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Quotation Marks
…the HIV epidemic in the U.S. has transformed over the last 30 years.

Advocacy

The Communities Advocating for Emergency AIDS Relief (CAEAR) Coalition’s advocacy work focuses on how the components of the Ryan White HIV/AIDS Program (RWHAP) can best address the service needs and improve the health status of people living with HIV.

The Ryan White system of care and support services is exemplary. It increases access to HIV-related health services for underserved populations, improves survival, and reduces HIV transmissions. Despite the success of the Ryan White, the United States is not on target to meet the global HIV goals where 95% of people with HIV know their status, 95% receive treatment, and 95% are virally suppressed by 2025. Reasons include the complexity of the U.S. healthcare and public health systems, health disparities, racial and gender inequities, and underfunded federal HIV/AIDS programs.

In addition, the HIV epidemic in the U.S. has transformed over the last 30 years. The current state includes a change of demographics of those who are newly diagnosed, an aging population of people with HIV, and biomedical care and prevention advancements have impacted service delivery models and systems. At this juncture in the HIV epidemic, the key to ending it is a commitment to addressing social determinants of health and embracing a syndemic approach to tackle the intersection of HIV, homelessness and housing instability, sexually transmitted infections, hepatitis C, substance use, and mental health.

Advocacy Agenda

The CAEAR Coalition’s new Advocacy Agenda details the organization’s updated priorities and provides a blueprint for its work. Developed through a community-driven process, the agenda formally expands the Coalition’s advocacy efforts to ensure a system of care and services that promotes optimal health for all. The CAEAR Coalition’s six main advocacy priorities are outlined below.

The CAEAR Coalition will focus on increasing federal HIV resources and modernizing the Ryan White HIV/AIDS Program. The modernization will include working with HRSA-HAB to improve the program’s flexibility and address administrative burdens. In addition, CAEAR will work to better integrate federal HIV care and prevention programs including efforts to address sexually transmitted infections, hepatitis C, substance use, and ways to address the housing needs of people living with HIV.

Email CAEAR to learn on how you can participate in the implementation of the Advocacy Agenda.

Appropriations

The CAEAR Coalition is actively advocating for increased federal appropriations for the Ryan White Program and the End the Epidemic (EHE) Initiative. Efforts include organizing grassroots efforts and educating members of Congress about the need for increased resources. CAEAR Coalition members meet with key Congressional leaders in Washington, DC, several times a year. At these meetings, the CAEAR Coalition reviews the success of the Ryan White Program and EHE Initiative and outlines strategic ways to strengthen these programs, noting the need to find ways to best leverage successes to continue the nation’s efforts to reduce HIV incidence and HIV-related health disparities and to increase access to care. Read the CAEAR Coalition’s Congressional Hill Visits Primer. CAEAR will post updated talking points and fact sheets on this webpage when the next Congressional Hill visits are planned.

Reauthorization

The CAEAR Coalition strongly believes it is neither advised nor prudent to reauthorize the Ryan White CARE Act in the current divisive political environment; therefore, it will not pursue this course of action in the near future. If the political landscape improves and the community agrees to such a pursuit, the CAEAR Coalition will engage in its historic role of convening the community to develop a reauthorization plan.

Advocacy Priorities

Priority 1: Ensure the Voice of the Community Remains a Central Component of the Federal Response to the HIV Epidemic in the U.S.
The hallmark of the CAEAR Coalition’s advocacy work for the past 30+ years has been its commitment to ensuring the community plays an active role in shaping local and federal HIV/AIDS policy. The Coalition will continue to embrace this responsibility and will work to ensure this is the lens from which all advocacy and policy work will be developed and implemented.

Priority 2: Increase Federal HIV/AIDS Resources
The CAEAR Coalition will advocate to increase appropriations for the Ryan White HIV/AIDS Program (RWHAP) and the End the HIV Epidemic (EHE) Initiative. In addition, CAEAR will seek to expand the EHE Initiative to add the Ryan White Part A jurisdictions that are not currently included. These efforts will ensure RWHAP and EHE services reach more people with HIV, especially people of color and those who are not virally suppressed.

Priority 3: Reduce the Administrative Burdens and Increase Flexibility of the RWHAP and EHE Initiative
Working with the community and Ryan White Part A jurisdictions, the CAEAR Coalition will identify programmatic roadblocks and work directly with HRSA-HAB to increase flexibility and reduce administrative burdens. The CAEAR Coalition will also serve as a liaison with HRSA-HAB to clarify policies and procedures, identify needed technical assistance, and address the need to streamline data systems and processes.

Priority 4: Promote the Integration of Federal HIV Care and Prevention Efforts
Key to ending the HIV epidemic is for individuals with HIV to know their status and to link them to ongoing care and prevention services. This linkage enables longer, healthier lives and reduces the risk of transmission. The CAEAR Coalition believes a more collaborative and integrated relationship is needed between HRSA-HAB (care) and CDC (prevention) to optimize the power of linkage-to-care to end the epidemic. The Coalition will tap its strong relationship with HRSA-HAB to find ways to improve the integration of its work with the CDC’s Division of HIV Prevention (DHP). Key to this effort will be leveraging the Coalition’s strategic partnership with the National Association of County and City Health Officials (NACCHO) and NACCHO’s strong working relationship with CDC.

Priority 5: Address Homelessness and the Housing Needs of PWH
Research has proven that stable, supportive housing correlates with a much higher likelihood of a person having a suppressed viral load. Even within the RWHAP system of care, PWH who are unstably housed have a viral suppression rate that is 20 percent lower than PWH who are stably housed. The CAEAR Coalition will work with federal housing agencies and national organizations, such as National HIV/AIDS Housing Coalition (NHAHC), to advocate for the housing needs of PWH. The CAEAR Coalition believes a more collaborative and integrated relationship is needed between HRSA-HAB and the U.S. Department of Housing and Urban Development’s (HUD) Housing Opportunities for Persons with AIDS (HOPWA) Program to maximize the impact of federal housing resources to end homelessness among PWH. The Coalition will work with HRSA-HAB to find ways to improve the integration of its work with HUD’s HOPWA administration.

Priority Six: Focus on Social Determinants of Health and Promote a Syndemic Approach
The CAEAR Coalition has a long history of working in partnership with other national HIV/AIDS organizations and allied associations to promote its advocacy agenda. As noted earlier, a commitment to address social determinants of health and to promote a syndemic approach are needed to end the epidemic in the U.S. To that end, the CAEAR Coalition will expand its reach and develop strategic partnerships and/or collaborations with national BIPOC and LGBTQIA+ organizations and national associations focused on harm reduction and overdose prevention, and mental health. The Coalition will seek to work with client-centered organizations that will help expand its ability to engage constituents.