The Division of HIV/AIDS Prevention is pleased to present its Strategic Plan 2011-2015. The Plan encompasses all aspect of the Division's work and will serve as a practical guide to inform development of work plans to ensure DHAP activities and resources are aligned with its priorities.

Living with HIV: A Patient's Guide, Second Edition builds on the success of the first edition by updating and adding critical information that will help the newly diagnosed adjust to their illness and the long-term survivor improve their life and supplement their foundation of HIV knowledge. In addition, new and useful topics have been added including the most complete medication information for even the latest medications to hit the market. The book discusses the growing practice of using HIV medication as a prevention method; PrEP as it is commonly called. Finally, there is essential information needed by those people living with HIV that use the wealth of information on the Internet to help them live a longer, healthier life. The second edition is written in an easy to understand, clear-cut style that makes it easy for anyone; from the long-term patient to the newly infected; to understand what it takes to live a healthy life with HIV.

How are we to appreciate and comprehend what it has been like to live with HIV and AIDS-related illness over the past three decades or more? When the AIDS pandemic began in the early 1980s, scientific knowledge and medical treatment had a limiting effect on quality of life and life expectancy for people living with HIV and AIDS-related illness. During this era the very idea of AIDS signified fear, panic, stigma, prejudice, acute chronic illness and the real threat of imminent death both within and outside of a UK context. As the global expansion of HIV scientific knowledge continues to develop, we observe a dramatic change in how the medical community defines HIV as a disease. The term AIDS has been largely discarded in the West and we resist the 'death sentence' scenario; instead we approach HIV as a chronic illness condition. With effective HIV combination therapies now available to those who can afford and access them, the successful management of HIV is perceived as within our reach. This story-of-stories brings together twenty eight long-term survivors all of whom were diagnosed between 1981 and 1994 prior to the advancement of HIV medicine; in some cases even before medical health checks for HIV, such as the CD4 count and viral load test were available. It is a passionate story-of-stories allowing the reader to become intimate with each story-teller who shared their personal experiences of living long-term with HIV and AIDS within a UK context: this is their gift We unearth how our story-tellers negotiated and managed everyday life living with this unpredictable illness condition based on in-depth interviews conducted during 2002. These poignant personal stories historically reflect upon long-term experiences of women and men living alongside HIV and AIDS-related illness; they show us how real people made sense of their lives and continued to 'live out' everyday life in the UK. It is a thorough and passionate portrayal of personal experiences revealed by the spirited women and men who took time out of their own lives to offer a valuable contribution to further public understanding of this stigmatised disease. By offering insights into different personal experiences of those who have lived long-term with an HIV-positive diagnosis, readers can appreciate and recognise the many ways of being HIV-positive. Chapter one explores how concepts such as health, illness and identity can be defined and how shared meanings differ between people who use these concepts on a daily basis. It also furnishes the reader with a brief history of HIV and AIDS to set the backdrop for how we should understand the potential dilemmas of living with a HIV-positive diagnosis during earlier more ignorant times. Chapter two reveals how story-tellers learned of their HIV-positive diagnosis. Chapter three examines the early years of living with HIV and explains how our story-tellers managed uncertainty. Chapter four discloses how sickness and health was negotiated and experienced before HIV medicine became more effective. In chapter five our story-tellers speak of how intimate and sexual relationships are experienced in the context of HIV. Chapters six and seven critically expose how long-term survivors experienced and negotiated complex and highly toxic combination therapies for the treatment of HIV in conjunction with relationships with the medical profession in earlier times. Chapter eight uncovers how networks of social support were negotiated and experienced over time. Following this, we reveal in chapter nine the positive and negative elements of living long-term with HIV or AIDS diagnoses. The final chapter delves into my own experiences as the researcher for the initial HIV study. The book offers an extensive glossary of medical terms at the back to assist readers in medical terms and words associated with HIV and AIDS.

Telling the story of a clinical trial testing an innovative gel designed to prevent women from contracting HIV, Negotiating Pharmaceutical Uncertainty provides new insight into the complex and contradictory relationship between medical researchers and their subjects. Although clinical trials attempt to control and monitor participants' bodies, Saethre and Stadler argue that the inherent uncertainty of medical testing can create unanticipated opportunities for women to exercise control over their health, sexuality, and social relationships. Combining a critical analysis of the social production of biomedical knowledge and technologies with a detailed ethnography of the lives of female South African trial participants, this book brings to light issues of economic insecurity, racial disparities, and spiritual insecurities of Johannesburg's townships. Built on a series of tales ranging from strategy sessions at the National Institutes of Health to witchcraft accusations against the trial, Negotiating Pharmaceutical Uncertainty illuminates the everyday social lives of clinical trials. As embedded anthropologists, Saethre and Stadler provide a unique and nuanced perspective of the reality of a clinical trial that is often hidden from view.

This first-person account by one of the pioneers of HIV/AIDS research chronicles the interaction among the pediatric HIV/AIDS community, regulatory bodies, governments, and activists over more than three decades. After the discovery of AIDS in a handful of infants in 1981, the next fifteen years showed remarkable scientific progress in prevention and treatment, although blood banks, drug companies, and bureaucrats were often slow to act. 1996 was a watershed year when scientific and clinical HIV experts called for treating all HIV-infected individuals with potent triple combinations of antiretroviral drugs that had been proven effective. Aggressive implementation of prevention and treatment in the United States led to marked declines in the number of HIV-related deaths, fewer new infections and hospital visits, and fewer than one hundred infants born infected each year. Inexplicably, the World Health Organization recommended withholding treatment for the majority of HIV-infected individuals in poor countries, and clinical researchers embarked on studies to evaluate inferior treatment approaches even while the pandemic continued to claim the lives of millions of women and children. Why did it take an additional twenty years for international health organizations to recommend the treatment and prevention measures that had had such a profound impact on the pandemic in wealthy countries? The surprising answers are likely to be debated by medical historians and ethicists. At last, in 2015, came a universal call for treating all HIV-infected individuals with triple-combination antiretroviral drugs. But this can only be accomplished if the mistakes of the past are rectified. The book ends with recommendations on how the pediatric HIV/AIDS epidemic can finally be brought to an end.

This first-person account by one of the pioneers of HIV/AIDS research chronicles the interaction among the pediatric HIV/AIDS community, regulatory bodies, governments, and activists over more than three decades. After the discovery of AIDS in a handful of infants in 1981, the next fifteen years showed remarkable scientific progress in prevention and treatment, although blood banks, drug companies, and bureaucrats were often slow to act. 1996 was a watershed year when scientific and clinical HIV experts called for treating all HIV-infected individuals with potent triple combinations of antiretroviral drugs that had been proven effective. Aggressive implementation of prevention and treatment in the United States led to marked declines in the number of HIV-related deaths, fewer new infections and hospital visits, and fewer than one hundred infants born infected each year. Inexplicably, the World Health Organization recommended withholding treatment for the majority of HIV-infected individuals in poor countries, and clinical researchers embarked on studies to evaluate inferior treatment approaches even while the pandemic continued to claim the lives of millions of women and children. Why did it take an additional twenty years for international health organizations to recommend the treatment and prevention measures that had had such a profound impact on the pandemic in wealthy countries? The surprising answers are likely to be debated by medical historians and ethicists. At last, in 2015, came a universal call for treating all HIV-infected individuals with triple-combination antiretroviral drugs. But this can only be accomplished if the mistakes of the past are rectified. The book ends with recommendations on how the pediatric HIV/AIDS epidemic can finally be brought to an end.

Telling the story of a clinical trial testing an innovative gel designed to prevent women from contracting HIV, Negotiating Pharmaceutical Uncertainty provides new insight into the complex and contradictory relationship between medical researchers and their subjects. Although clinical trials attempt to control and monitor participants' bodies, Saethre and Stadler argue that the inherent uncertainty of medical testing can create unanticipated opportunities for women to exercise control over their health, sexuality, and social relationships. Combining a critical analysis of the social production of biomedical knowledge and technologies with a detailed ethnography of the lives of female South African trial participants, this book brings to light issues of economic insecurity, racial disparities, and spiritual insecurities of Johannesburg's townships. Built on a series of tales ranging from strategy sessions at the National Institutes of Health to witchcraft accusations against the trial, Negotiating Pharmaceutical Uncertainty illuminates the everyday social lives of clinical trials. As embedded anthropologists, Saethre and Stadler provide a unique and nuanced perspective of the reality of a clinical trial that is often hidden from view.

The fifth edition of HIV and Aids: Education, care and counselling covers recent changes and advances in the field of HIV and AIDS treatment and care. These include a new emphasis on education, the latest statistics and the interpretation thereof; new updated biomedical information on vaccine research and testing, drug resistance (HIV and TB) and antiretroviral therapy; the standardised guidelines for antiretroviral treatment as recommended by the South African Department of Health, as well as strategies for adherence counselling. Section on children's law and it implication, and theories of behaviour change are new. The fifth edition contains many practical examples, exercises, activities, case studies and tips to assure full integration of theory and practical. It also comes with a support CD for readers.

The Ryan White HIV/AIDS Program was borne of a movement that began with the onset of the AIDS epidemic in America. First by the tens, then by the hundreds, then by the thousands, brave and commit-ted people from all walks of life made a decision to get involved. Some were public health officials; others were activists. Some were community leaders, and others-at least until that time-were citizens quietly living their lives. In this sixth edition of the U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) Progress Report, we celebrate the legacy of those first responders. We also celebrate the incredible journey we have taken since 1990, when the first Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was passed into law. Who could have imagined in those early years that we would one day have treatments powerful enough to forestall the progression of HIV/AIDS? Who could have known that we would touch so many lives? This year alone, through scores of grantees and providers* in cities and towns across America, the Ryan White HIV/ AIDS Program will serve well over half a million people. We continue to face hurdles in our fight against the epidemic, but we have made enormous progress. Highlights from this year include the following: At $2.29 billion, FY 2010 appropriations for the Program were the largest in Program history; Our AIDS Education and Training Centers (AETCs) conducted more than 18,000 trainings; Under the AIDS Drug Assistance Program (ADAP), we distributed medications to more than 175,000 clients; We treated the people most disproportionately affected by HIV: 73 percent of our clients were racial and ethnic minorities, and 88 percent of our clients had no private health insurance; We conducted research on innovative, replicable models of HIV care to reduce health disparities in women of color, improve access to oral health care, establish linkages between jail settings and HIV primary care, and expand health information technology and electronic medical systems; We have been involved in the Healthy People 2010 broad-based national collaborative to meet the Nation's most pressing health needs; We continue to set the standard for HIV/AIDS care using well-respected performance measures. This response to HIV/AIDS constitutes nothing less than a modern public health miracle. . . and within it lie other miracles, too-like that of an HIV-positive person living into old age, or the promising future that unfolds before the eyes of an HIV-positive adolescent. In this publication, you will read about many of the milestones we have encountered in our 20-year journey and the many qualities that make our team successful. We embarked on a quest that many would not. We stepped up to the plate when others stepped away. And today we constitute a powerful and cohesive force seldom seen in combating a single disease. Our rewards lie in victory after victory over isolation and disease and in the improved lives of our clients. It has been an amazing and empowering journey, and it is not over. We are trained. We are committed. We are full of resolve. And we will not stop. In this Progress Report, we remember and we honor the determination of those first responders and of Ryan White himself. It was the determination to go the distance for people living with HIV/AIDS, what-ever it took and whatever the cost. That determination has never been more alive than it is today.

"Making a Difference " has been developed to help community members to become involved in local decision making that will determine what HIV services are available in their community. While this Consumer Digest may be helpful to many types of community members, its primary purpose is to support persons living with HIV disease to be effective participants on Ryan White planning bodies. Whether you already are involved in your planning body process or wish to learn more before Making the Commitment to get involved, Making a Difference can help you. The CARE Act (Comprehensive AIDS Resources Emergency) is the Federal law that provides money to cities, States, community-based organizations and other types of organizations to provide HIV services. The CARE Act specifically requires that HIV services planning bodies include persons living with HIV disease. These Title I planning councils and Title II planning bodies and consortia (collectively referred to as Ryan White planning bodies throughout this document) have a big impact on determining the types of HIV services - and which specific programs - are available in a community. In recent years, Congress has appropriated (or designated) funding in the range of $2 billion per year to support HIV health services through the CARE Act. Much of this money is distributed to States and local governments that rely on planning bodies to help them identify who is affected by the HIV epidemic, set priorities for the types of HIV services that are needed, and determine how best to allocate funding among multiple priorities. Persons living with HIV disease (PLWH) are critical to the success of these planning processes because they bring a perspective that is different from other members and know firsthand what services are needed. They also can help make sure that different groups of PLWH are included in the process and that their service needs are not overlooked. The Health Resources and Services Administration's (HRSA) HIV/AIDS Bureau (HAB) is the Federal agency responsible for administering the CARE Act. HAB produced this Consumer Digest with the assistance of PLWH members of planning bodies and PLWH trainers at national HIV/AIDS organizations. This document provides new information regarding the CARE Act Amendments of 2000 related to PLWH involvement, and draws upon other publications and materials useful to PLWH on (or considering serving on) a planning body. This digest is intended to provide you with information and tools to help you Make a Difference by serving your community as an active and informed member of a Ryan White planning body.

What ideas are overlooked in contemporary feminist politics? How do particular issues become part of the feminist agenda? Why do we need to think about how feminists imagine and actualize their political objectives?This book explores these questions through the notion of oversight—a concept used both to consider what has been overlooked and to examine how particular objects of feminist politics become visible in the first place. Through chapters that focus on realities lived by trans women, Viviane Namaste explores diverse case studies and facets of political life: women’s labour, the archiving of everyday life, the history of HIV, urban development and displacement, bisexualities, and the culture of feminist activists themselves.Oversight suggests that feminists need to engage in careful, deep reflection on how feminist knowledge comes into being. This book will be of interest to scholars in women’s and gender studies, community development, sociology, social work, geography, history, and sexuality studies. Its accessible tone, pedagogical questions, and suggested readings make it well suited to classroom use. Its exploration of activist culture will be of particular interest to advocates of social justice both inside and outside of the university.All royalties from the sale of this book will be donated to the Emergency Relief Fund of PASAN—Prisoners’ HIV/AIDS Support Action Network. This fund helps support individuals who are newly released from jail and who need financial resources for housing, food, medications, and the replacement of identity documents.

The Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB), Division of Service Systems (DSS), is pleased to offer this manual to Ryan White CARE Act Title II grantees and planning bodies. This publication replaces the Ryan White CARE Act Title II Manual that was distributed after the CARE Act was first reauthorized in 1996. On October 20, 2000 Public Law 106-345, reauthorized the Ryan White CARE Act for a second time, with provisions that affect all CARE Act programs. This manual has incorporated all new provisions affecting the Title II program. This manual is intended for the use of grantees, planning bodies and people living with HIV disease. However, we encourage you to share it with colleagues and peers involved in all aspects of the Ryan White Title I program in your area. The manual is designed to encourage local photocopying and distribution: each section has its own cover and chapters that deal with specific topics in depth. Each section, and chapters within them, can be copied and circulated as standalone documents. This manual contains nine sections. Section One, General Information, contains information that is useful to all readers, such as an overview of the CARE Act, CARE Act 2000 legislation, summary of changes to the Title II program, a description of DSS, and an overview of technical assistance for grantees and planning bodies. Section Two, Grants Administration, includes updated information on local administration of the CARE Act as well as guidance on Maintenance of Effort. Section Three, Reporting Requirements, is new for this manual and provides in-depth history and instructions on reports that HAB/DSS requires of grantees, including allocations reports; budgeting, contracting, and fiscal reports; Minority AIDS Initiative (MAI) reports; and the new CARE Act Data Report (CADR). Sample repot forms are included. Section Four, Policies, is a complete list of Program Policy Guidance and Policy Notes that have been issued by HAB and DSS since the inception of the CARE Act. Section Five, Title II Program Categories, outlines program areas under Title II, which are designed to give States flexibility in meeting their needs. Section Six, Planning Bodies, provides materials to help Title II planning entities function more effectively. Section Seven, Coordination, reviews the various ways that Title II can coordinate in planning, funding of services, and service delivery. Section Eight, Program Guidance, presents updated legislation, DSS expectations and implementation suggestions on issues such as: needs assessment, comprehensive planning, quality management, early intervention services, and priority setting and resource allocation. Section Nine, Chief Elected Official Guide, is new for this manual and gives the reader a better understanding of the relationship of the CEO to the grantee and planning bodies. It covers both Title I and Title II CEO duties. Section Ten contains definitions and acronyms and a listing of approved service category definitions. Section Eleven is a listing of HRSA/HAB offices and Title II grantees. Points to Remember: This manual provides a practical, "how to" guide for many aspects of the Title II program. While the hope is that the manual will be a stand alone document, there are other manuals and resources such as the: Title I Manual, CARE Act Needs Assessment Guide, Training Guide: Preparing Planning Body Members, and Self Assessment Modules, as well as other HRSA publications that will supplement the information presented here; A reference list is included at the end of each chapter in the manual. Another excellent source of information and guidance for grantees and planning councils is the HAB website that is continually updated (see http: //hab.hrsa.gov); There will be continual updates and inserts sent to the Title II CARE Act community to keep your manuals as up to date as possible.

State ADAPs function as important components of Title II service systems, yet most State ADAPs are also large and complex enough to merit their own staff resources. As of January 2002, 78 percent of the States have separate individuals (or groups of individuals) administering the Title II program and the State ADAP. Given the unique role of ADAPs in the Ryan White service delivery system, HRSA prepared the ADAP Manual to assist ADAPs with their distinct issues and requirements. The ADAP Manual is meant to complement the information provided in the Ryan White CARE Act Title II Manual. ADAP-specific information from the Title II Manual has been reproduced and, in most cases, has been expanded upon and enhanced. Other areas, such as the Section 340B Drug Discount Program, are unique to the ADAP Manual. All of the information contained in this manual is designed to assist State ADAP coordinators, Title II directors, and others involved with improving access to HIV medications for low-income individuals. Some chapters of the ADAP Manual are taken directly from the Title II Manual. For a comprehensive understanding of the Title II program, however, the two manuals should be used together. Each chapter begins with a chapter summary for quick reference. In addition, each chapter includes a list of sources used and a reference list for further information.

This document is to help the CARE Act1 community conduct needs assessments so that they can better plan on how to use CARE Act resources to fill gaps in care. It describes the process of needs assessment and provides "how-to" information about tasks ranging from developing an epidemiologic profile to estimating the need for services. The Guide provides: Legislative requirements and HIV/AIDS Bureau (HAB) expectations for each CARE Act title; Types of needs assessment information; Steps in conducting a comprehensive needs assessment; Practical guidance on how to: Prepare an epidemiologic profile; Collect and use surrogate markers for HIV/AIDS, such as co-morbidity data; Collect information from people living with HIV disease (PLWH) and other community representatives through focus groups, surveys, interviews, and community forums; Prepare a resource inventory; Conduct an assessment of provider capacity/capability, and Assess service needs. Ways to use needs assessment results in decision making; The experiences of CARE Act Titles I, II, III, and IV grantees nationwide, and; Information on special HAB needs assessment initiatives (i.e., preparing a joint epidemiologic profile with an HIV prevention community planning body, developing a framework for estimating unmet need). The Needs Assessment Guide was designed for use by all CARE Act titles and can provide a common approach to needs assessment that facilitates cross-title collaboration. Input on its content was provided by HAB staff and a Field Review Group. Title I and Title II needs assessments typically involve planning bodies-Title I HIV services planning councils and Title II regional consortia or Statewide planning entities. Therefore, the roles of planning bodies are described throughout. For Title III or Title IV, the planning body may be an agency's planning committee or executive committee. Many programs also establish advisory bodies that include community and PLWH participation-or there may be no planning body involvement.