HIV/AIDS is getting top billing this month. Last Week, Dr. Anthony Fauci – Director of the National Institute of Allergy and Infectious Diseases and one of the world’s foremost HIV/AIDS experts – declared that we have “no more excuses” not to end the HIV pandemic. In an Op-Ed for the Washington Post, Dr. Fauci wrote: “[W]e have the tools to end the HIV/AIDS epidemic in the United States and globally. We can save the lives of infected individuals and prevent them from infecting others by getting them into treatment programs and maintaining them there. In addition, we can effectively prevent HIV infection in at-risk populations by a number of means, including the use of the highly effective [Pre-Exposure Prophylaxis, or] PrEP.”
In his State of the Union address, President Barack Obama pledged his commitment to the eradication of many common international killers – cancer, malaria and HIV: “Right now, we’re on track to end the scourge of HIV/AIDS. That’s within our grasp.”
DC Appleseed has been working on HIV at the local level for over a decade. We are heartened by the progress made in HIV diagnosis and treatment, and energized by the potential to dramatically reduce the threat of HIV. But we also know that the task is more nuanced than headlines suggest. As Benjamin Ryan wrote in POZ magazine this month: “It is not really one epidemic, but a loose collection of smaller epidemics among various risk groups… The epidemic also follows vastly different patterns in different metropolitan areas. So looking only at the big picture and not these finer details yields a particularly inadequate picture of HIV’s present condition.”
The District of Columbia has many advantages in this fight that other jurisdictions – particularly in the Southern states – don’t enjoy. One of our greatest assets is a robust Medicaid expansion, and the D.C. Alliance program to cover others who are not eligible. We have a syringe access program supported by local government, a mandate for comprehensive sex education in schools through the Healthy Schools Act, and an effective and engaged Department of Health with an arsenal of effective, evidence-based programs. Local healthcare providers are embracing PrEP, a powerful new prevention tool. Our rate of new infections has declined by 40% since just five years ago. But, we have a steep curve to climb. Over 16,000 D.C. residents (2.5% of the population) are living with HIV/AIDS. Anything above 1% is defined as an epidemic – we far exceed this threshold. And, as Dr. Fauci’s Op-Ed points out, social and economic factors like poverty, housing and hunger are deeply entangled in the fabric of HIV; we know these are deep-rooted challenges in the District.
Last year, Dr. Fauci did DC Appleseed the great honor of speaking at our annual event. His keynote address spoke to the potential for D.C. to be one of the first cities to end the HIV/AIDS epidemic.
This is why we are is working with the Mayor and Department of Health to develop a plan to end the HIV epidemic. In the research stages, our “90/90/90/50 plan” is built upon four primary targets: First, 90% of those infected with HIV know their status. Second, 90% of those diagnosed as HIV-positive are retained in ongoing treatment. Third, 90% of those in treatment have a viral load low enough that it is very unlikely they will pass on the virus. And fourth, this will all lead to a 50% reduction in new HIV infections by 2020.
We know that we must work closely with local experts and community members to craft an effective, culturally-competent and sustainable plan. Our second community meeting will take place on Thursday February 11th from 6-8 pm at Isreal Baptist Church (1251 Saratoga Avenue NE). We welcome the input of all District residents; without our community, we cannot end the HIV epidemic within our community.