COMMENTARY

HIV Rates Drop Across US, but Especially in These States

Heather Boerner

Disclosures

August 08, 2017

Mission Not Accomplished

In Georgia, a state that's seen a drop in both incidence and rate of undiagnosed infection, the data was shocking in a good way, said Wendy Armstrong, MD, director of the Ponce de Leon Center at Emory University in Atlanta and chair of the HIV Medicine Association.

"We're all using that word—'shocking,'" she said. "And I totally agree with Greg—the National HIV/AIDS Strategy was critical as a guiding principle for local clinics to be more aggressive and harness change."

Indeed, the strategy was a blueprint for Atlanta's local blueprint on HIV and AIDS. Because the strategy called for people diagnosed with HIV to be linked to care within 30 days instead of 90, for instance, she said that local physicians and policymakers were able to push for hospital policies that could establish linkage to care in as quick at 72 hours. As a result, fewer people are being diagnosed and then lost to care, she said, which may be showing up in the CDC data.

But with the website for the White House Office of National AIDS Policy still down and no word yet from the Trump Administration about its commitment to renewing the strategy or its investment in the President's Emergency Plan for AIDS Relief, Dr Armstrong warned that it's too soon to celebrate.

"These are gains in a long war," she said. "This is wonderful data that tells us that this ongoing, multipronged effort is having some success. We need to sustain the funding for that, sustain the energy, and continue to look for data that highlight harder-to-reach populations."

At Dr Armstrong's clinic, for instance, she said she still sees about one patient a week die from AIDS-defining illnesses. And about half of the people who are diagnosed with HIV in Atlanta are diagnosed when they already meet the clinical criteria for AIDS—evidence of very late diagnosis, which carries with it the likelihood that that person, unwittingly, has transmitted the virus to someone they care about.

"We have to be cautious about prematurely declaring victory," Dr Armstrong told Medscape. "'Mission accomplished' is not the message."

The study reported here was funded by the CDC. Dr Armstrong, Mr Millett, and Ms Johnson have disclosed no relevant financial relationships.

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