CDC in Houston to tout plan to end HIV
Top federal health officials Monday brought the Trump Administration’s ambitious initiative to end the HIV epidemic to Houston, home to one of the nation’s highest rates of new diagnoses.
The initiative, announced in President Donald Trump’s State of the Union address in February, seeks to dramatically cut the rate of new infections by better deploying drugs that stop the transmission of the virus that causes AIDS. The focus is on 50 “hot spots” — 48 counties, Washington, D.C., and San Juan — where half of new infections occur.
“This is a once in a generation opportunity to use tools science has spent decades developing,” said Dr. Robert Redfield, director of the Centers for Disease Control and Prevention. “We’ve had these tools to end the epidemic in our back pocket for a decade. Now it’s time to put them into action.”
Redfield met at Texas Southern University on Monday with local health officials and groups that serve populations living with HIV or at high risk of acquiring the infection. The meeting was one of many the CDC has been holding in the hot spots — Harris County is one — touting the plan and listening to ideas on the best strategies for the community.
Redfield told meeting partici
pants that the initiative can cut the rate of new infections by about 90 percent in 10 years — from about 40,000 a year nationally to about 4,000. Trump has called for $290 million for the program’s first year in the 2020 budget.
The initiative entails a two-pronged attack: get all Americans living with HIV on the triple-medication drug cocktail that lowers the viral load to a level where it is not transmitted during sex; and get all those at high risk of infection on an expensive daily pill, known as PrEP, that makes it impossible to get HIV.
HIV experts consider the plan medically sound, but add that it represents a big challenge because it requires getting people into care currently not being reached, either because they don’t know they have the virus, lack access or don’t seek it, typically because of the stigma associated with the disease.
In the 1980s and ’90s, the infection was diagnosed most often in whites, but it is now seen most often in minorities. In 2018 in Harris County, for instance, 48 percent of new diagnoses were in blacks and 35 percent were in Hispanics.
Currently, more than 26,000 people in Harris County have HIV. The county’s 1,200 new cases annually are the most in Texas, and Houston has the nation’s eighth highest rate of new infections.
Stephen Williams, director of the Houston health department, said he felt challenged by statistics mentioned at the meeting showing previously launched efforts in Baltimore and Washington have reduced the number of new diagnoses in those cities annually by 75 percent and 50 percent, respectively.
“Those cities have a lot of problems,” said Williams. “We need to look at what happened there and determine how we can replicate their improvement.”
AIDS peaked in the United States in the mid-1990s. In the ensuing years, drug cocktails made it a chronic disease.
But the infection continues to be transmitted and the South has become the new epicenter.
Trump’s plan to stop the epidemic has been welcomed by groups that work with HIV, though many have complained that other proposed actions by the administration — such as cuts to Medicaid and the Housing Opportunities for People with AIDS program — could undermine the effort.
Others have questioned whether there will be enough money going forward to fund a program that experts estimate could add as much as $25 million more a year to the amount the federal government already spends on HIV prevention and treatment.
But Redfield and Dr. Brett Giroir, assistant secretary for Health and Health Human Services, said they are “100 percent confident we will have the resources to do this.”