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Overview: Translation of Research Advances into Practice

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"I want all our fellow Americans to know that this investment in science has paid tremendous dividends."

President Clinton, December 5, 1996
The White House Conference
on HIV and AIDS


An important element in the fight against HIV and AIDS is ensuring that research advances are translated into improved HIV prevention programs and better care for HIV-positive persons. This aspect of the nation's response to the epidemic is as important as the other goals relating to research, prevention, care and services. Focusing on issues related to this translation will help assure that people living with HIV, or at risk for HIV, will benefit from what we are learning.

An example of the importance of such efforts is the translation of the NIH-supported research study that found that the use of AZT by pregnant women during pregnancy and childbirth, and its application to newborns for the first six weeks of life, can reduce the risk of perinatal transmission of HIV by two-thirds. Translation of these results required actions by: the National Institutes of Health and the Centers for Disease Control and Prevention, which prepared guidelines for physicians caring for pregnant women and for consumers; the Health Resources and Services Administration, which provided guidance to grantees on coverage of such services; and, the Health Care Financing Administration, which provided similar guidance to State Medicaid Directors.

Record of Accomplishment

Due in part to Federally-sponsored information dissemination activities, dramatic changes in the way HIV is treated have taken place. Ensuring dissemination of HIV-related information falls under the missions of several Agencies (See Appendix F.) Key examples are:

  • The National Institutes of Health (NIH) supports a broad range of efforts including a "Clinical Alerts" mechanism for the dissemination of clinical trials results to health professionals, patients, the media, and the public;
  • HHS supports and directs the International HIV/AIDS Clinical Conference Call series, which disseminates state-of-the-art clinical care information to primary care providers via live worldwide audio tele-conferencing;
  • NIH supports publicly available computerized databases such as AIDSDRUGS, AIDSTRIALS, and AIDSLINE;
  • The toll-free 1-800 TRIALS-A AIDS Clinical Trials Information Service (ACTIS) is co-sponsored by NIH, CDC, and FDA;
  • The Centers for Disease Control and Prevention disseminates information to clinicians, patients, and the public through the National AIDS Hotline (1-800-342-AIDS); its toll-free 1-800-HIV-0440 HIV/AIDS Treatment Information Service (ATIS); and the National AIDS Information Clearinghouse;
  • The CDC also develops and issues guidelines for health professionals and the public through its Morbidity and Mortality Weekly Report;
  • The Agency for Health Care Policy and Research (AHCPR) publishes a series of HIV-related clinical practice guidelines for clinicians and companion pamphlets for their patients; and
  • The Health Resources and Services Administration (HRSA) directs a nationwide system of AIDS Education and Training Centers that provides state-of-the-art HIV clinical information to health care providers. HRSA also has developed guidances for its Ryan White CARE Act grantees and funds an AIDS "warmline" that responds to questions from clinicians across the country.

Future Opportunities for Progress

Ensuring that research advances are translated into improved HIV prevention programs and better care for HIV-positive persons, will require a number of steps including:

Increasing Education and Training

Consumer education efforts are also important

As we continue to expand our base of knowledge about AIDS care, efforts to educate and train health care professionals in state-of-the-art care for people living with HIV and AIDS must be maintained. An AHCPR-supported study indicated that primary care physicians who do not routinely care for persons with HIV may miss significant HIV-related symptoms during patient examinations.[11] Other research indicates that a disturbing number of clinicians do not use universal precautions in the course of routine patient care.[12] The Administration successfully fought to preserve funding for the AIDS Education and Training Centers, which play a vital role in training providers. Achieving this goal will also require a renewed emphasis on HIV on the part of medical schools, professional organizations, and individual clinicians.

In light of the potential public health benefits that could result from the proper use of a wide range of therapies, it is vital to support programs that provide consumers with the information they need to make treatment decisions and comply with therapeutic regimens.

Disseminating Guidelines

One of the most difficult tasks for clinicians and patients is interpreting the patchwork of data and articles regarding treatments and converting it into a therapeutic strategy for their patients. With every research breakthrough, this task becomes more difficult. It is essential that practical information for practicing clinicians and their patients be provided as quickly as possible. To this end, during FY 1997, the Office of HIV/AIDS Policy at HHS is undertaking a program to develop clinical practice guidelines in conjunction with other government Agencies and private sector clinicians.

Coordination of Federal Activities

Enhancing coordination of information dissemination activities among Public Health Service agencies is an important priority. Within DHHS, the Office of HIV/AIDS Policy (OHAP) has the lead responsibility for coordinating the HIV-related activities of the Public Health Service agencies. Ensuring that information about a research breakthrough is easily available, that it reaches the appropriate people and organizations, and that policies and standard-of-care practices for Federally-sponsored programs are modified to reflect the latest treatment developments, requires a continued high level of cooperation and coordination among Public Health Service agencies.

Disseminating Prevention Models

Improved dissemination efforts also are needed in the area of primary prevention models. Partnerships between science and practice fosters better programs. Models of effective prevention interventions have been developed, but often this valuable information is not reaching those people developing, implementing, and evaluating prevention programs. The Public Health Service will take the lead in ensuring that information that can be used to stem the tide of new infections reaches those who can make a difference.




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