On World AIDS Day – A Call to Congress to Address an Epidemic of Inequalities
Jose A. Rodriguez, Associate Director of Public Policy & Advocacy of the HIV Medicine Association.
World AIDS Day, December 1, is an opportunity to raise awareness of the response to the HIV/AIDS pandemic, support individuals living with HIV, and honor the 40.1 million people who have died from HIV-related illnesses worldwide. This year’s theme, “Equalize” urges us to address the health inequalities that continue to impede progress in the fight to end the HIV epidemic.
World AIDS Day is a clear reminder that the epidemic is not over. There is still a critical need to invest in HIV prevention and treatment programs to achieve equity and overcome long-standing health disparities. In 2020, 42% of new HIV diagnoses were among Black/Africans, and 27% were among Hispanics/Latinos, and yet these populations have limited access to pre-exposure prophylaxis (PrEP)—a highly effective medication used to prevent HIV. Of PrEP users, only 14% were Black/African Americans, and 17% were Hispanic/Latinos.
IDSA’s HIV Medicine Association provides a professional home for more than 5,000 physicians, scientists and other health care professionals committed to ending HIV as an epidemic by advancing a comprehensive and humane response to the HIV pandemic, informed by science and social justice. HIVMA is committed to ending the HIV epidemic and recently published policy recommendations, which, if implemented, would bring the goals set by the federal Ending the HIV Epidemic (EHE) initiative within reach. These policy recommendations and additional funding are essential to eliminate barriers to health care that have long fueled the HIV epidemic.
HIV programs have seen an increased demand for HIV-related services due to the socioeconomic impacts of the COVID-19 pandemic and, more recently, the monkeypox outbreak. Like many public health programs, HIV programs have been chronically underfunded relative to the need for services. HIVMA urges Congress to accelerate progress by increasing funding for essential federal HIV programs, including the EHE initiative and the Ryan White HIV/AIDS Program (RWHAP), and funding a new National PrEP Program. These programs contain essential components that contribute to eliminating inequities in HIV prevention and treatment access. More about funding key HIV programs is below.
Provide new funding for the federal EHE initiative to meet the goal of reducing the number of new HIV infections in the United States by at least 90% by 2030. In the past three years, Congress has invested new funding in the initiative to scale up key HIV prevention and treatment strategies. Increases are modest compared to the scale needed to achieve EHE’s ambitious goals. Congress must expand and sustain the EHE initiative at the highest possible funding level to address the health disparities that have contributed to gaps in HIV prevention.
Provide increased funding for all parts of the Ryan White HIV/AIDS Program. The RWHAP is a vital part of the EHE initiative serving 50% of people diagnosed with HIV each year. The RWHAP has been an important safety net program for over thirty years and has been an equalizer for people who have access to RWHAP services. People with HIV receiving RWHAP services have better outcomes regardless of their health insurance status. More than 60% of people receiving RWHAP have incomes at or below 100% of the federal poverty level. More than 46% of people receiving RWHAP services identify as Black/African American, and more than 24% identify as Hispanic/Latino.
Increase equitable access to PrEP by funding a new national PrEP program within the CDC Division of HIV Prevention. PrEP is a highly effective HIV prevention drug. Yet, in the ten years since its FDA approval, PrEP uptake has been low, especially among the racial and ethnic groups most impacted by HIV. Congress must address the long-standing health disparities by creating a national PrEP program to expand access to PrEP and reach many more of the 1.2 million people who could benefit from it.
Support continued investment in HIV research to ensure meaningful progress in preventing HIV and improving health and wellbeing. Remarkable scientific advancements in research have been made in the more than four decades since the first known reported cases of AIDS. HIV research has been critical in developing innovative and effective tools for combating HIV and has led to new vaccines and treatments for many other diseases, such as cancer, Alzheimer’s, kidney disease, tuberculosis, and COVID-19.