LITTLE ROCK, Ark. — Public-health advocates in Arkansas are still waiting to hear the details of a recently announced federal initiative aimed at ending new HIV infections in the U.S.
During his State of the Union address in February, President Donald Trump announced a plan designed to cut new infections by 75 percent in five years and 90 percent in 10 years. Arkansas is one of seven states with high rates of the deadly virus where the program will be focused.
Cornelius Mabin, president and CEO at the health education group Arkansas RAPPS, said while the state does have one of the highest rates of HIV/AIDS in the country, they have only heard sketchy details of what exactly the plan entails.
"The plan that the Trump administration is talking about is to really look out into more of the rural parts of Arkansas or the rural parts of the state, where we do have some issues with people finding care, and continuing in care and finding clinicians and facilities out in those areas,” Mabin said.
Arkansas RAPPS is a foundation that operates programs across the state to treat and prevent HIV/AIDS, hepatitis C and other infectious diseases. The president's program is aimed at preventing new cases of HIV/AIDS, focusing initially in Arkansas, Alabama, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina, as well as 48 "high-burden" counties.
Mabin said the rate of HIV/AIDS in Arkansas falls disproportionately on minority and LGBTQ populations.
"According to our epidemiologist, we have 5,380 individuals who live with HIV here in Arkansas,” he said. “We do know that primarily people of color, blacks, African-American men basically 18-24. We've seen increases and we've concentrated our efforts in that area. "
Mabin said his group already participates in established HIV programs, but his main concern is with how much money the new program will provide and when Arkansas officials will see it.
"We haven't really had adequate time to get all of the details of it, but I understand where they're trying to go,” Mabin said. “But technically, what we've been using here is the National HIV Strategy, which was already done from the Obama administration."
According to the U.S. Health and Human Services Department, the new efforts will focus on four key strategies: Diagnose, Treat, Protect, and Respond.
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Today is National HIV Testing Day. First observed in the U.S. in 1995, anyone who is sexually active is urged to get tested to know their HIV status.
The federal government underscores the importance of testing to show self-value, compassion and respect. According to the Centers for Disease Control and Prevention, almost 14,000 Hoosiers are living with HIV, the virus that causes AIDS.
Alan Witchey, president and CEO of the Damien Center, an HIV/AIDS resource in Indianapolis, said the blood test is free and confidential, and insurance is not required.
"Nobody has to know that you're coming, and you can either make an appointment or you can just walk in," Witchey explained. "It's just a quick finger prick; you will have your results in 20 minutes."
He added testing for other sexually transmitted diseases can be performed at the same time. A positive test result will alert the Damien Center staff to connect the person to support services and the clinic. For a negative result, medication is available for HIV prevention. The services are available at little to no cost.
The Centers for Disease Control and Prevention said 100,000 cases of AIDS, the condition which mutates from an HIV diagnosis, were reported in the U.S. between 1981 -- the first reported case -- and 1989. Since then, the invention of life-extending medications has lessened the public's urgency to get tested.
Witchey emphasized HIV is still growing and spreading, even as other epidemics have evolved.
"Even though you don't hear about HIV as much anymore, it is still here," Witchey pointed out. "And a lot of people still have this misconception that HIV is a death sentence, or they won't be able to afford the medications even if they are HIV-positive."
"Ending the HIV Epidemic in the U.S." is a federal program with the aim of lowering new HIV infections nationwide by 75% by next year and at least 90% by 2030. Funding will be used to zero in on locations with the most frequent HIV transmission.
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New Mexico activists are tapping today's World AIDS Day, Dec. 1, to announce they'll ask the State Legislature to provide more money for treatment and prevention.
Equality New Mexico Executive Director Marshall Martinez voiced concern that many primary care providers fail to prescribe treatments known as PrEP and PEP, perhaps worried that they are specialized and complex. His group will ask lawmakers to provide more funding to the Department of Health to initiate educational outreach.
Marshall said the treatments significantly reduce risk and the effects of AIDS: "Since the beginning of the epidemic in the '80s, we've never had as powerful of a preventive tool as we have in PrEP."
According to Martinez, the New Mexico Department of Health reports there are between 3,000 and 4,000 people in the state living with HIV.
Federal data show American Indians and Alaska Natives have over twice the rate of HIV infection as their white counterparts. They also are more likely to die from HIV infection.
Nonetheless, Martinez noted the majority of those taking preventive medications are cisgender, white men. He stressed this demonstrates how important it is for the state to reach Indigenous and immigrant communities, starting with funds to train medical providers.
"And then public messaging in those sort-of non-traditional communities and from non-traditional messengers to say, 'Hey, there's this drug called PrEP - it would prevent HIV - you should ask your doctor about it,'" he explained.
It is estimated that since 1981, more than 40 million people have died from AIDS; in some countries, it is still the leading cause of death. Currently, almost 30 million people are using therapies to inhibit HIV and prevent AIDS.
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Today is National Gay Men's HIV/AIDS Awareness Day, and Nevada is one of the 10 states with the highest HIV infection rates.
In 2021, more than 11,000 Nevadans were living with HIV. Recent data show nearly 70% of all new HIV diagnoses in the U.S. are among gay and bisexual men.
Dr. Laura Cheever, associate administrator of the HIV/AIDS Bureau for the Health Resources and Services Administration, said despite progress in care and treatment, there are still many who do not realize they have the disease. HIV today is what she called a "manageable, chronic disease," which can be treated with antiretroviral therapy leading to viral suppression and have no risk of transmitting HIV sexually to someone else.
"In order to live a near normal life span, a person with HIV needs to get on medication and stay on them," Cheever explained. "A lot of people just don't want to deal with the fact that they may have HIV because there is so much stigma still around the HIV diagnosis as well as other issues including homophobia and racism."
Cheever advised getting tested is the first step. For those who test negative, there are ways to prevent future infections. She noted pre-exposure prophylaxis, commonly known as "PrEP," is a great option. According to the Centers for Disease Control, PrEP reduces the risk of getting HIV from sex by 99% when taken as prescribed.
Cheever pointed out like other chronic diseases, HIV disproportionately affects those who are part of minority populations. She added for those looking to receive care or treatment for HIV at low or no cost, you can visit hiv.gov. You can also visit takemehome.org, and enter your ZIP code to see if you are eligible to receive a free, at-home HIV testing kit.
Cheever stressed it is important to realize HIV does not solely affect men who have sex with men.
"It can be transmitted between any two people having sex," Cheever cautioned. "It is disproportionate in the population of gay men in this country which is largely based on sort of historically how it entered this country, but anyone who is sexually active is potentially at risk for HIV."
Cheever added access to health care, education and prevention efforts are all contributing factors in decreasing the rates of HIV.
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