Structural Factors and the National HIV/AIDS Strategy of the USA

  • Ronald O. ValdiserriEmail author
  • Catherine H. Maulsby
  • David R. Holtgrave
Part of the Social Aspects of HIV book series (SHIV, volume 4)


The United States of America’s (USA) first-ever comprehensive, National HIV/AIDS Strategy (NHAS) was released in July 2010 and delineated three goals: reduce new HIV infections, increase access to care and improve health outcomes for people living with HIV and reduce HIV-related disparities and health inequities. Increased attention to the social and structural factors influencing disease risk and affecting health outcomes is deemed essential to achieving the NHAS goals. Employing the broad taxonomy of ‘environment’ and ‘social context’, this chapter reviews the major structural interventions called for in the initial 2010 release of the NHAS and its subsequent update in 2015, providing examples that highlight the HIV epidemic among Black men who have sex with men, the community in the USA that is currently most disproportionately affected by the HIV epidemic. The review documents both positive movement toward the NHAS goals as well as instances where progress has been insufficient. The authors conclude that a systems science approach will be required to address the ‘upstream factors’ that contribute to poor HIV outcomes, including social disadvantage and social inequity.


HIV/AIDS Stigma Structural Interventions Disparities Social Determinants of Health 


  1. Abdul-Quader, A. S., Feelemyer, J., Modi, S., Stein, E. S., Briceno, A., Semaan, S., et al. (2013). Effectiveness of structural-level needle/syringe programs to reduce HCV and HIV infection among people who inject drugs: A systematic review. AIDS and Behavior, 17(9), 2878–2892. doi: 10.1007/s10461-013-0593-y.CrossRefPubMedGoogle Scholar
  2. Aidala, A. A., Wilson, M. G., Shubert, V., Gogolishvili, D., Globerman, J., Rueda, S., et al. (2016). Housing status, medical care, and health outcomes among people living with HIV/AIDS: A systematic review. American Journal of Public Health, 106(1), e1–e23. doi: 10.2105/AJPH2015.302905.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Auerbach, J. D., Parkhurst, J. O., & Caceres, C. F. (2011). Addressing social drivers of HIV/AIDS for the long terms response: Conceptual and methodological considerations. Global Public Health, 6(Suppl. 3), S293–S309. doi: 10.1080/17441692.2011.594451.CrossRefPubMedGoogle Scholar
  4. Ayala, G., Bingham, T., Kim, J., Wheeler, D. P., & Millett, G. A. (2012). Modeling the impact of social discrimination and financial hardship on the sexual risk of HIV among Latino and Black men who have sex with men. American Journal of Public Health, 102(S2), S242–S249. doi: 10.2105/ajph.2011.300641.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Benach, J., Vives, A., Amable, M., Vanroelen, C., Tarafa, G., & Muntaner, C. (2014). Precarious employment: Understanding an emerging social determinant of health. Annual Review of Public Health, 35, 229–253. doi: 10.1146/annurev-publhealth-032013-182500.CrossRefPubMedGoogle Scholar
  6. Berry, S. A., Fleishmann, J. A., Yehia, B. R., Cheever, L. W., Hauck, H., Korthuis, P. T., et al. (2016). Healthcare coverage for HIV provider visits before and after implementation of the Affordable Care Act. Clinical Infectious Diseases, 63(3), 387–395. doi: 10.1093/cid/ciw278.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Bharmal, N., Derose, K. P., Felician, M., & Weden M. M. (2015). Understanding the upstream social determinants of health (Rand Health Working Paper. WR-1096-RC). Available at:
  8. Bird, J. D., & Voisin, D. R. (2013). ‘You’re an open target to be abused’: A qualitative study of stigma and HIV self-disclosure among black men who have sex with men. American Journal of Public Health, 103(12), 2193–2199. doi: 10.2105/ajph.2013.301437.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Blankenship, K. M., Friedman, S. R., Dworkin, S., & Mantell, J. E. (2006). Structural interventions: Concepts, challenges and opportunities for research. Journal of Urban Health, 83(1), 59–72. doi: 10.1007/s11524-005-9007-4.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Bonacci, R. A., & Holtgrave, D. R. (2016). Evaluating the impact of the US National HIV/AIDS Strategy, 2010–2015. AIDS and Behavior, 20(7), 1383–1389. doi: 10.1007/s10461-016-1416-8.CrossRefPubMedGoogle Scholar
  11. Bramson, H., Des Jarlais, D. C., Arasteh, K., Nugent, A., Guardino, V., Feelemyer, J., & Hodel, D. (2015). State laws, syringe exchange, and HIV among persons who inject drugs in the United States: History and effectiveness. Journal of Public Health Policy, 36(2), 212–230. doi: 10.1057/jphp.2014.54.CrossRefPubMedGoogle Scholar
  12. Braverman, P. A., Egerter, S. A., Woolf, S. H., & Marks, J. S. (2011). When do we know enough to recommend action on the social determinants of health? American Journal of Preventive Medicine, 40(1S1), S58–S66. doi: 10.1016/j.amepre.2010.09.026.CrossRefGoogle Scholar
  13. Buchanan, D., Kee, R., Sadowski, L. S., & Garcia, D. (2009). The health impact of supportive housing for HIV-positive homeless patients: A randomized controlled trial. American Journal of Public Health, 99(S3), S675–S680. doi: 10.2105/ajph.2008.137810.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Burris, S., & Gostin, L. O. (2003). The impact of HIV/AIDS on the development of public health law. In R. O. Valdiserri (Ed.), Dawning answers: How the HIV/AIDS epidemic has helped to strengthen public health (pp. 96–117). New York: Oxford University Press.Google Scholar
  15. Cahill, S. R., Mayer, K. H., & Boswell, S. L. (2015). The Ryan White HIV/AIDS Program in the age of health care reform. American Journal of Public Health, 105(6), 1078–1085. doi: 10.2105/ajph.2014.302442.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Centers for Disease Control and Prevention. (2011). CDC’s new high-impact approach to HIV prevention funding for health departments: Advancing the National HIV/AIDS Strategy. Program Backgrounder. Accessed 10 May 2016.
  17. Centers for Disease Control and Prevention. (2012a). HIV prevention funding allocations at CDC-funded state and local health departments, 2010. Accessed 11 May 2016.
  18. Centers for Disease Control and Prevention. (2012b). New CDC campaign fights stigma and apathy fueling HIV epidemic. NCHHSTP Press Release. Accessed 22 June 2016.
  19. Centers for Disease Control and Prevention. (2015a). HIV among gay and bisexual men. CDC Fact Sheet. Accessed 30 May 2016.
  20. Centers for Disease Control and Prevention. (2015b). Health department demonstration projects for comprehensive prevention, care, behavioral health, and social services for men who have sex with men of color at risk for and living with HIV infection: CDC-RFA-PS15-1509. Funding Opportunity Announcement. Accessed 4 May 2016.
  21. Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., et al. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine, 365(6), 493–505. doi: 10.1056/nejmoa1105243.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Congress of the United States of America. (2015). Consolidated Appropriations Act, 2016. Accessed 7 June 2016.
  23. Conrad, C., Bradley, H. M., Broz, D., Buddha, S., Chapman, E. L., Galang, R. R., et al. (2015). Community outbreak of HIV infection linked to injection drug use of oxymorphone – Indiana, 2015. Morbidity and Mortality Weekly Report, 64(16), 443–444.PubMedGoogle Scholar
  24. Conyers, L., & Boomer, K. B. (2014). Examining the role of vocational rehabilitation on access to care and public health outcomes for people living with HIV/AIDS. Disability and Rehabilitation, 36(14), 1203–1210. doi: 10.3109/09638288.2013.837968.CrossRefPubMedGoogle Scholar
  25. Dasgupta, S., Oster, A. M., Li, J., & Hall, I. (2016). Disparities in consistent retention in HIV care – 11 states and the District of Columbia, 2011–2013. Morbidity and Mortality Weekly Report, 65(4), 77–82. doi: 10.15585/mmwr.mm6504a2.CrossRefPubMedGoogle Scholar
  26. Denning, P. H., DiNenno, E. A., & Wiegand, R. E. (2011). Characteristics associated with HIV infection among heterosexuals in urban areas with high AIDS prevalence – 24 cities, United States, 2006–2007. Morbidity and Mortality Weekly Report, 60(31), 1045–1049.Google Scholar
  27. Doran, K. M., Misa, E. J., & Shah, N. R. (2013). Housing as health care – New York’s boundary-crossing experiment. New England Journal of Medicine, 369(25), 2374–2377. doi: 10.1056/nejmp1310121.CrossRefPubMedGoogle Scholar
  28. Doshi, R. K., Milberg, J., Isenberg, D., Matthews, T., Malitz, F., Matosky, M., et al. (2015). High rates of retention and viral suppression in the US HIV safety net system: HIV care continuum in the Ryan White HIV/AIDS Program, 2011. Clinical Infectious Diseases, 60(1), 117–125. doi: 10.1093/cid/ciu722.CrossRefPubMedGoogle Scholar
  29. Eaton, E. F., & Mugavero, M. J. (2016). Editorial Commentary: Affordable Care Act, Medicaid expansion…or not: Ryan White Care Act remains essential for access and equity. Clinical Infectious Diseases, 63(3), 404–406. doi: 10.1093/cid/ciw280.CrossRefPubMedGoogle Scholar
  30. Elmer, M. (2012). HIV prevention cuts raise fears. Iowa Center for Public Affairs Journalism. Accessed 1 Jul 2016.
  31. Garcia, J., Parker, C., Parker, R. G., Wilson, P. A., Philbin, M. M., & Hirsch, J. S. (2015). ‘You’re really gonna kick us all out?’ Sustaining safe spaces for community-based HIV prevention and control among black men who have sex with men. PloS One, 10(10), e0141326. doi: 10.1371/journal.pone.0141326.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Gorman, A. (2016, February 17). Needle exchanges can now get federal funding. Kaiser Health News. Accessed 7 June 2016.
  33. Green, T. C., Martin, E. G., Bowman, S. E., Mann, M. R., & Beletsky, L. (2012). Life after the ban: An assessment of US syringe exchange attitudes about the early experiences with federal funding. American Journal of Public Health, 102(5), e9–e16. doi: 10.2105/ajph.2011.300595.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Hatzenbuehler, M. L., O’Cleirigh, C., Grasso, C., Mayer, K., Safren, S., & Bradford, J. (2012). Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment. American Journal of Public Health, 102(2), 285–291. doi: 10.2105/ajph.2011.300382.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103(5), 813–821. doi: 10.2105/ajph.2012.301069.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Hergenrather, K. C., Geishecker, S., Clark, G., & Rhodes, S. D. (2013). A pilot test of the HOPE intervention to explore employment and mental health among African American gay men living with HIV/AIDS: Results from a CBPR study. AIDS Education and Prevention, 25(5), 405–422. doi: 10.1521/aeap.2013.25.5.405.CrossRefPubMedGoogle Scholar
  37. Hightow-Weidman, L. B., Muessig, K. E., Pike, E. C., LeGrand, S., Baltierra, N., Rucker, A. J., & Wilson, P. (2015). Building community through a mobile-optimized, online health promotion intervention. Health Education & Behavior, 42(4), 493–499. doi: 10.1177/1090198114562043.CrossRefGoogle Scholar
  38. Holtgrave, D. R. (2010). On the epidemiologic and economic importance of the National AIDS Strategy for the United States. Journal of Acquired Immune Deficiency Syndromes, 55(2), 139–142. doi: 10.1097/qai.0b013e3181f4107a.CrossRefPubMedGoogle Scholar
  39. Holtgrave, D. R., Hall, H. I., Wehrmeyer, L., & Maulsby, C. (2012). Costs, consequences and feasibility of strategies for achieving the goals of the National HIV/AIDS Strategy in the United States: A closing window for success? AIDS and Behavior, 16(6), 1365–1372. doi: 10.1007/s10461-012-0207-0.CrossRefPubMedGoogle Scholar
  40. Holtgrave, D. R., Kim, J. J., Adkins, C., Maulsby, C., Lindsey, K. D., Johnson, K. M., Montoya, D. C., & Kelley, R. T. (2014). Unmet HIV service needs among black men who have sex with men in the United States. AIDS and Behavior, 18(1), 36–40. doi: 10.1007/s10461-013-0574-1.CrossRefPubMedGoogle Scholar
  41. Jeffries, W. L., & Johnson, O. D. (2015). Homonegative attitudes and risk behaviors for HIV and other sexually transmitted infections among sexually active men in the United States. American Journal of Public Health, 105(12), 2466–2472. doi: 10.2105/ajph.2015.302780.CrossRefPubMedGoogle Scholar
  42. Jeffries, W. L., Marks, G., Lauby, J., Murrill, C. S., & Millett, G. A. (2013). Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men. AIDS and Behavior, 17(4), 1442–1453. doi: 10.1007/s10461-012-0189-y.CrossRefPubMedGoogle Scholar
  43. Jeffries, W. L., Townsend, E. S., Gelaude, D. J., Torrone, E. A., Gasiorowicz, M., & Bertolli, J. (2015). HIV stigma experienced by young men who have sex with men (MSM) living with HIV infection. AIDS Education and Prevention, 27(1), 58–71. doi: 10.1521/aeap.2015.27.1.58.CrossRefPubMedGoogle Scholar
  44. Kail, B. L., Acosta, K. L., & Wright, E. R. (2015). State-level marriage equality and the health of same-sex couples. American Journal of Public Health, 105(6), 1101–1105. doi: 10.2105/ajph.2015.302589.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Kaiser Family Foundation. (2016). Current status of state Medicaid expansion decisions. Accessed 25 May 2016.
  46. Kates, J. (2013). Implications of the Affordable Care Act for people with HIV infection and the Ryan White HIV/AIDS Program: What does the future hold? Topics in Antiviral Medicine, 21(4), 138–142.PubMedGoogle Scholar
  47. Klausner, J. D., Pollack, L. M., Wong, W., & Katz, M. H. (2006). Same-sex domestic partnerships and lower-risk behaviors for STDs including HIV infection. Journal of Homosexuality, 51(4), 137–144. doi: 10.1300/j082v51n04_07.CrossRefPubMedGoogle Scholar
  48. Lawrence, J. (1987, October 14). Senate says federal AIDS education material can’t promote homosexuality. Associated Press. Available at: Accessed 18 May 2016.
  49. Lennon, C. A., White, A. C., Finitsis, D., Pishori, A., Hernandez, D., Kelly, D. M., et al. (2013). Service priorities and unmet service needs among people living with HIV/AIDS: Results from a nationwide interview of HIV/AIDS housing organizations. AIDS Care, 25(9), 1083–1091. doi: 10.1080/09540121.2012.749337.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Liptak, A. (2015, June 26). Supreme Court ruling makes same-sex marriage a right nationwide. The New York Times. Accessed 23 June 2016.
  51. Luke, D. A., & Stamatakis, K. A. (2012). Systems science methods in public health: Dynamics, networks, and agents. Annual Review of Public Health, 33, 357–376. doi: 10.1146/annurev-publhealth-031210-101222.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22(Suppl 2), S67–S79. doi: 10.1097/01.aids.0000327438.13291.62.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Margerison-Zilko, C., Goldman-Mellor, S., Falconi, A., & Downing, J. (2016). Health impacts of the Great Recession: A critical review. Current Epidemiology Reports, 3(1), 81–91. doi: 10.1007/s40471-016-0068-6.CrossRefPubMedPubMedCentralGoogle Scholar
  54. Martin, E. G., & Schackman, B. R. (2012). What does US health reform mean for HIV clinical care? Journal of Acquired Immune Deficiency Syndromes, 60(1), 72–76. doi: 10.1097/qai.0b013e31824c0dd4.CrossRefPubMedPubMedCentralGoogle Scholar
  55. Martin, D. J., Chernoff, R. A., Buitron, J., Comulada, W. S., Liang, L. J., & Wong, F. L. (2012). Helping people with HIV/AIDS return to work: A randomized clinical trial. Rehabilitation Psychology, 57(4), 280–289. doi: 10.1037/a0030207.CrossRefPubMedGoogle Scholar
  56. Matthews, D. D., Herrick, A. L., Coulter, R. W., Friedman, M. R., Mills, T. C., Eaton, L. A., et al. (2016). Running backwards: Consequences of current HIV incidence rates for the next generation of black MSM in the United States. AIDS and Behavior, 20(1), 7–16. doi: 10.1007/s10461-015-1158-z.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Maulsby, C., Millett, G., Lindsey, K., Kelley, R., Johnson, K., Montoya, D., & Holtgrave, D. (2014). HIV among black men who have sex with men (MSM) in the United States: A review of the literature. AIDS and Behavior, 18(1), 10–25. doi: 10.1007/s10461-013-0476-2.CrossRefPubMedGoogle Scholar
  58. Mayer, K. H., Wang, L., Koblin, B., Mannheimer, S., Magnus, M., del Rio, C., et al. (2014). Concomitant socioeconomic, behavioral, and biological factors associated with the disproportionate HIV infection burden among black men who have sex with men in 6 U.S. cities. PloS One, 9(1), e87298. doi: 10.1371/journal.pone.0087298.CrossRefPubMedPubMedCentralGoogle Scholar
  59. Millett, G. A., Crowley, J. S., Koh, H., Valdiserri, R. O., Frieden, T., Dieffenbach, C. W., et al. (2010). A way forward: The National HIV/AIDS Strategy and reducing HIV incidence in the United States. Journal of Acquired Immune Deficiency Syndromes, 55(S2), S144–S147. doi: 10.1097/qai.0b013e3181fbcb04.CrossRefPubMedGoogle Scholar
  60. Mugavero, M. J., Norton, W. E., & Saag, M. S. (2011). Health care system and policy factors influencing engagement in HIV medical care: Piecing together the fragments of a fractured health care delivery system. Clinical Infectious Diseases, 52(Suppl. 2), S238–S246. doi: 10.1093/cid/ciq048.CrossRefPubMedPubMedCentralGoogle Scholar
  61. National Alliance of State and Territorial AIDS Directors. (2013). National HIV Prevention Inventory: 2013 funding survey report. Accessed 10 May 2016.
  62. Nguyen, T. Q., Weir, B. W., Des Jarlais, D. C., Pinkerton, S. D., & Holtgrave, D. R. (2014). Syringe exchange in the United States: A national level economic evaluation of hypothetical increases in investment. AIDS and Behavior, 18(11), 2144–2155. doi: 10.1007/s10461-014-0789-9.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Oldenburg, C. E., Perez-Brumer, A. G., Hatzenbuehler, M. L., Krakower, D., Novak, D. S., Mimiaga, M. J., & Mayer, K. H. (2015). State-level structural sexual stigma and HIV prevention in a national online sample of HIV-uninfected MSM in the United States. AIDS, 29(7), 837–845. doi: 10.1097/qad.0000000000000622.CrossRefPubMedPubMedCentralGoogle Scholar
  64. Poundstone, K. E., Strathdee, S. A., & Celentano, D. D. (2004). The social epidemiology of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. Epidemiologic Reviews, 26(1), 22–35. doi: 10.1093/epirev/mxh005.CrossRefPubMedGoogle Scholar
  65. Public Health Law Research. (2016). LawAtlas: Syringe distribution laws. Accessed 14 May 2016.
  66. Purcell, D. W., McCray, E., & Mermin, J. (2016). The shift to high-impact HIV prevention by health departments in the United States. Public Health Reports, 131(1), 7–10. doi: 10.1177/003335491613100104.CrossRefPubMedPubMedCentralGoogle Scholar
  67. Robert Wood Johnson Foundation. (2013). How does employment – or unemployment – affect health? Issue Brief. Accessed 4 May 2016.
  68. Rosenberg, E. S., Grey, J. A., Sanchez, T. H., & Sullivan, P. S. (2016). Rates of prevalent HIV infection, prevalent diagnoses, and new diagnoses among men who have sex with men in the US states, metropolitan statistical areas, and counties, 2012–2013. JMIR Public Health and Surveillance, 2(1), e22. doi: 10.2196/publichealth.5684.CrossRefPubMedPubMedCentralGoogle Scholar
  69. Rudavsky, S. (2015, March 26). Indiana OKs clean needle exchange amid HIV outbreak. Indianapolis Star. Accessed 2 June 2016.
  70. Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient Protection and Affordable Care Act: Opportunities for prevention and public health. Lancet, 384(9937), 75–82. doi: 10.1016/s0140-6736(14)60259-2.CrossRefPubMedGoogle Scholar
  71. Singer, M. (1994). AIDS and the health crisis of the U.S. urban poor; the perspective of critical medical anthropology. Social Science and Medicine, 39(7), 931–948. doi: 10.1016/0277-9536(94)90205-4.CrossRefPubMedGoogle Scholar
  72. Singh, S., Bradley, H., Hu, X., Skarbinski, J., Hall, H. I., & Lansky, A. (2014). Men living with diagnosed HIV who have sex with men: Progress along the continuum of HIV care – United States, 2010. Morbidity and Mortality Weekly Report, 63(38), 829–833.PubMedGoogle Scholar
  73. Snider, J. T., Juday, T., Romley, J. A., Seekins, D., Rosenblatt, L., Sanchez, Y., & Goldman, D. P. (2014). Nearly 60,000 uninsured and low-income people with HIV/AIDS live in states that are not expanding Medicaid. Health Affairs, 33(3), 386–393. doi: 10.1377/hlthaff.2013.1453.CrossRefPubMedGoogle Scholar
  74. Stahre, M., VanEenwyk, J., Siegel, P., & Njai, R. (2015). Housing insecurity and the association with health outcomes and unhealthy behaviors, Washington state, 2011. Preventing Chronic Disease, 12(E109), 140511. doi: 10.5888/ped12.140511.CrossRefGoogle Scholar
  75. Stangl, A. L., Lloyd, J. K., Brady, L. M., Holland, C. E., & Baral, S. (2013). A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: How far have we come? Journal of the International AIDS Society, 16(Suppl 2), 18734. doi: 10.7448/IAS.16.3.18734.PubMedPubMedCentralGoogle Scholar
  76. Strathdee, S. A., & Beyrer, C. (2015). Threading the needle – how to stop the HIV outbreak in rural Indiana. New England Journal of Medicine, 373(5), 397–399. doi: 10.1056/nejmp1507252.CrossRefPubMedGoogle Scholar
  77. Sweat, M. D., & Denison, J. A. (1995). Reducing HIV incidence in developing countries with structural and environmental interventions. AIDS, 9(Suppl. A), S251–S257.PubMedGoogle Scholar
  78. Talbert-Slagle, K. M., Canavan, M. E., Rogan, E. M., Curry, L. A., & Bradley, E. H. (2016). State variation in HIV/AIDS health outcomes: The effect of spending on social services and public health. AIDS, 30(4), 657–663. doi: 10.1097/qad.0000000000000978.CrossRefPubMedPubMedCentralGoogle Scholar
  79. U.S. Department of Health and Human Services. (2016). Department of Health and Human Services implementation guidance to support certain components of syringe services programs, 2016. Accessed 25 May 2016.
  80. U.S. Department of Housing and Urban Development. (2015). HUD and Department of Labor launch training curriculum for HIV/AIDS housing and service providers. HUD Press Release No. 15-088. Accessed 3 May 2016.
  81. U.S. Department of Justice, Civil Rights Division. (2014). Best practices guide to reform HIV-specific criminal laws to align with scientifically-supported facts. Accessed 22 June 2016.
  82. Ungar, L. (2016, January 7). Funding ban on needle exchanges effectively lifted. USA Today. Accessed 2 June 2016.
  83. United States Government Accountability Office. (2015). Persons with HIV: Funding formula for housing assistance could be better targeted, and performance data could be improved. GAO-15-298. Accessed 9 May 2016.
  84. Valdiserri, R. O. (2002). HIV/AIDS stigma: An impediment to public health. American Journal of Public Health, 92(3), 341–342. doi: 10.2105/ajph.92.3.341.CrossRefPubMedPubMedCentralGoogle Scholar
  85. Valdiserri, R. O. (2003). HIV/AIDS in historical profile. In R. O. Valdiserri (Ed.), Dawning answers: How the HIV/AIDS epidemic has helped to strengthen public health (pp. 3–32). New York: Oxford University Press.Google Scholar
  86. Valdiserri, R. O. (2011). Thirty years of AIDS in America: A story of infinite hope. AIDS Education and Prevention, 23(6), 479–494. doi: 10.1521/aeap.2011.23.6.479.CrossRefPubMedGoogle Scholar
  87. Valdiserri, R. O. (2013). Preventing HIV/AIDS in the United States, 1981–2009: History in the making. In S. O. Aral, K. A. Fenton, & J. A. Lipshutz (Eds.), The new public health and STD/HIV prevention: Personal, public and health systems approaches (pp. 309–337). New York: Springer.CrossRefGoogle Scholar
  88. Valdiserri, R. O. (2014). Improving outcomes along the HIV care continuum: Paying careful attention to the non-biologic determinants of health. Public Health Reports, 129(4), 319–321.CrossRefPubMedPubMedCentralGoogle Scholar
  89. Valdiserri, R. O. (2016). Shining a light on America’s HIV epidemic among men who have sex with men. JMIR Public Health and Surveillance, 2(1), e25. doi: 10.2196/publichealth.5864.CrossRefPubMedPubMedCentralGoogle Scholar
  90. Weinmeyer, R. (2016). Needle exchange programs’ status in US politics. AMA Journal of Ethics, 18(3), 252–257. doi: 10.1001/journalofethics.2016.18.3.hlaw1-1603.CrossRefPubMedGoogle Scholar
  91. White House, Office of National AIDS Policy. (2010a). National HIV/AIDS Strategy for the United States. Accessed 2 May 2016.
  92. White House, Office of National AIDS Policy. (2010b). National HIV/AIDS Strategy: Federal implementation plan. Accessed 2 May 2016.
  93. White House, Office of National AIDS Policy. (2015). National HIV/AIDS Strategy for the United States: Updated to 2020. Accessed 2 May 2016.
  94. Whiteside, Y. O., Cohen, S. M., Bradley, H., Skarbinski, J., Hall, H. I., & Lansky, A. (2014). Progress along the continuum of HIV care among blacks with diagnosed HIV – United States, 2010. Morbidity and Mortality Weekly Report, 63(5), 85–89.PubMedGoogle Scholar
  95. Wilson, P. A., & Moore, T. E. (2009). Public health responses to the HIV epidemic among black men who have sex with men: A qualitative study of US health departments and communities. American Journal of Public Health, 99(6), 1013–1022. doi: 10.2105/ajph.2008.140681.CrossRefPubMedPubMedCentralGoogle Scholar
  96. Wolitski, R. J., Kidder, D. P., Pals, S. L., Royal, S., Aidala, A., Stall, R., et al. (2010). Randomized trial of the effects of housing assistance on the health and risk behaviors of homeless and unstably housed people living with HIV. AIDS and Behavior, 14(3), 493–503. doi: 10.1007/s10461-009-9643-x.CrossRefPubMedGoogle Scholar
  97. Yehia, B. R., Stewart, L., Momplaisir, F., Mody, A., Holtzman, C. W., Jacobs, L. M., et al. (2015). Barriers and facilitators to patient retention in HIV care. BMC Infectious Diseases, 15(1), 246. doi: 10.1186/s12879-015-0990-0.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Ronald O. Valdiserri
    • 1
    Email author
  • Catherine H. Maulsby
    • 1
  • David R. Holtgrave
    • 1
  1. 1.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA

Personalised recommendations