As HIV Spikes In Southeast, What We Need To Fight The Epidemic

With Meghna Chakrabarti

Southern states now make up the majority of new HIV diagnoses. We look at the political and structural reasons behind the increase, and at solutions.

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Guests

Nic Carlisle, executive director of the Southern AIDS Coalition (@SouthernAIDSCo). Former member of the Presidential Advisory Council on HIV/AIDS, 2016-2017.

Nicole Roebuck, executive director for AID Atlanta, an HIV/AIDS service organization in Georgia. (@aidatlanta)

Dr. Deborah Holmes, HIV specialist, medical director of the AIDS Healthcare Foundation (AHF) Healthcare Center at the Jackson North Medical Center in Miami. (@AIDSHealthcare)

From The Reading List

Los Angeles Times: “Halting HIV by 2030 is a challenge. Here’s why it’s especially tough in the South” — “By midmorning, a line snaked out the door of AID Atlanta’s Midtown clinic. It was National Black HIV/AIDS Awareness Day, and the waiting room was packed with people — a worker in an orange safety vest, a mother cradling a toddler, a man in a navy suit — waiting to be tested.

“Downstairs, Ted Krug, a volunteer with the Georgia AIDS and STI Information Line, picked up the telephone and tried to calm a 54-year-old woman who was panicking because she’d had unprotected sex with someone she later learned was bisexual.

“In her office cubicle, medical case manager Carla McCray checked the time. A client, 22 and without health insurance, had not shown up for his appointment to apply for federal funds for HIV drugs. She called his cellphone to ask what was going on, but got no answer.

“In his State of the Union address earlier this month, President Trump announced a plan to halt the transmission of HIV in the United States by 2030. But clinics across the country face a knot of obstacles to meeting that target. The problems are most severe in the Southeast, currently the epicenter of the nation’s HIV epidemic.”

Politico: “Trump’s HIV strategy faces potential minefield” — “President Donald Trump has vowed to end the nation’s HIV epidemic in a decade — but to do so, he’ll need to win over skeptics in the health community and on Capitol Hill, tamp down concerns from faith leaders and navigate hurdles inside his administration.

“The ambitious State of the Union pronouncement has been undermined by Trump’s own actions: He’s tried to cut nearly $1 billion in global HIV/AIDS funding, roll back protections for patients living with the disease and strike down health benefits for LGBTQ Americans.

“‘There’s a lot of distrust between the community and the administration, understandably,’ said Carl Schmid, deputy executive director of the AIDS Institute, who was recently tapped to help lead Trump’s advisory council on HIV/AIDS. ‘This could be a good opportunity to show they’re committed to this.’

“More than 1 million Americans live with HIV and about 40,000 Americans — two-thirds of whom are gay or bisexual men — are newly infected every year. The administration has initially targeted about $250 million in new funding next year, steered mostly to the CDC and the health department’s Ryan White HIV/AIDS Program, according to three people with knowledge of the plan. Hundreds of millions of dollars in additional funding would be phased in over subsequent years, although the commitment could change significantly as the Trump administration works through the budget process.”

Vox: “Trump called for an end to HIV in the US by 2030. That’s totally realistic.” — “There are currently more than a million Americans living with HIV, and about 40,000 new infections are diagnosed here every year. African-American gay and bisexual men are the group most affected by HIV in the US, and diagnoses in the mid-20s to mid-30s age cohort have been rising in recent years. But Trump’s proposal is not at all as far-fetched as it may seem.

“That’s because we actually know what needs to be done to stop the spread of HIV, even in those high-risk groups. Antiretroviral treatment can now suppress the virus to the point that it’s undetectable in the blood, so people on treatment are unlikely to pass the virus to others. We also have a drug — PrEP, sold by the brand name Truvada — that can prevent people at risk of infection from contracting the virus. (The drug has also recently been linked to riskier sexual behaviors.) Together with public health measures — like diagnosing cases, clean needle exchanges, and messaging about safe sex — ending HIV is truly within reach.

“For now, the details of the administration’s plans are still murky. All we have is a two-page HHS fact sheet to go on. So we asked seven HIV and public health experts to weigh in on what Trump’s plan to end HIV in the US should do if the administration is serious about tackling the ongoing epidemic. Here’s what they told us. Their answers have been lightly edited for clarity.”

Brian Hardzinski and Aceel Kibbi produced this hour for broadcast.

This article was originally published on WBUR.org. [Copyright 2019 NPR]