On World AIDS Day, it’s important to think about people living with or at risk for HIV/AIDS, especially those most impacted by the disease. These include gay, bisexual, and other men who have sex with men (MSM), especially Black and Latino men, a group that is over-represented among both existing HIV/AIDS cases as well as new HIV infections. Indeed, this is the only subpopulation for which new infections continue to grow. MSM of all races and ethnicities is the first key population identified in the recently updated National HIV/AIDS Strategy (NHAS). Other groups highly impacted and therefore prioritized by the NHAS include Black women and men, Latino men and women, people who inject drugs, youth aged 13 to 24 years, people in the Southern United States, and Transgender women.
The availability of health insurance to these groups, as well as all Americans, has been greatly expanded under the Affordable Care Act (ACA) and is the first significant achievement noted in the updated NHAS. Expanding access to insurance increases access to HIV testing for everyone at risk of infection. For PLWH, many of whom now have insurance for the first time, they can receive treatment and care for non-HIV health care needs, such as injuries or diabetes treatment. At JSI, our Affordable Care Enrollment Technical Assistance Center is in its third year of providing tools, resources and targeted assistance to Ryan White HIV/AIDS Program recipients across the nation to support outreach and enrollment of people living with HIV (PLWH) into both marketplace and Medicaid options.
The NHAS includes a call to action to “imagin[e] a future free of new HIV infections in the United States and healthier, longer lives for people living with HIV.” A major new tool for eliminating new HIV infection is Pre-Exposure Prophylaxis or PrEP. The one-pill-a-day regimen has been shown to virtually eliminate the risk of HIV infection for those who take the pill regularly. While behavior change and condom use remain important prevention strategies, PrEP has become more widely disseminated in the past year, with tens of thousands of at –risk individuals now taking preventive medication. More information about its effectiveness is being communicated both to prescribing health care providers and people at risk for infection. We will learn in the next few years if PrEP can “bend the curve” downward in terms of new HIV infections nationally.
With World AIDS Day falling so soon after Thanksgiving, I’d be remiss in not expressing my thanks for the opportunity to live 30+ years after becoming infected with HIV. From the activists who organized to speed up treatment research to my many doctors and nurses and counselors who provided me with care to my employers and colleagues who have always stood with me on this issue and to my friends, family and life partner who have supported and loved me – THANK YOU! On this World AIDS, I hope everyone affected by HIV/AIDS has the support they need to stay well and live happy, fulfilled lives.