To coincide with World AIDS Day, the CDC has issued a new report on the state of the HIV epidemic in the US. It contains some good news, like infection rates in gay/bi men falling 8% in the last decade.
However, things could be a lot better. Gay and bi men account for two-thirds of all new HIV infections in the US, and although new infections “decreased significantly among White” men who have sex with men [MSM], they decreased very little among “Black or African American (Black) MSM and Hispanic/Latino MSM.”
The wide disparity in HIV infection rates between ethnic groups is not new. In 2016, a CDC report said 50% of gay, Black American men would likely become HIV positive during their lifetime. That compared to 1 in 11 White gay men. Five years later, infection rates have fallen for White gay men, but not for other ethnic groups.
The new report found HIV-positive Black gay/bi men less likely to have received a diagnosis (83% compared to 90% of White gay/bi men). They were also less likely to be virally suppressed.
Black and Hispanic/Latino HIV-negative men were less likely to take PrEP or talk with their health provider about the medication. Taken daily, PrEP greatly reduces the chances of HIV infection.
The CDC also said falls in infection rates were not uniform across all ages. Although most age groups saw a drop, those aged 25-34 saw a rise in rates. That group saw a rise in infections from 6,700 in 2010 to 10,000 in 2019.
The CDC concluded, “Longstanding inequities in access to and delivery of needed services among some racial/ethnic and age groups … have persisted despite focused efforts to prevent HIV in these populations for decades. Efforts to reduce these and other disparities must address their root causes, including systemic racism, stigma, discrimination, homophobia, poverty, homelessness, and unequal access to care and prevention services.”
In a media briefing about the report, Demetre Daskalakis, director of the CDC’s Division of HIV Prevention, said, ”It’s clear that persistent factors, like discrimination, healthcare access and use, education, income, housing and transportation are contributing to continuing HIV disparities and standing in the way of our goals.
“To end the HIV epidemic, we will need to address the systemic factors that turn health differences into public health injustice.”
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The Trump administration previously pledged to end the HIV epidemic by 2030. Those in the field take this to mean a 90% reduction in infections. The Biden administration has vowed to continue with this goal.
For this to happen, the CDC says 95% of those living with the virus must be diagnosed and virally suppressed. It says more needs doing to encourage all sexually active gay/bi men to get an annual HIV test.
It also wants at least 50% of sexually-active HIV-negative gay and bi men on PrEP. That compares to around 30% at the moment.
Unsurprisingly, it says much of the focus must be on the communities most at risk.
“Intensified and innovative efforts to expand access to HIV testing, prevention, and treatment services for MSM, particularly Black MSM, Hispanic/Latino MSM, and younger MSM, are required to decrease health disparities and reduce new HIV infections.”
“We are focused on addressing health inequities and inequalities and ensuring that the voices of people with HIV are at the center of our work to end the HIV epidemic globally,” he said.
“My Administration remains steadfast in our efforts to end the HIV epidemic, confront systems and policies that perpetuate entrenched health inequities, and build a healthier world for all people.
“My budget request includes $670 million to support the Department of Health and Human Services’ Ending the HIV Epidemic in the U.S. Initiative — to reduce HIV diagnoses and AIDS-related deaths. My Administration has also strengthened the Presidential Advisory Council on HIV/AIDS by adding members from diverse backgrounds who bring the knowledge and expertise needed to further our Nation’s HIV response.
This year marks the 40th anniversary of the first reports of AIDS by the CDC. During that time, 36 million people worldwide have died of HIV-related illness, including 700,000 Americans.