By Tiffany Williams –
In his first term as president, President Donald Trump articulated an ambitious and historically bipartisan goal: to end the HIV epidemic in the United States. This initiative aimed to significantly reduce new infections and improve the quality of life for those affected by HIV/AIDS. However, as of the first 30 days of his second term, President Trump has notably not addressed the pressing issue of HIV.
In a striking contrast, just a little over a month before leaving office, President Joe Biden emphasized his administration’s commitment to combating HIV. On the eve of World AIDS Day, he stated, domestically, the implementation of the updated National HIV/AIDS Strategy (NHAS) has not only focused on reducing new HIV infections and improving health outcomes for people with HIV but also expanded efforts to address the social determinants of health, reform outdated HIV criminalization laws, and strengthen partnerships with communities and organizations nationwide. This reflects a comprehensive approach aimed not only at treatment but also at tackling systemic barriers to healthcare access.
In December, the White House released data indicating promising trends in the fight against HIV. In 2022, there was a reported 12% decrease in HIV incidence among individuals aged 13 and older compared to 2018, with an impressive 30% decrease specifically among young people aged 13-24. Furthermore, among gay, bisexual, and other men who have sex with men (MSM), new HIV infections among Black men decreased by approximately 16%, and by 20% among White men, both in comparison to 2018. However, concerning disparities remain, as there was no decrease in new infections among Hispanic/Latino men, who accounted for a staggering 39% of estimated new HIV infections in this demographic.
The White House also highlighted a significant decline in HIV-related deaths, down by 25%, underscoring the importance of early diagnosis and timely access to care. Additionally, as of 2022, 36% of individuals who could potentially benefit from pre-exposure prophylaxis (PrEP) were prescribed this preventive medication, a marked increase from 25% in 2020.
President Trump initiated the Ending the HIV Epidemic (EHE) initiative in 2019, which aimed to reduce new HIV infections in the United States by 90% by the year 2030, building upon strategies developed during the Obama administration. The ambitious goals of the EHE initiative include reducing new HIV infections by 75% by 2025, promoting health equity, ensuring rapid diagnosis and effective treatment for all people with HIV, preventing new transmissions, and swiftly responding to potential outbreaks.
The U.S. Department of Health and Human Services (HHS) launched the EHE initiative in 2019 to implement innovative, community-driven solutions that leverage scientific advancements in HIV prevention, diagnosis, treatment, and outbreak response in regions with the greatest need. Data from jurisdictions receiving EHE funding revealed a 21% decrease in HIV incidence among individuals aged 13 and older in 2022 compared to the 2017 baseline.
From 2021 to 2023, more than 61,000 individuals received PrEP through CDC-funded EHE programs. Moreover, the Health Resources and Services Administration (HRSA) supported health centers provided PrEP services to 183,000 patients between 2021 and 2023. The Ryan White HIV/AIDS Program, through EHE funding, supported over 22,000 new clients and re-engaged 19,000 individuals, with an impressive 79.2% of those new to treatment achieving viral suppression in 2022. The EHE funding also enabled 406 community health centers to conduct a cumulative total of 7.2 million HIV tests, significantly increasing the percentage of patients aware of their HIV status. Additionally, Indian Health Service EHE-supported sites performed over 20,000 HIV tests, while the CDC distributed more than 600,000 free HIV self-tests.
Between 2017 and 2022, the EHE initiative is credited with preventing approximately 9,500 new HIV infections in these jurisdictions, translating to more than $5.1 billion in lifetime medical costs saved—a figure expected to rise with continued efforts. Despite these advancements, it is notable that President Trump has yet to publicly address the ongoing challenges of HIV/AIDS during his current term.
In New Jersey, Governor Phil Murphy took significant action by signing Executive Order No. 381, which establishes an Advisory Council on HIV, STIs, and Viral Hepatitis. This new council aims to enhance the state’s public health strategies and combat the HIV epidemic, along with rising cases of sexually transmitted infections (STIs) and viral hepatitis, particularly as these are exacerbated by risks associated with injection drug use.
The Advisory Council, overseen by the New Jersey Department of Health, revitalizes the over 20-year-old Governor’s Advisory Council on HIV/AIDS and Related Blood Borne Pathogens, broadening its mission. This initiative seeks to unify government officials and community members with a defined purpose: to address the urgent public health challenges posed by communicable diseases, with a specific focus on the disproportionate impact of HIV, STIs, and viral hepatitis on Black, Hispanic, Latino, and LGBTQIA+ communities in New Jersey.
Governor Murphy’s office noted that this initiative is especially timely, given recent federal actions removing crucial public health information and services from federally maintained websites. Such moves pose risks to the ongoing progress made in combating these diseases and could hinder treatment access for those living with HIV/AIDS, STIs, and viral hepatitis.
The Advisory Council’s Key Purposes and Structure:
The Advisory Council is established to serve several critical functions aimed at enhancing public health initiatives in New Jersey. Its main purposes include:
1. Coordinating Comprehensive Efforts:
The Council will work to streamline collaboration among diverse stakeholders, including public and private healthcare agencies, local community-based organizations, and other strategic partners. The goal is to enhance public awareness and education on the prevention and treatment of HIV, sexually transmitted infections (STIs), and viral hepatitis. This includes informing the community about how to access related services throughout New Jersey, ensuring that individuals have the necessary resources and information for optimal health outcomes.
2. Identifying Innovative Strategies: The Council is tasked with identifying or developing effective strategies and opportunities to combat the ongoing HIV epidemic, STIs, and viral hepatitis. This encompasses a range of initiatives, including the implementation of the Strategic Plan to End the HIV Epidemic in New Jersey by the year 2025. The Council will analyze current data trends, research, and community needs to devise targeted interventions.
3. Recommending Policy Initiatives:
The body will recommend impactful policies, projects, programs, and initiatives aimed at improving health outcomes across the state. This will specifically target reducing health disparities and address systemic inequities affecting healthcare access and treatment for HIV, STIs, and viral hepatitis. The Council is committed to ensuring that marginalized and underserved populations receive equitable care.
Through the execution of New Jersey’s End the HIV Epidemic Plan, the state has pledged to significantly decrease the number of new HIV infections. This effort includes expanding access to HIV testing services, facilitating more efficient processes for individuals diagnosed with HIV to enter and remain in care, and ensuring smooth linkage to necessary health services.
Leadership and Composition of the Advisory Council:
The governance of the Advisory Council will be led by the Commissioner of the New Jersey Department of Health or their designated representative. The Council will comprise senior officials from various state government departments, each playing a vital role in bolstering public health infrastructure and policies.
In terms of legislative representation, both the Senate President and the Assembly Speaker will nominate two members from their respective bodies to join the Council. This inclusion ensures that legislative perspectives are integrated into the Council’s discussions and decisions.
Moreover, the Commissioner of Health will appoint a minimum of 25 public members to the Advisory Council. These members will include a diverse range of stakeholders such as public health care professionals, policy analysts, representatives from social and direct care organizations, advocates for public health, and individuals with lived experiences relating to HIV, STDs, or viral hepatitis. This diversity is intended to foster a comprehensive understanding of the issues and enhance the Council’s effectiveness in addressing public health challenges.