President Biden announced a new National HIV/AIDS strategy that he described as “a roadmap for how we’re going to put our foot on the gas, and accelerate our efforts to end the HIV epidemic in the United States by the year 2030.”
On World AIDS Day, the president spoke from the East Room of the White House, alongside Department of Health and Human Services (HHS) Secretary Xavier Becerra. Also in attendance was Gabriel Maldonado, founder and CEO of TruEvolution, a California-based organization that provides comprehensive HIV support for people living with the virus. Maldonado is a person living with HIV.
Biden thanked Maldonado and other advocates, as well as lawmakers and House Speaker Nancy Pelosi (D-Calif.) in particular, for their tireless efforts on behalf of people with HIV.
“It’s because of all of you, and the dedication of scientists and activists around the world, that we’ve been able to dramatically reduce new HIV transmissions and make individuals with HIV today lead long and healthy lives,” he said.
Through efforts like the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by President George W. Bush in 2003, 21 million lives have been saved and millions of HIV infections have been prevented, Biden noted. Yet he also pointed out that, in the 40 years since the first AIDS cases were reported by the CDC, 700,000 people in the U.S. have died (36 million globally). In addition, nearly 13,000 people living with HIV in the U.S. die each year, according to a Kaiser Family Foundation report.
According to the new plan, the U.S. “will be a place where new HIV infections are prevented, every person knows their status, and every person with HIV has high-quality care and treatment, lives free from stigma and discrimination, and can achieve their full potential for health and well-being across the lifespan.”
Racism: A Public Health Issue
The Biden-Harris administration’s new 4-year plan builds on previous administrations’ efforts and provides a blueprint to guide policies, research, and programs through 2025 with the goal of ending the HIV epidemic by 2030, the report noted. A key principle of the plan is its recognition of racism as “a public health threat” that “contribute[s] to the excess burden of disease” in communities at risk for HIV, viral hepatitis, and other sexually transmitted infections.
On Tuesday, the CDC issued a Vital Signs report highlighting racial disparities in HIV trends from 2010 to 2019. Infections declined about 32% for white men who have sex with men (MSM) but infections among Black and Latino MSM remained mostly flat, according to the report.
The new plan promotes “a whole-of-society response” to end the HIV epidemic, while also expanding support for people with HIV, and curbing HIV morbidity and mortality, explained a senior administration official during a press call prior to the briefing. This response includes preventing new HIV infections through increased awareness of the virus and expanded access to testing and pre-exposure prophylaxis; reducing HIV-related disparities and health inequities by training a more diverse HIV workforce; and reducing HIV-related stigma and discrimination.
The plan also calls for expanding access to services for people with HIV, highlights the particular needs of people aging with HIV, and calls for more attention to quality-of-life concerns, the official said.
Another critical element is the plan’s focus on social determinants of health, which have an impact on both the risk of contracting HIV and of other negative outcomes. The plan aims to leverage the most recent data on HIV incidence, prevalence, and trends; calls for states to reform HIV criminalization laws; and renews efforts to collaborate with private sector partners.
President Biden stressed the importance of eliminating laws that “perpetuate discrimination, exacerbate disparities, discourage HIV testing, and take us further away from our goal.” As an example, he cited unscientific state laws that make it a crime for people with HIV to spit, because it was once believed that the virus could be transmitted through saliva.
Finally, the plan also aims to develop a more “coordinated” and “integrated” response from federal departments other than HHS, a senior official told reporters. For instance, the Department of Housing and Urban Development (HUD) has previously been involved in addressing the HIV epidemic through the Housing Opportunities for People with AIDS (HOPWA) program. Now HUD is looking at how Section 8 housing can also support HIV response efforts, the official noted.
That integrated response also extends to addressing the needs of people with HIV in the context of other challenges such as substance use disorders and mental health disorders.
‘We Can Do This’
Biden highlighted the recent announcement that the U.S. will host the Global Fund’s Seventh Replenishment Conference. In November, the administration signed onto the fund’s new 5-year strategy that “places HIV/AIDS at the center of global efforts to strengthen health systems and respond to future health shocks.”
A White House fact sheet noted other significant actions the Biden administration has carried out, such as:
The president has pledged to issue a new 5-year strategy for PEPFAR in 2022 that will continue to promote core programs, including those focused on HIV primary prevention; data-driven HIV testing; and enhanced care and treatment for people living with HIV.
“We still have a difficult road ahead of us… We can’t kid ourselves,” Biden said. “We can do this. We can eliminate HIV transmission. We can get the epidemic under control here in the United States and countries around the world… Folks, together we’re going to save lives.”