Top federal officials in charge of drafting a comprehensive national strategy for combating HIV/AIDS will be in Seattle Wednesday for a community town hall.

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Nearly three decades after the AIDS epidemic began in the United States in June 1981, the Obama administration is crafting what supporters say is a first: a comprehensive national plan for combating and treating a disease that has largely morphed into a chronic, yet still stigmatized, illness.

Two of the top federal officials on HIV/AIDS policy will be in Seattle today as part of a five-city community discussion on how best to corral a virus that infects 56,000 Americans annually, including 330 people in King County last year.

“HIV is a completely preventable epidemic,” said Dr. Howard Koh, assistant secretary for health with the U.S. Department of Health and Human Services (HHS).

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Koh will appear tonight at an HIV/AIDS community town hall at Seattle’s Asian Counseling and Referral Services. He will be joined by Christopher Bates, director of HHS’ Office of HIV/AIDS Policy, and other health officials.

Koh and Bates are among the key people charged with carrying out President Obama’s three goals for HIV/AIDS: to reduce the number of new HIV infections; to improve the care and health of those with HIV or AIDS; and to reduce health disparities caused by HIV, which in this country hits black gay and bisexual men and black women the hardest.

Public-health officials and patients’ advocates welcomed the premise of a singular strategy as a way to prevent goals and means from clashing.

For instance, the Centers for Disease Control (CDC) since 2006 has recommended HIV screening for all people between 13 and 64. Yet routine HIV testing is not covered by even some government insurance plans, including Medicaid, which covers millions of pregnant women. Medicare, which covers seniors, on Tuesday said it would pay for HIV screening for any member who requests it.

What’s more, decisions about sex-education classes are left to local school authorities, with the result that some students never learn about safe-sex practices.

Dr. Bob Wood, King County’s top AIDS-control officer, believes that it no longer makes sense to confine HIV testing largely to people in high-risk categories, such as men who have sex with men or those who use needles to do drugs.

As many as a quarter of the people with HIV do not know they are infected, Wood said. Making tests routine — such as is done in Washington to screen pregnant women for syphilis — would help destigmatize the disease and reduce virus transmissions.

“We need to bring HIV back into the realm of sexually transmitted diseases,” said Wood, 66, an openly gay man who has been HIV positive since 1985 and who has made reducing HIV infections a personal and professional crusade.

Though a vaccine to prevent HIV infections does not yet exist, a cocktail of antiretroviral drugs has, for many, turned AIDS into a manageable, chronic condition. More than 1.1 million Americans, including some 12,000 Washington residents, are HIV positive or have developed AIDS. Globally, an estimated 33 million people are living with HIV or AIDS.

John Peppert, director of infectious diseases and reproductive health for the Washington State Department of Health, noted that HIV/AIDS has taken very different tolls in different parts of the country.

In King County, for example, 69 percent of those with HIV are gay men, compared to 47 percent for the nation as a whole. In areas such as Washington, D.C., Peppert said, the epidemic has hit a disproportionately higher percentage of black women and intravenous drug users.

“Policy decisions are most effective when they recognize that communities vary” in the nature of their challenges, Peppert said.

Worldwide, women and girls account for 60 percent of HIV cases, according to the CDC.

Sean Cahill, managing director of public policy at Gay Men’s Health Crisis, a New York City nonprofit advocacy group, contends that the view of HIV as primarily a disease of gay men and IV drug users has kept it from being regarded as a greater public-health menace.

Cahill said he hoped that the new national strategy will embrace the full spectrum of needs for people infected — and not yet infected — with HIV, from insurance coverage to acceptance of homosexuality.

Kyung Song: 206-464-2423 or

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