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US HIV rates are declining. but progress is negligible

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hHealth officials at the US Centers for Disease Control and Prevention (CDC) are reporting encouraging news about HIV. From 2017 to 2019, the estimated number of new infections in the US fell 12%, from 36,500 to 32,100. The decline has been driven in large part by fewer cases among young gay and bisexual men.

have had new HIV infections Declining Since 2016 there has been an increase in access to more widespread testing and treatment, as well as more education and the use of pre-exposure prophylaxis (PrEP) drugs, which can protect sexually active people at high risk from becoming infected. Among young gay and bisexual men in the US, 56% were aware of their HIV status in 2019, compared to 42% in 2017. And prescriptions for PrEP among sexually active 16- to 24-year-olds—the age most at risk for new infections—increased from 8% in 2017 to 20% in 2021.

“Improved access to testing, treatment, and PrEP is contributing to progress among youth,” said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, and STDs. [sexually transmitted diseases] and TB [tuberculosis] Prevention, during a briefing. “When evidence-based interventions are implemented, we see results.”

During the briefing, Mermin pointed to specific changes driving the drop in cases, including a collaboration between the CDC and Emory University to make HIV self-testing kits more available. The program hopes to distribute 200,000 tests this year and reach 1 million in five years, and it is already on its way to exceeding those goals.

Read more, How COVID-19 Disrupted the Fight Against HIV

However, the positive trends are still not equally distributed among different racial and ethnic groups. Persistent inequalities remain a challenge CDC’s goal To reduce new HIV infections by 90% by 2030. more young gay and bisexual men who are white are accessing treatment and prevention options like PrEP than their Hispanic and black counterparts; 45% of white men in this group who test positive are receiving PrEP or anti-HIV treatment, compared to 27% of black men and 36% of Hispanic men. The disparities are particularly stark when it comes to access to PrEP. Overall, 30% of the estimated 1.2 million Americans who are at highest risk of HIV infection and eligible to receive it were taking PrEP—but only 11% of those were black and 21% were Hispanic, compared to 78%. were white.

The discrepancy extends to other treatments as well. The latest data show that 66% of HIV-positive people will control their infection with antiviral drugs in 2021, compared to 63% in 2017. Only 62% of blacks and 64% of Hispanics will have their virus levels undetectable. Kept on 72% white.

“Deep social determinants of health continue to influence HIV treatment and prevention outcomes,” said Dr. Robin Neblett Fanfare, acting director of CDC’s Division of HIV Prevention. “Racism, systemic inequities, social marginalization, and longstanding barriers to care are key drivers of HIV’s disproportionate impact on certain communities, including gay and bisexual men and especially black women.”

Neblet Fanfare said the agency is targeting community-based campaigns to populations and regions of the country with the lowest PrEP coverage, including black and Hispanic gay and bisexual men in the South. These campaigns educate people about PrEP by collaborating with local health care providers and clinics that treat sexually transmitted infections. CDC also plans to dedicate more funding to patient hotlines and other services to help communities increase access to HIV prevention and treatment.

While the Affordable Care Act mandated that insurers fully cover PrEP for those who do not need it, recently decision That coverage is in jeopardy by a Texas judge reversing the mandate and ruling that employers are not required to provide coverage for PrEP. Biden administration has appealed That decision, but if the appeal is not successful, it could drive a deep divide between those who are able to get the drug and those who are not.

“While we are on the right track, progress is not being made adequately or equally among all people or in all regions of the country,” Mermin said. And as encouraging as infections are declining, the pace of reform is not on track to meet the CDC’s ambitious target. “We know the way, but do we have the will?”

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