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Overview of Domestic HIV/AIDS Activities Across Federal Departments

The National HIV/AIDS Strategy (NHAS) calls upon 

Federal Departments and Agencies to think differently 

about their efforts to address the HIV epidemic, 

including working to better coordinate efforts within 

and across their organizations. The President 

designated six “lead agencies” with primary 

responsibility for implementing the Strategy: 

Department of Health and Human Services

Department of Labor

Department of Justice

Department of Veterans Affairs

Department of Housing and Urban Development

Social Security Administration.

Each has developed and presented to the White House 

an Operational Plan detailing their approaches to 

implementing the Strategy. These agencies are also 

represented on the Federal Interagency Working Group 

that advised on the development of the Strategy and 

which continues to convene and foster coordination of 

and collaboration on HIV prevention, care and 

treatment, and research efforts across the government. 

Each of these Departments addresses unique and 

important aspects of Nation’s efforts to realize the 

vision of the NHAS: 

The United States will become a place where new 

HIV infections are rare and when they do occur, 

every person, regardless of age, gender, 

race/ethnicity, sexual orientation, gender identity or 

socio-economic circumstance, will have unfettered 

access to high quality, life-extending care, free from 

stigma and discrimination. 

The White House’s Office of National AIDS Policy

(ONAP) led the development of the NHAS. ONAP serves

as the lead entity for setting the Administration’s 

HIV/AIDS policies and oversees government-wide 

efforts to improve the Nation’s response to the HIV

epidemic. This role includes working with the lead 

agencies to support and monitor the implementation of 

the National HIV/AIDS Strategy. The following 

highlights the range of HIV-related activities across 

those Departments. 

Department of Labor 

The Department of Labor (DOL) 

fosters, promotes, and develops the 

welfare of the wage earners, job 

seekers, and retirees of the United 

States; improves working 

conditions; advances opportunities 

for profitable employment; and assures work-related 

benefits and rights. While DOL has no specific domestic 

HIV/AIDS programs, it addresses activities important 

to achieving the Strategy’s goals and completing several 

of the activities identified in the NHAS Federal 

Implementation Plan. 

As part of coordinated Federal efforts to strengthen the 

current HIV/AIDS care provider workforce and

improve the quality of care and health outcomes for 

people living with HIV, DOL and HHS will work with 

health professions associations and collaborate on 

workforce training efforts to increase the number of 

health providers who are culturally competent. DOL 

will also collaborate with other Federal Departments to 

develop standardized occupational guidelines for 

outreach workers, health educators, hotline operators, 

peer counselors, and testing/counseling personnel.

As part of efforts by multiple Federal Departments to 

help individuals living with HIV access income 

supports, including job skills and employment, DOL’s 

Employment and Training Administration and Office of 

Disability Employment Policy will consider ways to 

increase supports for employers to hire and maintain 

employment of people with HIV and how to integrate 

them in broader employment initiatives for people with 

disabilities. 

Finally, DOL will also participate in a government-wide 

effort to enforce antidiscrimination laws applicable to 

people living with HIV or AIDS. DOL’s Office of Federal 

Contract Compliance Programs enforces Section 503 of 

the Rehabilitation Act of 1973, which requires that that 

contractors doing business with the Federal 

government do not discriminate against people with 

disabilities.

Contacts: Ms. Noelle Lee, Policy Advisor, Office of the 

Assistant Secretary for Policy

Mr. Dylan Orr, Special Assistant, Office of 

Disability Employment Policy

Department of Justice 

The Department of Justice (DOJ) is 

responsible for enforcing Federal

laws and administering justice in the 

United States. The DOJ’s NHAS 

responsibilities fall primarily into 

two main areas: addressing 

HIV/AIDS in Federal prisons and combating 

discrimination against people living with HIV or AIDS. 

Through the Bureau of Prisons DOJ operates the largest 
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correctional facility system in the U.S. with 

approximately 210,000 inmates and 115 institutions. 

Among those inmates are approximately 1,500 

individuals being treated for HIV or AIDS. DOJ’s NHAS 

Operational Plan will address HIV screening and care 

and treatment of inmates diagnosed with HIV as well as 

support linkages to care upon their release to the 

community. 

DOJ is leading the Federal government’s efforts to 

strengthen enforcement of civil rights laws as called for 

in the Strategy. DOJ works to eradicate discrimination 

against people with disabilities, including those with 

HIV/AIDS, by implementing the Americans with 

Disabilities Act (ADA). DOJ is enhancing cooperation 

with other Federal agencies, including HHS, HUD, DOL, 

and EEOC to facilitate enforcement of Federal antidiscrimination laws.

Finally, the Strategy also calls for State legislatures to 

consider reviewing HIV-specific criminal statutes to 

ensure that they are consistent with current knowledge 

of HIV transmission and support public health 

approaches to screening for, preventing and treating 

HIV. To support these efforts, DOJ is providing technical 

assistance to States considering changes to HIV 

criminal statutes in order to align laws and policies 

with public health principles.

Contacts: CAPT Chris Bina, Chief Pharmacist, Bureau

of Prisons

Ms. Allison Nichols, Deputy Chief, Disability 

Rights Section, Civil Rights Division 

Department of Veterans Affairs 

The Department of Veterans Affairs

(VA) is the largest single provider of 

medical care to people with HIV in 

the United States supporting over 

24,000 Veterans living with HIV, 

over half of whom are over the age 

of 50. This includes HIV testing, care, and treatment, 

clinician and patient education, prevention activities, 

and research directed at continuous improvement of 

medical and preventive services and delivery of care to 

veterans. The Department’s HIV/AIDS efforts are 

carried out by VA medical facilities across the country. 

In support of the Strategy, VA will collaborate with 

other Departments to develop plans that support health 

care providers and other staff who deliver HIV test 

results to conduct linkages to high quality care and 

ensure that providers are knowledgeable about 

HIV/AIDS treatment guidelines. VA will also 

collaborate with other Departments to develop 

educational and training materials to improve mental 

health and substance use assessments and treatments 

among those who are HIV positive. In addition, VA will 

participate in developing strategies to encourage 

providers to collect and report standardized viral load 

and CD4 data from infected individuals.

Department of Housing and Urban 

Development 

The Department of Housing and 

Urban Development (HUD) 

administers a number of federal 

housing programs that work to 

prevent and end homelessness, 

assist persons with disabilities and address housing 

challenges of low-income households. HUD's Office of 

HIV/AIDS Housing manages the Housing Opportunities 

for Persons with AIDS (HOPWA) program. The Office 

also works with other HUD offices to ensure that all 

HUD programs and initiatives are responsive to the 

special needs of people with HIV/AIDS. HOPWA 

promotes stable housing as a platform for delivering a 

wide variety of health and social services for many of 

the nation’s most vulnerable households. HOPWA funds 

may be used for a wide range of housing, social 

services, program planning, and development costs. 

These include rental assistance and short-term 

payments to prevent homelessness, as well as the 

acquisition, rehabilitation, or new construction of 

housing units, and costs for facility operations. HOPWA 

funds also may be used to support access to health care 

and mental health services, chemical dependency 

treatment, nutritional services, case management, 

assistance with daily living, and other supportive 

services.

Ninety percent of HOPWA funds are distributed by 

formula to cities and States based on the number of 

AIDS cases reported to the Centers for Disease Control 

and Prevention. HUD's formula grants are managed by 

124 local and State jurisdictions, which coordinate 

AIDS housing efforts with other HUD and community 

resources. HUD made available a record $335 million in 

HOPWA funds in FY2010 to help communities provide 

housing for this special needs population. Overall, these 

resources assist 60,669 households annually to 

promote stable housing and reduced risks of 

homelessness for those living with HIV and other 

challenges.

Under the National HIV/AIDS Strategy, HUD will lead a 

process with relevant Federal agencies to identify ways 

to collaborate and increase access to nonmedical 

supportive services (e.g., housing, food/nutrition 

services, transportation) as critical elements of an 

effective HIV care system. In addition, HUD and other 

relevant Federal agencies will develop joint strategies 

to encourage co-location of and enhance the availability 
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of HIV-related services at housing and other 

nontraditional HIV care sites.

Contact: Mr. David Vos, Director, Office of HIV/AIDS 

Housing

Social Security Administration 

People with HIV/AIDS who cannot

work may qualify for disability 

benefits from the Social Security 

Administration (SSA). Supplemental 

Security Income (SSI) is designed to 

provide financial support for people with disabilities 

and extremely low incomes. The Social Security 

Disability Insurance (SSDI) program provides benefits 

for people with disabilities who meet insured status by 

accruing a specified number of work credits through 

their payroll tax contributions. People living with 

HIV/AIDS can begin the Social Security application 

process immediately after quitting work or significantly 

limiting their work hours because they are no longer 

able to perform gainful work. 

Under the Strategy, SSA will be working with other 

Departments to help individuals living with HIV access 

income supports, including job skills and employment. 

SSA is also updating the HIV infection entry in the 

Listing of Impairments, the screening tool used by SSA 

to identify claimants who are so severely impaired that 

they are unable to do any gainful work, regardless of 

their age, education, or work experience, and thus 

qualify for disability benefits.

Contact: Mr. David Rust, Deputy Commissioner for 

Retirement and Disability Policy

Department of Health and Human 

Services

The Department of Health and 

Human Services (HHS) is the United 

States government’s principal agency 

for protecting the health of all 

Americans and providing essential 

human services, especially for those who are least able 

to help themselves. HHS administers a wide array of 

programs spanning HIV/AIDS education, prevention, 

testing, care and treatment, and research. 

Contacts: Dr. Howard Koh, Assistant Secretary for 

Health

Dr. Ronald Valdiserri, Deputy Assistant 

Secretary for Health, Infectious Diseases

Agencies and offices from across HHS have key 

responsibilities for implementing specific activities in 

support of the NHAS goals:

Centers for Disease Control and Prevention – The 

mission of the Centers for Disease Control and 

Prevention (CDC) is to collaborate to create the 

expertise, information, and tools that people and 

communities need to protect their health – through 

health promotion, prevention of disease, injury and 

disability, and preparedness for new health threats. 

CDC is the lead agency for the nation’s efforts to 

prevent HIV with responsibilities for public health 

surveillance, prevention research, and programs to 

prevent and control HIV. 

Centers for Medicare and Medicaid Services – The 

Centers for Medicare and Medicaid Services (CMS) 

ensures effective, up-to-date health care coverage and 

promotes quality care for beneficiaries. CMS supports 

HIV/AIDS care for low income or disabled beneficiaries. 

Food and Drug Administration – The Food and Drug 

Administration (FDA) is responsible for protecting the 

public health by assuring the safety, effectiveness, and 

security of human and veterinary drugs, vaccines and 

other biological products, medical devices, our nation’s 

food supply, cosmetics, dietary supplements, and 

products that give off radiation; regulating tobacco 

products; advancing the public health by helping to 

speed product innovations; and helping the public get 

the accurate, science-based information they need to 

use medicines and foods to improve their health. FDA’s 

HIV/AIDS activities include ensuring the safety of the 

nation’s blood supply and regulating HIV medicines, 

HIV testing, and barrier devices such as condoms. 

Health Resources and Services Administration – The 

Health Resources and Services Administration (HRSA) 

is the primary Federal agency for improving access to 

health care services for people who are uninsured, 

isolated or medically vulnerable. HRSA’s HIV/AIDS 

Bureau administers the Ryan White Care Act, the 

largest Federal program focused exclusively on 

HIV/AIDS care. The program is for those who do not 

have sufficient health care coverage or financial 

resources for coping with HIV disease. HRSA also funds 

Health Centers in communities, providing access to 

high quality, family oriented, comprehensive primary 

and preventive health care for people who are low 

income, uninsured, or living where health care is 

scarce. In addition, HRSA supports programs that 

increase access to health care by developing, 

distributing and retaining a diverse, culturally 

competent health workforce. 

Indian Health Service – The Indian Health Service

(IHS), an agency within the Department of Health and 

Human Services, is responsible for providing Federal

health services to American Indians and Alaska Natives. 

The IHS provides a comprehensive health service 

delivery system for approximately 1.9 million American 
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Indians and Alaska Natives who belong to 564 

Federally recognized tribes in 35 states. The IHS 

HIV/AIDS Program is cultivated from a myriad of 

services, projects, facilities, funding sources and field 

expertise. The program encompasses the major servicedelivery systems accessed by the American 

Indian/Alaska Native community, including IHS, tribal, 

and urban facilities.

National Institutes of Health – The mission of the 

National Institutes of Health (NIH) is to seek 

fundamental knowledge about the nature and behavior 

of living systems and the application of that knowledge 

to enhance health, lengthen life, and reduce the 

burdens of illness and disability. It is the leading U.S. 

government organization for HIV/AIDS research, with 

activities underway in nearly all 27 institutes and 

offices. The NIH represents the largest and most 

significant public investment in AIDS research in the 

world. The research takes place in laboratories and 

clinics on the NIH campus in Bethesda, Maryland, and 

through a vast network of supported research at 

universities, medical centers and clinical trial sites 

around the globe. 

Office of the Assistant Secretary for Health – The 

Office of the Assistant Secretary for Health (OASH) is 

comprised of 12 core public health offices and the 

Commissioned Corps, a uniformed service of more than 

6,500 health professionals who serve at HHS and other 

Federal agencies. OASH is playing a lead role in 

supporting the implementation of the Strategy by 

forging collaborations across HHS and with other 

Federal Departments and coordinating Federal efforts 

with States. Within the OASH key offices with HIV/AIDS 

portfolios include the Office of HIV/AIDS Policy, Office 

on Women’s Health, Office of Minority Health, Office of 

Adolescent Health, Regional Health Administrators, 

Office of Population Affairs, Office of Disease 

Prevention and Health Promotion, and the Secretariat 

for the Presidential Advisory Council on HIV/AIDS

(PACHA). 

Office for Civil Rights – The Office for Civil Rights

(OCR) helps to protect Americans from discrimination 

in certain healthcare and social service programs. OCR 

also helps to protect the privacy of American’s health 

information held by health insurers and certain health 

care providers and health insurers.

Substance Abuse and Mental Health Services 

Administration – The mission of the Substance Abuse 

and Mental Health Services Administration (SAMHSA) 

is to reduce the impact of substance abuse and mental 

illness on America's communities. SAMHSA’s HIV/AIDS 

activities address mental health and substance use 

issues that can put individuals at greater risk for HIV 

infection or which co-occur with HIV infection and can 

hinder access to treatment and maintenance in care. 

Their programs also support substance abuse 

treatment for people living with HIV/AIDS which 

reduces their transmission risk. 

Other Federal Activities

In addition to the efforts of these lead agencies, other 

Federal Departments and Agencies are supporting the 

implementation of the National HIV/AIDS Strategy. 

Department of Defense

The Secretary of Defense has 

submitted to the White House Office 

of National AIDS Policy (ONAP) and 

the Office of Management and 

Budget (OMB) a plan for aligning the 

health care services provided by the Department of 

Defense (DOD) with the Strategy, to the extent feasible 

and permitted by law. The plan addresses, in 

particular, HIV/AIDS prevention, care, and treatment.

Department of State

The Secretary of State has provided 

ONAP and OMB recommendations 

for improving the government-wide 

response to the domestic HIV/AIDS 

epidemic based on lessons learned 

in implementing the President’s 

Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is 

the U.S. Government initiative to help save the lives of 

those suffering from HIV/AIDS around the world.

Equal Employment Opportunity 

Commission 

The Chair of the Equal Employment 

Opportunity Commission (EEOC) 

has prepared for ONAP and OMB 

recommendations for increasing 

employment opportunities for 

people living with HIV and a plan for addressing 

employment-related discrimination against people 

living with HIV, consistent with the Commission’s 

authorities and other applicable law.

Finally, the Centers for Faith-Based and 

Neighborhood Partnerships from DOJ, DOL, HUD, 

HHS, and VA, joined by the Department of Education

and the White House’s Office of Faith-Based and 

Neighborhood Partnerships, are also engaged in a 

cross-departmental effort to engage more faith leaders 

in promoting nonjudgmental support for people living 

with HIV and other HIV prevention, care and treatment 

activities contributing to the realization of the 

Strategy’s goals.