Living History Timeline

2019

HRSA Plays a Leading Role in Ending the HIV Epidemic

HRSA meeting with community health leaders in South Carolina in July 2019 to discuss the Ending the HIV Epidemic: A Plan for America initiative and the progress made toward ending the HIV epidemic in the state. Left to right: Dr. Eric Schlueter, Chief Medical Officer, Eau Claire Cooperative Health Center (ECCHC), Peatra Cruz, Chief Organizational Development and Communications, ECCHC, Mulamba Lunda, Regional Director, Ryan White HIV/AIDS Program & Prevention Programs, ECCHC, Jim Macrae, Associate Administrator, Bureau of Primary Health Care, HRSA, Lisa Mariani, Regional Administrator, Office of Regional Operations – Region 4, HRSA, Dr. Laura Cheever, Associate Administrator, HIV/AIDS Bureau, HRSA, Lathran Woodard, CEO, South Carolina Primary Care Association.

The Health Resources and Services Administration (HRSA) is one of five federal agencies within the U.S. Department of Health & Human Services leading a new nationwide initiative to end the HIV epidemic by 2030

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2018

Data and Innovation to End the HIV Epidemic

Alex Azar, HHS Secretary

Approximately 4,000 HIV healthcare providers, HRSA’s Ryan White HIV/AIDS Program recipients and subrecipients, partners, people living with HIV (PLWH), other stakeholders, and members of the general public gathered for the 2018 National Ryan White Conference on HIV Care & Treatment.

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2017

HIV and Hepatitis C Coinfection

Doctor and patient

Approximately one in five people living with HIV (PLWH) is coinfected with the hepatitis C virus (HCV), and hepatitis C-related liver disease has become one of the leading causes of non-AIDS-related death among PLWH.

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2016

HRSA’s Efforts to Achieve the Goals of the National HIV/AIDS Strategy

The 2016 National Ryan White Conference

The National HIV/AIDS Strategy (the Strategy) is a 5-year plan to reduce new HIV infections, improve health outcomes, reduce disparities, and achieve a more coordinated national response to the HIV epidemic.

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Optimizing Health Outcomes

Doctor and chart

Today over 1.2 million people in the United States are living with HIV - one in eight people living with HIV don't know it.

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2015

Celebrating 25 Years of Passion, Purpose, and Excellence

25 Years, Ryan White HIV/AIDS Program

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, the legislation that created the Ryan White HIV/AIDS Program (RWHAP), celebrates 25 years of providing comprehensive care for people living with HIV (PLWH) in 2015.

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2014

HIV Care Continuum One Step Closer to an AIDS-free Generation

Optimal HIV care and treatment for all

The continuum of engagement in care (later changed to the HIV Care Continuum) was a phrase used by Dr. Laura Cheever, HRSA’s Associate Administrator for the HIV/AIDS Bureau, in her seminal 2007 editorial to describe the fluid nature of HIV health care delivery and patient experience.

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2013

High-Impact Prevention

Photo of an African American woman with a health care professional

Current prevention strategies are drastically reducing the number of annual HIV infections.

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2012

Care is Prevention

Photo of two African American health care professionals

The future has never looked brighter for people living with HIV/AIDS (PLWHA) in the United States.

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2011

30 Years of AIDS: Honoring the Past, Looking Toward the Future

Photo of a portion of the AIDS quilt

June 5, 2011, marked the passing of 30 years since AIDS was first recognized as a public health concern in a 1981 article published in a Morbidity and Mortality Weekly Report about a handful of gay men in several large cities who contracted rare infections.

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The Road Ahead

Female in lab coat looking in microscope

With no AIDS vaccine and no cure, the road ahead is familiar. We must continue our assault on barriers to care.

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2010

20 Years and a Legacy of Care

Going the distance

Twenty years ago, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was passed into law.

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2009

Improving Performance Data

2009 image

The Ryan White HIV/AIDS Treatment Extension Act of 2009 contains implicit guidance to the HIV/AIDS Bureau (HAB) to collect client-level, or name-based, data. Grantees and service providers now complete the Ryan White HIV/AIDS Program Services Report (RSR) detailing information on all the clients served during a calendar year.

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2008

Continuing Work on Re-entry Programs

Doctor examining patient

The rate of incarceration among people living with HIV disease has long been alarming: 1 in 4 people with HIV have been in a correctional setting at some point in their lives.

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2007

New Policies— Waves of Change

Buildings

The year 2007 was one of monumental change.

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2006

The CARE Act Makeover

Child at HIV/Aids walk

The Ryan White CARE Act was renamed the Ryan White HIV/AIDS Treatment Modernization Act of 2006 on December 19, 2006.

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New Approaches

25th anniversary of the AIDS

The world observed the 25th anniversary of the AIDS epidemic in June 2006.

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2005

New Treatment for Addiction

Staff at the Tarzana Treatment Center in Los Angeles meet to discuss the week’s activities. Tarzana, a Ryan White HIV/AIDS Program grantee, provides HIV/AIDS services for people also dealing with substance abuse.

HIV/AIDS poses serious challenges both to people living with the disease and to their care providers.

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2004

HRSA Addresses Severity of Need

This man is a resident at a Los Angeles shelter. Homelessness is seen with alarming frequency among PLWHA and is one of many factors related to severity of need.

In the 2000 reauthorization of the Ryan White HIV/AIDS Program, Congress asked the Institute of Medicine (IOM) to report on...

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2003

Global HIV/AIDS Program Begins

An HIV-positive woman prepares an AIDS symbol to be used in an International AIDS Candlelight Memorial in the Philippines.

In 2003, HRSA’s HIV/AIDS Bureau took a major step to broaden its mission by establishing a Global AIDS Program.

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2002

CARE Act Expertise Goes Global

In 2002 FDA approved the first rapid HIV test using blood drawn from a finger stick and granted permission to use it outside the laboratory, promoting fast, widespread adoption.

In 2002 HRSA and the Centers for Disease Control and Prevention (CDC) established the International Training and Education Center on HIV, known as I-TECH.

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2001

HRSA Publishes Treatment Guide for Women

Women march for AIDS relief outside the United Nations in New York City.

<em>A Guide to the Clinical Care of Women With HIV/AIDS</em>, published by HRSA in 2001, is now the primary textbook on the treatment of women with HIV the world over.

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A New Millennium

HIV/AIDS services

By 2001, HRSA had been providing HIV/AIDS services for more than 15 years.

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2000

Reauthorization Focuses on People Not in Care

The CDC reported that as many as 1 in 4 people with HIV know they are HIV positive but are not receiving regular medical attention.

On July 25, 2000, the CARE Act was reauthorized with many new provisions aimed at enhancing health outcomes and reaching the hundreds of thousands of PLWHA not receiving appropriate services.

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1999

Minority AIDS Initiative is Launched

Surgeon General David Satcher, left, speaks with Louis Sullivan, president, Morehouse School of Medicine, at a conference to mobilize African-Americans around the rising threat of AIDS in their communities.

By 1999, African-Americans made up only 13 percent of the U.S. population but accounted for 43 percent of all new AIDS cases.

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1998

Administration Addresses Epidemic in Minorities

The Minority AIDS Initiative is created in response to the disproportionate impact of HIV/AIDS on racial and ethnic populations in the United States.

Minority Leaders Work to Address AIDS. In the mid-1990s, the prevalence of AIDS rose to alarming levels in some minority communities.

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1997

Programs Unite Under One Umbrella

The red ribbon was the creation of the Visual AIDS Artists Caucus in New York, which was searching for a visual symbol to show compassion for people living with AIDS and their caregivers. First worn publicly at the Tony Awards in 1991, it continues to be a powerful force in the fight to increase public awareness of HIV/AIDS and to increase funding for AIDS services and research.

Many advocates and people living with HIV/AIDS (PLWHA) who pressed so tirelessly for Federal action in the first decade of the AIDS epidemic did not live long enough to see the second.

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1996

CARE Act Is Reauthorized for a 5-Year Period

In 1996, Time Magazine named AIDS researcher David Ho Man of the Year. Recognizing the dynamic nature of HIV replication in the body, Ho and his coworkers were early proponents of combination antiretroviral therapy, including use of protease inhibitors.

In 1996, in a major victory for the HIV/AIDS community, the Ryan White CARE Act was reauthorized through the year 2000.

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Adapting to Change

Adapting to Change

In December 1995, encouraging clinical trial results moved the FDA to quickly approve a new drug to be used in combination with others.

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1995

The Age of Combination Therapy Arrives

HAART was approved by the FDA in 1995 because and becomes widely available 1 year later.

In a development that would forever change the HIV/AIDS treatment landscape, the FDA approved an open label study of saquinavir in June 1995.

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1994

AZT Is Found to Protect Newborns From HIV

AIDS rates among minorities dwarfed those among Whites, with the number of cases per 100,000 at 100.8 for Blacks, 51.0 for Hispanics, and 17.2 for Whites.

HRSA Launches Massive Effort to Disseminate Findings. Findings from the AIDS Clinical Trial Group (ACTG) 076 demonstrated that with a particular regimen of AZT (zidovudine), the incidence of perinatal HIV transmission plummeted from 22.6 to 7.6 percent.

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1993

Largest Epicenters Now Number 25

From 1992 to 1993, reported AIDS cases in the US more than doubled, from 47,572 to 106,949.

With AIDS incidence and mortality skyrocketing, seven more metropolitan regions became eligible for Title I (Part A) funding as Eligible Metropolitan Areas (EMAs), bringing the total number of EMAs to 25.

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1992

Training Creates Access to Expert Care

The National AIDS Memorial Grove Located in San Francisco’s Golden Gate Park

In the 6 years following the launch of its first AIDS program, one of HRSA’s top priorities was to take HIV/AIDS service delivery knowledge back into the community.

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1991

HRSA Awards First CARE Act Grants

In 1991 NBA basketball player Earvin “Magic” Johnson

With ink barely dry on the new Ryan White CARE Act, HRSA distributed its first grants in April 1991.

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The Early Years

The Early Years

The Comprehensive AIDS Resources Emergency (CARE) Act of 1990 brought hope in an environment of loss.

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1990

CARE Act Is Adopted, Named for Indiana Teen

Ryan White at age 14 adjusting an earphone for simultaneous translation during a live interview in Rome.

On August 18, 1990, by wide bipartisan margins, both houses of Congress passed the groundbreaking Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, named for an Indiana teen who lost his life to AIDS. By the time the bill became law, more than 150,000 U.S. AIDS cases had been reported in the United States. More than 100,000 had died.*

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1989

HRSA Funds Move Outside Epicenters

From 1988 to 1989, AIDS rates skyrocketed 32.6 percent in nonurban areas versus 4.2 percent in cities, signaling the epidemic’s reach into communities large and small.1

In fiscal year 1989, HRSA appropriated a total of $3.9 million in Low Prevalence Planning Grants to 22 grantees.

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1988

Pediatric AIDS Grants Begins

This poster, inspired by Ryan White, became one of the most effective images used to promote AIDS awareness.

Funding Set at $5 Million for First Year. In the first years of HIV/AIDS, some believed that perinatal transmission was not a risk factor for HIV. In his blockbuster book, And the Band Played On, Randy Shilts documents a meeting in which a clinician reporting HIV infection among his infant patients was regarded with suspicion.

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1987

AZT Reimbursement Program Launches

The AIDS Memorial Quilt was first displayed on the National Mall in Washington, DC, in October 1987.1

On March 20, 1987, the HIV/AIDS community received news that a powerful breakthrough in HIV treatment had been achieved.

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1986

HRSA Debuts First AIDS Program

U.S. Surgeon General C. Everett Koop applauded HRSA’s AIDS Demonstration Grants: These projects emphasize case management and a coordinated approach to caregiving, by bringing together local, State, and Federal resources. . . . What we learn from these demonstration projects will be very helpful to us in assisting other States and localities to understand their needs and to respond to their problems.1

The AIDS Service Demonstration Grants marked HRSA’s first AIDS-specific health initiative.

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Toward Passage

Senate Chaplain Reverend Richard C. Halverson, D.D.

On the morning of May 16, 1990, as the Senate prepared to debate, the Senate Chaplain Reverend Richard C. Halverson, D.D. noted in his morning prayer that "rarely will the Senate be called upon to deal with an issue more complicated by prejudice, fear, and emotion, nor more presently or potentially destructive, than the issue of AIDS."

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