Evaluating efforts to curb HIV, Trussell heads committee

Associate Dean of the Wilson School James Trussell recently chaired a committee that reported the United States is not doing enough to prevent the spread of HIV.

The resulting study, titled "No Time to Lose," was commissioned by the Centers for Disease Control and Prevention and the Institute of Medicine and published in mid-September, Trussell said.

"The Centers for Disease Control asked the Institute of Medicine to do a thorough review of HIV-prevention strategies and to do a visionary framework of what should be done now and for the next five years," Trussell explained. "That was our charge."

The six-member committee — which started meeting in January and was co-chaired by Harvey Fineberg, Harvard's provost — heard testimony from "literally dozens and dozens" of experts on HIV who shared their opinions of the United States' attempts to curtail the spread of the virus, Trussell said.

The 164-page report concluded, "the nation does not have a comprehensive, effective, and efficient strategy for preventing the spread of [HIV]," according to the committee's executive summary.

Trussell said, at the start of the study, he did not know what conclusion the committee would reach.

"I didn't have any idea what in fact we would say in the end. We really waited until we could sift through all the evidence to determine what it was we had to say," he said, adding that few recommendations actually were made in the committee's findings. "It's an unusual report."

In the executive summary, the committee stated that "women, youth, and racial and ethnic minorities now account for a growing proportion of new AIDS cases, and increasing number of cases are emerging in rural and smaller urban areas."

Prevention, however, has most often been aimed at "gay white men in major metropolitan areas," the summary said.

The report also stated that "advances in treating AIDS have helped foster a growing sense of complacency in many sectors of both the government and the general public," and added that "improved treatment is critically important."

Trussell said committee members were chosen because of their expertise in the field of HIV research.

He said his studies have focused on reproductive health, particularly contraception and abortion.

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"I used to teach a course on HIV, and I've followed it quite carefully," he said, adding, "I think I was picked as one of the co-chairs simply because I was quite familiar with [HIV] but didn't have many strong opinions already formed."