COMMENTARY

HIV Rates Drop Across US, but Especially in These States

Heather Boerner

Disclosures

August 08, 2017

The Power of a Plan

What is happening in these states? It's simple, said Greg Millett, MPH, an epidemiologist and vice president and director of public policy for amfAR, the Foundation for AIDS Research: The test, treat, and prevent programs laid out in the National HIV/AIDS Strategy are working.

Sure, he said, individual areas have programs that have hastened the drop in transmission. DC, for instance, repealed a ban on syringe exchange programs, and the area expanded HIV testing specifically aimed at the black and Latino populations.

But the message overall is that a state doesn't have to have all the advantages of political support or massive funding to affect the HIV epidemics in their areas. What they need is a plan that targets testing at the communities most affected and prioritizes effective prevention methods when there is funding. That's what the National HIV/AIDS Strategy does.

The message overall is that a state doesn't have to have all the advantages of political support or massive funding to affect the HIV epidemics in their areas.

Millett was a senior policy advisor for the White House Office of National AIDS Policy, which helped develop the strategy.

"What we see is that it doesn't matter if you're in a southern or a northern state, in a state that expanded Medicaid or didn't, whether you're in a state that had access to [pre-exposure prophylaxis] or not," Millett told Medscape. "The number of new infections fell when you followed a small set of proven interventions."

When Millett and Jeff Crowley left the Office of National AIDS Policy last year, he said the pair wrote an exit memo to the new administration. They detailed the actions the office had taken, delineated the strategy, and estimated how big of an impact they thought they'd had on new rates of HIV. This was before the CROI data came out, though.

When they saw the results, he said, they both had the same reaction: "Wow—we undersold how effective this strategy was."

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