It often seems as if HIV/AIDS has moved out of the public consciousness, and is just an occasional blip on the 24-hour news cycle radar.
Where progress is made
But HIV is back making headlines, this time with some encouraging data from the Centers for Disease Control and Prevention. The data shows that annual new HIV infections in the United States dropped 18 percent from 2008 to 2014, from an estimated 45,700 to 37,600.
This is good news and is in large part a testament both to the effectiveness of the National AIDS Strategy, launched in 2010 by President Obama, and to the expansion of access to treatment and care made possible by the Affordable Care Act. Unfortunately, progress has not been the same across all populations and communities.
Disparities in health
While annual HIV infections dropped among heterosexuals and people who inject drugs, gay and bisexual men — who make up two-thirds of people diagnosed with HIV every year — were the only group that did not experience an overall decline over six years.
Annual HIV infection rates among young gay and bisexual men aged 13 to 24 declined 18 percent. And they remained stable for gay and bisexual men overall and among black gay and bisexual men. This is a hopeful sign after decades of rising incidence among both groups.
Despite these gains, there was a 35 percent increase in HIV infections among 25 to 34-year-old gay and bisexual men, as well as a 20 percent increase among Latino gay and bisexual men.
Improving the numbers
What’s clear is that we need to do a better job of HIV education and outreach that targets these vulnerable groups and urges them to get tested and to seek treatment if they test positive for HIV. We also need to reduce HIV-related stigma, especially within the gay community. It deters people from getting tested and seeking treatment. And we need to support research that will help us find a cure that would obviate the need for a lifetime of antiretroviral treatment.
What is worrisome is that it’s easy to envision a resurgence of HIV infection rates, particularly among gay men. In states that expanded Medicaid coverage under the Affordable Care Act, the proportion of people receiving HIV medications under Medicaid rose from 39 percent in 2012 to 51 percent in 2014. It’s important to bear in mind that people on treatment are rendered more or less non-infectious.
If, as seems likely, the Affordable Care Act is dismantled or repealed, and access to Medicaid curtailed as a result, HIV could once again become more than just a blip on the news radar.
Kevin Robert Frost, CEO, amfAR, [email protected]