The Affordable Care Act and low-income people living with HIV: looking forward in 2014 and beyond.

Winston Abara, MD, PhD, is a Health Policy Fellow, Satcher Health Leadership Institute, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia. Harry J. Heiman, MD, MPH, is the Director, Division of Health Policy, Satcher Health Leadership Institute, and an Assistant Professor, Department of Family Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA. There are approximately 1 million people living with HIV (PLWH) in the United States, with an estimated 50,000 new HIV infections occurring annually (Centers for Disease Control and Prevention [CDC], 2012a). Racial and ethnic minorities, sexual minorities, and low-income populations bear a disproportionate burden of HIV (CDC, 2012a; 2012b). In the United States, African Americans and Hispanics/ Latinos accounted for 44% and 21% of all new HIV infections in 2010 respectively, while men who have sex with men comprised an estimated 63% of all new HIV infections in the same year (CDC, 2012a). In an effort to address the HIVepidemic in the United States, the Obama administration put forward the National HIV/AIDS Strategy (NHAS) in 2010 with a vision for the ‘‘United States to 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 socioeconomic circumstance will have unfettered access to high-quality, life-extending care, free from stigma and discrimination’’ (CDC, 2012c, p. vii). This vision drives the goals of the NHAS to reduce new HIV infections, increase access to care, optimize health outcomes, and reduce HIV-related health disparities. Unfortunately, not all PLWH have access to highquality care and treatment (Hall et al., 2013) despite extant data and clinical guidelines that show that HIV