs with limited competition.

Remove Disparities and Barriers to Accessing Care

• Ensure disparities and barriers to care are emphasized when setting timelines and strengthening the National HIV/AIDS Strategy. Disparities and barriers to accessing care include age, gender, and regional differences. In setting timelines for ending AIDS as an epidemic, and in strengthening the National HIV/AIDS Strategy to meet these timelines, Clinton will place particular emphasis on expanding evidenced-based prevention, treatment, and community outreach initiatives for at-risk groups, including black men who have sex with men (MSM), transgender individuals, African American women, and injection drug users. She will also account for regional variations, like the particular needs of the southeast corridor of the United States. 

• Invest in services that support health, prevention, and retention in care. Making health care and prescription drugs accessible and affordable is critical to ending the HIV/AIDS epidemic. However, we also must also address other barriers in the way of effective HIV prevention, treatment, and care. Clinton believes that providing stable housing, drug addiction services, and comprehensive family supports are central to addressing HIV/AIDS. That’s why Clinton will:

• Address housing insecurity among people living with HIV and AIDS. Access to safe, affordable, stable housing plays an important role in ensuring successful adherence to HIV/AIDS treatment. That’s why Clinton is committed to protecting dedicated funding programs like Housing Opportunities for People with AIDS. She is also committed to combating housing discrimination against people with HIV or AIDS by ensuring that the Department of Justice strictly enforces fair lending and housing laws, including the Fair Housing Act’s Section 504 protections. While we make access to housing more fair, we also must make it more affordable. Clinton will increase incentives for new affordable rental housing development, ease local barriers to building affordable housing in areas of economic opportunity, and expand the current supply of Low Income Housing Tax Credits. She will also help put Americans, including those living with HIV and AIDS, on the path to sustainable homeownership with a $10,000 matching program for responsible homeowners who earn less than area median income to put towards a down payment on a first home.

• Launch a $10 billion initiative to combat America’s deadly epidemic of drug addiction. Drug addiction is a national epidemic that our nation is failing to address—and it is interconnected with the epidemic of HIV/AIDS. According to the National Institute of Health (NIH), drug abuse can worsen HIV symptoms, and Americans addicted to drugs are more likely to engage in risky behaviors such as having unsafe sex with an infected partner in exchange for drugs. As a result, tackling the epidemic of drug addiction is a critical component of tackling the HIV/AIDS epidemic. Clinton will launch a $10 billion partnership between the federal government, states, and local communities to prevent and treat addiction. States will be eligible for generous grant funding if they work with local stakeholders to put forward a comprehensive plan that addresses key priority areas, including prevention, treatment and recovery, emergency first-response, prescribing practices, and criminal justice reform.

• Defend the Ryan White HIV/AIDS program from partisan attacks. The Ryan White HIV/AIDS Program provides health and supportive services to assist those living with HIV and AIDS to engage in HIV medical care. As president, Clinton will support and protect the Ryan White program to ensure we address gaps in care and essential services. And she will continue to work with HIV/AIDS advocates to make the program more effective going forward. This includes adapting the program to new scientific breakthroughs and ensuring that we leverage the program’s HIV/AIDS expertise to strengthen the quality of health care nationwide.

End Stigma and Discrimination

• Launch a campaign to end stigma and discrimination associated with HIV and AIDS. Nearly 40 years have passed since the HIV and AIDS crisis first began, and yet even with everything we have learned, intolerance and stigma still exist. According to the Kaiser Family Foundation, 45 percent of Americans surveyed in 2011 said they would be uncomfortable having their food prepared by someone who is HIV-positive, 29 percent said they would be uncomfortable having their child in a classroom with an HIV-positive teacher, and 18 percent said they would be uncomfortable working with someone with HIV. This stigma also manifests itself in our criminal laws, and serves as a barrier to effective prevention and treatment. That’s why, as president, Clinton will launch a campaign to end the stigma and discrimination associated with HIV and AIDS, including by:

• Working to reform outdated HIV criminalization laws and aggressively enforce the Americans with Disabilities Act. Americans living with HIV are too often subject to outdated and stigmatizing criminal justice laws. As of 2014, at least 30 states have laws explicitly focused on persons living with HIV. Clinton will work with advocates, HIV and AIDS organizations, Congress, and others to review and reform outdated and stigmatizing federal HIV criminalization laws—and will call on states to do the same. She will also aggressively enforce the Americans with Disabilities Act and other civil rights laws to fight HIV-related discrimination.

• Partner with advocacy groups and community organizations to conduct public education. Clinton knows there is great work already being done across the country on this critical issue, and under her direction, ONAP will leverage these efforts in a national campaign to end stigma associated with HIV and AIDS.

• Confront stigma across the globe. In roughly 35 percent of countries with data available, over 50 percent of men and women report discriminatory attitudes towards people living with HIV. Globally, stigma around HIV and AIDS can have negative effects on willingness to disclose HIV status, health-seeking behavior, access to testing and treatment, and ability to receive social support. Clinton will work with the Global Fund to Fight AIDS, TB and Malaria to engage in public education campaigns in key countries where stigma and discrimination are rampant.

Clinton has fought for decades to combat HIV and AIDS—and the stigma and discrimination that accompany it:

• At the 1992 Democratic National Convention, when her husband accepted the nomination for president, they marked a break with the past by having an HIV-positive speaker—the first time that ever happened at a national convention. And when Hillary accepted the Democratic Party’s nomination for president in 2016, she once again invited a person living with HIV to the national stage to tell the story of our progress and the work we still have to do.

• As first lady, Clinton brought together global leaders to strategize and coordinate efforts to take on HIV and AIDS. She advocated for increased funding for prevention and research efforts—especially for pediatric AIDS—and honored scientists committed to AIDS research.

• In the United States Senate, Clinton put forward legislation to expand global AIDS research and assistance and to increase prevention and education. She voted for the creation of PEPFAR and to defend and protect the Ryan White Act. Clinton also voted to increase funding to combat HIV and AIDS and co-sponsored legislation to extend Medicaid coverage to low-income people with the virus.

• As Secretary of State, Clinton launched a campaign to usher in an AIDS-free generation through prevention and treatment—targeting the populations at greatest risk of contracting HIV. Under her leadership, American aid directly supporting people on antiretroviral treatment increased to reach over 6.7 million men, women, and children around the world. Clinton also oversaw the repeal of the HIV travel ban, which prevented people with HIV and AIDS from entering the United States, and led efforts to end mother-to-child transmission.

 

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After HIV/AIDS is Highlighted at the Democratic National Convention, Clinton Builds on Her Commitment to End AIDS as an Epidemic

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Last Wednesday, in an historic address to the 2016 Democratic National Convention in Philadelphia, Daniel Driffin — a black, gay man living with HIV — discussed the progress America has made and the work that remains in our fight to achieve an AIDS-free generation. Explaining how he believes we reach that goal, Driffin said "We invest in research and education. Expand treatment and prevention. And we elect Hillary Clinton."

 

Throughout her career, Clinton has fought to combat HIV and AIDS—and the stigma and pain that accompany it.  As First Lady, she advocated for increased funding for U.S. prevention and research efforts—especially for pediatric AIDS—and honored scientists committed to AIDS research. In the Senate, Clinton put forward legislation to expand global AIDS research, voted for the creation of PEPFAR and to defend and protect the Ryan White Act, and co-sponsored legislation to extend Medicaid coverage to low-income people living with HIV. Under Clinton's leadership as secretary of state, American aid directly supporting people on antiretroviral treatment increased over 200 percent to reach over 6.7 million men, women, and children around the world. Clinton began an ambitious campaign to usher in an AIDS-free generation, oversaw the repeal of the HIV travel ban, which prevented people living with HIV and AIDS from entering the United States, and led efforts to end mother-to-child transmission.

Clinton's record of commitment stands in stark contrast to that of Donald Trump and Mark Pence. Both Trump and Pence want to defund Planned Parenthood, a critical resource for HIV testing services. Under Mike Pence, Indiana experienced one of the worst HIV epidemics in the past two decades. Despite the fact that Indiana's recent HIV epidemic was fueled by intravenous drug use, Pence’s rigid, ideological opposition to needle exchange programs stopped him from acting quickly to alleviate suffering in the hardest hit areas. One year later, counties that see skyrocketing HIV rates must foot the bill for their own needle exchanges without assistance from the state. Pence has a long record of putting his own ideological agenda before funding for HIV/AIDS. Pence has been called out for supporting diverting money away from the Ryan White HIV/AIDS Program and providing it instead to organizations performing so-called "conversion therapy" when he ran for Congress. In this campaign, Trump and Pence have not proposed a single idea for addressing the domestic and global HIV/AIDS epidemic.

Unlike Trump and Pence, Clinton will continue to fight to achieve an AIDS-free generation. She believes we have reached a critical moment in this fight: We have the tools to end this epidemic once and for all, and we need to rededicate ourselves to fighting HIV and AIDS and leaving no one behind. During this campaign Clinton has outlined specific steps she will take to combat HIV/AIDS, and today, she built on this comprehensive agenda, committing to:

• Convene an “End the Epidemic” working group to adopt aggressive and attainable timelines for ending AIDS as an epidemic in the United States and globally. Clinton’s Office of National HIV/AIDS Policy will immediately begin to engage a wide range of experts, advocates, and stakeholders to adopt timelines for ending AIDS as an epidemic in the United States and globally.

• Work to fully implement and strengthen the National HIV/AIDS Strategy to meet these timelines. Clinton’s Office of National HIV/AIDS Policy will work to fully implement the National HIV/AIDS Strategy, and strengthen it to align with the timelines developed for ending AIDS as an epidemic. Particular emphasis will be placed on expanding evidenced-based prevention, treatment, and community outreach initiatives for at-risk groups, including black men who have sex with men (MSM), transgender individuals, African American women, and injection drug users. She will also account for regional variations, like the particular needs of the southeast corridor of the United States.

• Launch a campaign to end the stigma and discrimination associated with HIV and AIDS. Nearly 40 years have passed since the HIV/AIDS crisis first began, and yet even with everything we have learned, intolerance and stigma still exist. This stigma manifests itself in our criminal laws, and also serves as a barrier to effective prevention and treatment. That’s why, as president, Clinton will launch a campaign to end stigma associated with HIV/AIDS. She will work to reform outdated HIV criminalization laws, aggressively enforce the Americans with Disabilities Act, and partner with advocacy groups and community organizations to conduct public education.

Daniel Driffin’s address can be viewed here: https://youtu.be/tEISxyexaeg
His remarks are transcribed below: 

DANIEL DRIFFIN:

“Good afternoon. I live in Atlanta, Georgia and I serve as the co-founder of THRIVE SS. Together with more than one million Americans, I’m living with HIV. When the HIV/AIDS epidemic first emerged in the 1980’s, I was not born yet. It was a mysterious virus, then a deadly one too. It seemed to be picking off gay men one by one, especially black and Latino.

The community spoke out so that policymakers would take notice. And while summoning their voices, Hillary Clinton listened. She advocated for the increased funding for prevention and research as first lady. Then worked to increase the funding in the Senate. She defended the rhyme white care act and expanded researchers in testing and education. As secretary of state, Hillary helped to ensure that 6.7 million people around the world got access to antiretroviral therapy. And she cracked down on the stigma around the virus and helped lift the travel ban with the help of the Congressional Black Caucus, which presented people with HIV/AIDS from entering our country. As a result of her work and the work of so many others, many of whom are here tonight, the number of new HIV/AIDS diagnoses are on the decline in the United States by nearly 20 percent over the last decade for certain populations.

We know how to prevent the virus now. We know how to diagnose the virus now. We know how to treat it and we know how to suppress it. We have learned all that within my lifetime. But still, there are many living with HIV. And who are most at risk? Young, gay, black men. Men like me. In fact one in two gay black men will be diagnosed with HIV in their lifetime if current rates continue. And if we have enough data, I’m sure black transgender women are more at risk too.

So, what do we do to fight HIV/AIDS today? We invest in research and education. Expand treatment and prevention. And we elect Hillary Clinton. With Hillary Clinton as our president, I believe that we can meet our goals of an AIDS-free generation. So, as an organizer, as an advocate, as a black man, as a gay man, and as a man living with HIV, I ask you to go get tested, and then go and vote.”

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