Policy and advocacy for the HIV practitioner

In no field of medicine has advocacy, including physician advocacy, been more crucial in shaping policy for delivery of care than in HIV/AIDS. Although the historic tradition is strong, there is an urgent need to re-energize advocacy efforts nationally and internationally to support programs that fund care, change policies that perpetuate stigma and discrimination, and change the public perception that the HIV/AIDS crisis is over. Established programs that require ongoing advocacy attention include the Ryan White Comprehensive AIDS Resources Emergency Act, a US program that serves as a payer of last resort for care for patients with HIV infection, and international programs like the President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Newer issues have emerged, including the need to ensure fair drug pricing and guarantee sustained access to care and medications. Amidst the opioid epidemic, the preservation and establishment of policies to support syringe services programs take on new urgency, and ongoing efforts are necessary to decrease stigma about HIV infection, maintain protection of LGBTQ rights, and reform HIV criminalization laws. All stakeholders in the HIV community, including practitioners, individuals with HIV infection, and professional organizations, need to make their voices heard as they have done in the past in order to effectively continue to address the epidemic. This commentary was submitted by Carlos del Rio, MD, and Wendy S. Armstrong, MD, in March, 2018, and accepted in July, 2018.