Cross posted from AIDS.gov, originally authored by Richard J. Wolitski, PhD
“Right now, we’re on track to end the scourge of HIV/AIDS. That’s within our grasp.”
— President Barack Obama, January 12, 2016
The power of those words really struck me when I heard President Obama say them in his final State of the Union address last week. I’ve wanted to believe that this was possible for the 30 years I’ve been working in HIV—but, until recently, I never really thought it could be true.
So much has changed in just a few short years. We’ve made remarkable progress in treating HIV, both here and around the globe. Now we also have tools (e.g., PrEP, PEP, and “treatment as prevention”) that can dramatically lower the number of new HIV infections.
In addition, we know that starting treatment early can stop HIV from progressing and bring down the unacceptably high rate of HIV-related deaths.
But having the tools isn’t enough—and neither is being able to envision an end to the epidemic. We have to keep up the fight until it’s really over. Ultimately, we will need to act quickly and decisively, follow the science and the data, and use all of the tools at our disposal efficiently and effectively. If we don’t, the opportunity that is within our grasp today may slip through our fingers tomorrow.
In the last decade, we’ve seen a significant drop in the total number of new HIV diagnoses in the United States, including dramatic declines in new diagnoses for black women. We’ve also seen modest increases in the percentage of people living with HIV who are getting the care they need to stay healthy.
We continue to make scientific advances toward more effective HIV prevention and treatment, as well as the development of an HIV vaccine. Policy changes, like the Affordable Care Act, are making it possible for people living with/at risk for HIV to get affordable health care and access to HIV-prevention services. And changes regarding using Federal funds to support syringe services programs can also help improve our response.
The gains are real—but the progress is uneven. Men who have sex with men (particularly black and Latino men), African American and transgender women, and people living in the South are still at disproportionate risk for contracting HIV—or dying from it. No one should have to die from HIV today.
We also know that too many people living with HIV continue to fall out of care—leading to poor health outcomes and increasing their risks for transmitting the virus. In addition, the CDC estimates that more than one million people at risk for HIV could benefit from taking PrEP, but too many don’t have access.
It’s important to recognize and celebrate the incredible progress we’ve made, but we can’t afford to let up now. Too many lives remain at stake, and we still have work to do.
To realize the potential to end the epidemic, it will take all of us—government and every sector of society—working together to increase access and improve our delivery of HIV testing, PrEP, and other prevention services within the healthcare system.
We will also need to develop or expand partnerships and build capacity to help people with HIV stay in care and achieve viral suppression—which will then serve to decrease the number of HIV-related deaths.
The National HIV/AIDS Strategy: Updated to 2020 has given us a clear roadmap for addressing the challenges and taking advantage of the opportunities. The President’s words remind me that we’ve fought too long and too hard to pull back on our efforts now. We must commit ourselves to doing what needs to be done to realize the Strategy’s vision that:
The United States will 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 socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.
Let’s not let this opportunity slip through our fingers.
Dr. Rich Wolitski is the Acting Director of the Office of HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services.