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 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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Once viewed as an automatic death sentence with the first diagnosis in 1981, HIV today is met with effective treatment options. Today is National HIV Testing Day, which encourages people to get tested to determine if they are infected. Testing is free and confidential at multiple sites around the country.
Alan Witchey, president and CEO of The Damian Center, an Indiana AIDS service organization, said testing for the virus is simple.
"You can come in and get your status in minutes. It's a rapid test," he explained. "It's just a pin prick to your finger and you can get your status in minutes, so it's worthwhile going and finding out."
According to the Centers for Disease Control and Prevention, in Indiana, 540 new cases of HIV were detected as of January 2022 - currently, there are 13,900 people living with HIV in the state.
The agency also says an estimated 1.2 million people in the United States had HIV at the end of 2021. Of those people, about 87% reported being aware they were HIV positive. Witchey admits the urgency and attention to the diagnosis and treatment of HIV and AIDS has faded over time due to medications that help infected people live long and healthy lives, but added it is a misnomer to believe the HIV and AIDS epidemic is over.
"The epidemic is still going on in central Indiana," he said. "We had 300 new cases last year. There are about 1,000 people in central Indiana that are living with HIV and don't know it."
Witchey added often people will get diagnosed later, and they may already feel ill or have side effects related to the disease - which is why it is so important to get an early diagnosis. A 2020 study by 'aidsvs.org' found that 76% of people who developed AIDS had a late HIV diagnosis, which is defined as having an AIDS diagnosis within three months of testing positive for the HIV virus.
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Today is National Black HIV/AIDS Awareness Day, and advocates say barriers remain when it comes to testing and social stigma. More than 40% percent of people currently living with HIV are Black, despite accounting for only 12% of the U.S. population.
Laura Cheever, associate administrator with the HIV/AIDS Bureau, Health Resources and Services Administration, said viral suppression treatment, in the form of daily medication, has allowed most HIV patients to live a successful and near-normal lives.
"So it's no longer a death sentence," Cheever said. "So, that's really important. And second, that person cannot transmit HIV sexually to other people. So it's important both for their health and for our work towards ending the HIV epidemic."
More than 87% of Black Americans living with HIV/AIDs are receiving medical care and viral suppression drugs, according to federal data. Cheever added that is a huge increase from the number of Black patients receiving treatment in 2010.
In 2020, North Carolina ranked in the top ten states for new HIV cases among adults and adolescents, with more than 1,000 residents newly diagnosed, most of whom are Black men, according to the Centers for Disease Control and Prevention.
Cheever said an ongoing challenge, especially in rural areas and in the South, is encouraging people to get tested.
"One in eight people living with HIV don't know they have it," Cheever said. "So, we need better testing. And we need people to come in here and stay in care, we estimate that of the 1.2 million people with HIV in this country, 250,000 are out of care. "
According to research focused on the deep South, common barriers to testing include transportation, cost, not knowing where to receive specialty care, stigma, and fear of others in the community finding out.
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