83rd PACHA Meeting Focuses on HIV Response in Alabama and the South

The Presidential Advisory Council on HIV/AIDS (PACHA) met December 11–12, 2024, in Montgomery, Alabama, for its 83rd meeting, focusing on the HIV response in Alabama and in the South. The meeting included remarks from federal leaders, panels of local and regional experts, PACHA-to-the-people engagement sessions, and more.

Focus on HIV in Alabama and the South

PACHA engaged in conversation with several panels that examined aspects of HIV in the state and across the South. Scott Harris, MD, MPH, Alabama’s State Health Officer, provided an overview of HIV in the stateExit Disclaimer and some of its challenges. The first panelExit Disclaimer explored how the history of the civil rights movement in the South impacts HIV disparities today and can support efforts to end the HIV epidemic. The second panel reviewed the epidemiology of HIV in AlabamaExit Disclaimer, highlighting trends over time and the multi-level drivers of the epidemic in Alabama. The third highlighted barriers to addressing the intersection of HIV, stigma, and social determinants of health in the SouthExit Disclaimer. The conversation concluded with a discussion of local solutions for addressing HIV disparitiesExit Disclaimer.

PACHA-to-the-People Visits and Community Engagement Session

PACHA continued hearing firsthand from people in communities who are responding to HIV every day through both visits and a community engagement session. Members visited two community-based organizations providing HIV services:

• Five Horizons Health ServicesExit Disclaimer: The agency provides a variety of HIV, STI, and social services for populations in need of specialized or general care, meeting the needs of citizens from the Alabama Wiregrass region to the Alabama Black Belt and across East Mississippi.
• Selma AIR/Blackbelt Wellness Center: Selma AIR works to prevent the spread of HIV and death from AIDS across the multiple counties in the Black Belt of Alabama by providing comprehensive educational opportunities and access to quality health services. The Blackbelt Wellness Center serves as a safe, affirming environment for persons seeking to improve their whole person, emphasizing sexual wellness.

During a PACHA-to-the-People community engagement sessionExit Disclaimer, community members shared observations, recommendations, and questions for the Council’s consideration. These ranged from requests for greater representation of and services for populations disproportionately affected by HIV, including Latinos and transgender and nonbinary people, and the need for transformation of Ryan White care for people aging with HIV to better address the comorbidities they experience to the need for stronger recommendations and incentives for implementation of opt-out HIV testing in emergency departments in rural areas.

PACHA Business Matters

PACHA’s several subcommittees shared updatesExit Disclaimer on their work and discussed what is next on their agendas. They also heard an update from the liaison from the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and TreatmentExit Disclaimer. The Council also received public commentExit Disclaimer from community members participating in person and virtually. PACHA members also discussed, finalized, and voted to approve two resolutions making recommendations to the U.S. Secretary of Health and Human Services (HHS):

• The first resolution (PDF, 200KB) recommended that the United States embrace and follow the “Multinational Undetectable = Untransmittable (U=U) Call-to-Action” (MUCA) and that HHS formally recognize and collaborate with a community-led multi-sector U=U National Task Force to follow the action steps outlined in the MUCA.
• The second resolution (PDF, 155KB) recognized that stigma associated with HIV is the pervasive structural barrier to effectively address the impact of HIV on our nation and that eradicating this stigma is an essential factor in promoting the goals of the Ending the HIV Epidemic in the U.S. (EHE) initiative and recommended to the HHS Secretary that “Stigma Eradication” be added as the EHE’s fifth pillar.

Updates from the ASH, ONAP, and HHS

The Council received updates from several federal HIV leaders. In her remarksExit Disclaimer, ADM Rachel Levine, MD, HHS Assistant Secretary for Health, thanked PACHA for its work and lauded Alabama’s work as one of the priority jurisdictions in the EHE initiative. She shared updates on several recent HHS priority activities. ADM Levine also thanked two PACHA members whose terms were ending, Alicia Diggs and Laura Platero, and administered the oath of office for five members whose terms were extended for one year: Tori Cooper, Jen Kates, Marlene McNeese, Leo Moore, and Kayla Quimbley Young.

Francisco Ruiz, Director of the Office of National AIDS Policy (ONAP) at the White House, also shared an updateExit Disclaimer, thanking PACHA for its advice and counsel and highlighting the recent observance of World AIDS Day at the White House. He also discussed the December 5 White House meeting on quality of life among people with HIV, the new National HIV/AIDS Strategy 2024 Progress Report, and HIV priorities for the final weeks of the Biden–Harris administration.

Finally, PACHA also heard a reviewExit Disclaimer of Biden–Harris administration HHS policy achievements that support the response to HIV in the United States from Adrian Shankar, Deputy Assistant Secretary for Health for Policy, and Brian Kaplun, Senior Advisor to the Chief of Staff in the Immediate Office of the Secretary.

HIV.gov Conversations from the PACHA Meeting

During the PACHA meeting, HIV.gov’s Tevin Warren spoke with several participants who shared their thoughts from the meeting.

• View the conversationExit Disclaimer with ONAP Director Francisco Ruiz about the new National HIV/AIDS Strategy 2024 Progress Report (PDF, 462KB).
• View the conversationExit Disclaimer with PACHA Member Dafina Ward, Executive Director of the Southern AIDS Coalition, about why it is important for PACHA to be meeting in Alabama and the challenges facing the HIV response in the South.
• View the conversationExit Disclaimer with PACHA Members Marvell Terry II and Dafina Ward on lessons from the Civil Rights Movement that inform work to address the disproportionate impact of HIV in the South.
• View the conversationExit Disclaimer with PACHA Co-chair Marlene McNeese and former PACHA Member Alicia DiggsExit Disclaimer reflecting on what they are most hopeful for in their HIV work.

Visit the Prior PACHA Meetings and Recommendations page on HIV.gov to access the agenda and links to video recordings of these sessions. The slides from the presentations and a summary of the meeting will be posted there soon. Learn more about PACHA on HIV.gov.

The next PACHA meeting is scheduled for March 27–28, 2025, in Washington, DC.