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Will Joe Biden pick Karen Bass for VP? She fits the bill

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Rep. Karen Bass with her gay LA deputy Darryn Harris during a visit to In The Meantime Men in South LA. (Photo by Karen Ocamb)

Heading into the COVID-crazy Fourth of July holiday, the nation is wrestling with the very meaning of freedom as even red states are mandating mask wearing, stay-at-home orders and small family gatherings. Many are now heeding Infectious disease expert Dr. Anthony Fauci’s blaring siren: “I would not be surprised if we go up to 100,000 [cases] a day if this does not turn around, and so I am very concerned,” Fauci told lawmakers.

America is in trouble. The Trump administration’s failure to keep the country safe from the highly infectious novel coronavirus has exposed an inadequate healthcare system that largely impacts the elderly and marginalized minorities, including LGBTQ people at high risk for contracting the new coronavirus.

Many are turning their frightened eyes to presumptive Democratic presidential nominee Joe Biden to heal the horribly divided nation this November.

“Today we’re facing a serious threat, and we must meet it — as one country. But this President gives us no direction. He pits us against one another,” Biden said June 30 in televised remarks.

For a running mate, Biden say he wants an experienced woman who could immediately assume presidential leadership, if needed; someone with whom he is “simpatico;” and someone who shares his priorities and values, which includes LGBTQ equality.

The New York Times identified 13 candidates, including out Wisconsin Sen. Tammy Baldwin.

Many politicos assume that California Sen. Kamala Harris has a lock on the spot. She is a highly qualified Black/Asian former presidential candidate who Biden knows through her relationship with his beloved late son Beau when they served as attorneys general. Biden was clearly hurt when Harris attacked him over segregation during a presidential debate but she apologized and they made up. Others are not as forgiving.

Several of the other candidates might fit the moment but no one matches the breadth of bona fides offered by California Rep. Karen Bass.

The Times frames Bass as a long shot since the Biden team “has reached an advanced stage of the vetting process” and Bass’ extensive record may require more vetting than is possible before Biden’s announcement date around August 1. Bass also lacked national name recognition.

That changed when she became the Congressional leader most identified with pushing for police reform after the world witnessed the 8 minutes and 46 seconds cellphone video showing a white Minneapolis police officer calmly kneeling on the neck of a Black man in his custody, pleading for air and his mother until he expired.

The video of that May 25 murder exposed the scourge of systemic racism and sparked mass marches supporting Black Lives Matter. People of all races, ages and identities demanded police reform and justice for the death of George Floyd, including 25,000 people who marched on June 14 with LGBTQ All Black Lives Matter from Hollywood to West Hollywood, spotlighting the murders of Black trans people.

“That was a slow, torturous murder, and the whole world saw it,” Bass told the New York Times. “I think it was just one murder too many.”

Karen Bass has been working to dismantle systemic racism, as well as other forms of social, racial and economic injustice, for decades. She is a community activist who was raised on civil rights activism in LA’s Jewish Venice-Fairfax district, volunteered for Bobby Kennedy’s presidential campaign in middle school, graduated from Hamilton High School in West LA in 1971, studied philosophy at San Diego University but switched her attention to healthcare, graduating from USC’s Keck School of Medicine Physician Assistant Program. She subsequently received her BA in health sciences from Cal State/Dominguez Hills and her Masters in Social Work from USC.

Bass focused that training on fighting the crack epidemic in South LA, where she founded the Community Coalition to fight for substance abuse prevention programs and better foster care and relative caregivers, like grandmothers.

She also fought the AIDS epidemic — all experience directly applicable to dealing with the ongoing Opioid crisis, as well as COVID-19.

“I went through the AIDS crisis from its very beginning. I watched all of Santa Monica Boulevard get wiped out near Vermont (Ave.). That whole area there. I watched everybody die within a matter of two years,” Bass told the Los Angeles Blade last March. “But I think that this [COVID-19 crisis] is really hard because you don’t have to have any physical contact….People are building the plane while it’s flying.”

Torie Osborn c 1980/90 (screen grab from National Coming Out Day video produced by Karen Ocamb)

Torie Osborn, the executive director of the Los Angeles Gay and Lesbian Community Services Center in 1989, met Bass at a meeting of progressive grassroots activists in a South LA church basement.

“This woman I didn’t know came up, introduced herself as Karen Bass from South LA, an anti-police violence activist and a physician assistant,” Osborn says. The two talked all day with Bass noting that the gay community’s experience of AIDS deaths was similar to what the Black community was experiencing during the crack epidemic.

“I had never heard anything like this before. She knew gay men. She clearly was an ally,” Osborn says.

Bass also talked about the LAPD battering rams used to level suspected crack houses. “They just had like a militarized response to the epidemic and she was really angry about it. And she said, ‘Do you understand that the genocidal attacks on my community are similar to the genocidal attacks on yours?’” Osborn says. “I never thought about the similarities between attacks by the state – for gays, it was the genocidal neglect of the Reagan years.”

At a June 10 hearing on the bill she crafted with Rep. Jerry Nadler and Sens. Harris and Cory Booker — the George Floyd Justice in Policing Act of 2020 — Bass noted that “she had begun protesting police violence the same year that Mr. Floyd was born, in 1973,” the New York Times reported. She also recalled LAPD Chief Daryl Gates “calling a news conference to claim that the reason so many black people were dying of chokeholds in police custody was ‘because our neck veins were different.’”

Bass says the 1992 LA riots after the acquittal of four white police officers videotaped beating unarmed Black motorist Rodney King hit her personally.

“I just drove around feeling that all of the years of my involvement and all of the things I had tried to do had been a failure,” Bass recalled in 2011. “I failed the young people because they felt no outlet other than to destroy.”

Bass was talked into running for elective office by Miguel Contreras, the late chief of the Los Angeles County Federation of Labor. In 2005, she won the Assembly seat being vacated by Diane Watson. She was immediately given leadership positions of majority whip then majority leader by Speaker Fabian Nunez. She risked political support by helping gay Assemblymember Mark Leno push AB 19, the state’s first marriage equality bill.

Three years later, Bass was unanimously elected Speaker of the Assembly, making history as California’s first Black women Speaker.

Bass’s political skills were tested in 2008/2009 when the Speaker dealt with renown sexist Republican Gov. Arnold Schwarzenegger — with whom Bass felt “fine” working since he was from the LA entertainment industry — as well as difficult Democrats, to get California, the epicenter of the foreclosure crisis, out of the Great Recession.

For that work, Bass, Senate leader Darrell Steinberg and the two Republican leaders — Assemblyman Mike Villines and Sen. Dave Cogdill — all received the annual Profile in Courage Award from the John F. Kennedy Library, the LA Times noted.

“She was great,” Villines recalls to LA Times columnist George Skelton. “If she were the VP, she’d be fantastic. She’s a normal person. Negotiating with her was easy. She would listen. It was never confrontational. I found her to be truthful and honest, someone just trying to get things done.”

There is a reason Bass has been mentioned as the most likely to succeed House Speaker Pelosi, if she steps down.

“Having had the great pleasure to serve with Congresswoman Bass in the State Assembly, before and after she became Speaker, I am not surprised that she is being considered by Joe Biden,” Leno tells the Los Angeles Blade. “Her talents and potential are obvious to all. Having authored the legislature’s Equal Marriage Rights bills, I know personally of her commitment to LGBTQ
equality. She is a fierce champion of not only our community but
to all those who are disenfranchised and struggling for equal treatment under
the law.”

Another plus for Biden in attempting to heal the nation — Bass sincerely reaches across the partisan divide to get things done. She calls Republican House Minority Leader Kevin McCarthy a friend from their days in the Assembly. She successfully passed the Justice in Policing Act by a 236-181 margin with three Republicans — moderate Reps. Will Hurd (R-Texas), Fred Upton (R-Mich.) and Brian Fitzpatrick (R-Pa.) — voting in favor.

“The Justice in Policing Act is a bill for human rights in our country,” said Bass, Chair of the 50-plus-member Congressional Black Caucus.

“She comes through it all with the greatest gentility and strength,” House Speaker Nancy Pelosi told the New York Times.

Karen Bass with LA City Councilmember Mike Bonin, Rep. Ted Lieu and LA County Supervisor Sheila Kuehl at an event sponsored by activist Torie Osborn before the coronavirus exploded (Photo courtesy Osborn) 

“The best change takes place with outside pressure on the kind of issues I work on,” Bass told The Times. “It’s not like the issues I work on have 10 legal firms and lobbyists and all that. If you don’t have wealth, you have people. The thousands of people out protesting are moving Congress to act.”

Though police reform efforts have stalled in the Senate, Sen. Tim Scott, the Senate’s only Black Republican who has his own bill, told CNN’s Jake Tapper on June 28 that he has spoken often with Bass.

“I give Karen Bass a lot of credit. She’s very serious about getting to a compromise,” Scott said.

It’s a trait Bass brought with her to the House in 2011, one of nine freshman Democrats in a GOP-run House. Another of the nine was Democrat David Cicilline, the former mayor of Providence, R.I., and the first openly gay mayor of a state capital. The two served on the House Foreign Affairs Committee.

“She’s been a really important part of our freshman class,” Cicilline told Politico. “Her skills as speaker of the house have enabled her to understand the legislative process but also the importance of relationships in getting work done.”

Bass told a Politico town hall on June 30 that she does not negotiate in public but she’ll keep pushing to make Justice in Policing Act law, “especially when we have this moment where transformative change is possible. But we have to push, we have to keep pushing, and I’m ready to do that.”

Pushing for justice is at her core.

“So the values that I treasure really were a result of watching the Civil Rights Movement on TV, talking to my father about what growing up in the South meant, and then growing up during the ’60s and watching young people try to change the world, led me to making a lifetime commitment to working for social and economic justice,” Bass told Jewish Journal columnist Raphael Sonenshein in 2009.

And then there’s martial arts.

“When I was in my early 20s, I studied tae kwon do and hapkido. I earned brown belts in both of them. What it taught me was how to fight in a manner that is respectful; don’t personalize and get to the point. The goal of a martial artist is actually to not fight, [it’s] to prevent the fight. If somebody attacks you, you’re taught how to take their energy and use it against them,” Bass told LA Times columnist Patt Morrison in 2009.

“Remember those old Bruce Lee movies? When somebody who had watched a Bruce Lee movie would think they knew how to fight — with no discipline, no control — they would come in just flailing, swinging,” Bass continued. “You should have goals; it should be clear where the beginning, middle and end game is, and that’s what I felt I was taught.”

Those lessons helped Bass as Assembly Speaker. “The discipline, the control of emotions and picking your fights — not just fighting because it makes you feel good but fighting with a purpose.”

Karen Bass delivering eulogy at Rep. Elijah Cummings’ funeral. (Photo courtesy Congressional Black Caucus)

It’s a lesson reiterated by her beloved mentor, the late Honorable Elijah E. Cummings, whom she called “a warrior for all” in an op-ed Bass penned for the LA Blade last October.

“As throughout the entirety of his life, Mr. Cummings was not deterred by bigotry, he was not swayed by ignorance, and he was not stopped by indifference.

 

In fact, it was incidents at this time in his life that only strengthened his commitment to ensuring his community overcame these obstacles….

 

As the Chairman of the House Committee on Oversight and Government Reform, Mr. Cummings used his gavel to speak truth to power on behalf of the American people. We watched his heartfelt passion as he fought for the rights of children separated from their families, as he fought for everyone to have healthcare, and medications that are affordable, and as he fought for everyone to have the right and access to vote.

 

In 2016, we watched Mr. Cummings swiftly debunk the logic behind a bill which would prevent the government from acting against businesses or individuals who discriminate against LGBTQ+ people.

 

As he did almost daily here in Congress and in his community, he spoke as a guided moral light for all of those gathered to listen.”

Perhaps that moral light has been passed to a new generation. “She’s the real deal with a level of civil rights movement bona fides that few vice presidential nominees have ever had,” former L.A. Mayor and Assembly Speaker Antonio Villaraigosa, who has known Bass since the early 1970s, told columnist George Skelton. “She’s had a leadership voice wherever she’s gone.”

Karen Bass, 66, and Joe Biden, 77, have another commonality, a shared grief. Like Biden, Bass suffered the tragic loss of her daughter Emilia, 23, a Loyola Marymount University student, and son-in-law Michael Wright, 23, in a 2006 car crash on the I-405 freeway.

Bass fits Biden’s bill for VP: she is a highly regarded coalition-builder; has executive legislative experience during a financial crisis; is passionate about foster care, healthcare and fighting against systemic racism; and her values stem from a long battle for human rights. And she’s nice.

“It’s almost like the Scripture says: She’s come for such a time as this,” Rep. Barbara Lee, who’s known Bass since the 1980s, told the New York Times.  “This is a moment that the country needs her leadership, and she certainly has stepped up.”

What more could Joe Biden and a desperate country want?

 

 

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AIDS and HIV

White House urged to expand PrEP coverage for injectable form

HIV/AIDS service organizations made call on Wednesday

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Apretude is a long-lasting PrEP injection that has proven to be significantly more effective at reducing the risk of sexually-acquired HIV. (Photo courtesy of ViiV Healthcare)

A coalition of 63 organizations dedicated to ending HIV called on the Biden-Harris administration on Wednesday to require insurers to cover long-acting pre-exposure prophylaxis (PrEP) without cost-sharing.

In a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, the groups emphasized the need for broad and equitable access to PrEP free of insurance barriers.

Long-acting PrEP is an injectable form of PrEP that’s effective over a long period of time. The FDA approved Apretude (cabotegravir extended-release injectable suspension) as the first and only long-acting injectable PrEP in late 2021. It’s intended for adults and adolescents weighing at least 77 lbs. who are at risk for HIV through sex.

The U.S. Preventive Services Task Force updated its recommendation for PrEP on Aug. 22, 2023, to include new medications such as the first long-acting PrEP drug. The coalition wants CMS to issue guidance requiring insurers to cover all forms of PrEP, including current and future FDA-approved drugs.

“Long-acting PrEP can be the answer to low PrEP uptake, particularly in communities not using PrEP today,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The Biden administration has an opportunity to ensure that people with private insurance can access PrEP now and into the future, free of any cost-sharing, with properly worded guidance to insurers.”

Currently, only 36 percent of those who could benefit from PrEP are using it. Significant disparities exist among racial and ethnic groups. Black people constitute 39 percent of new HIV diagnoses but only 14 percent of PrEP users, while Latinos represent 31 percent of new diagnoses but only 18 percent of PrEP users. In contrast, white people represent 24 percent of HIV diagnoses but 64 percent of PrEP users.

The groups also want CMS to prohibit insurers from employing prior authorization for PrEP, citing it as a significant barrier to access. Several states, including New York and California, already prohibit prior authorization for PrEP.

Modeling conducted for HIV+Hep, based on clinical trials of a once every 2-month injection, suggests that 87 percent more HIV cases would be averted compared to daily oral PrEP, with $4.25 billion in averted healthcare costs over 10 years.

Despite guidance issued to insurers in July 2021, PrEP users continue to report being charged cost-sharing for both the drug and ancillary services. A recent review of claims data found that 36 percent of PrEP users were charged for their drugs, and even 31 percent of those using generic PrEP faced cost-sharing.

The coalition’s letter follows a more detailed communication sent by HIV+Hepatitis Policy Institute to the Biden administration on July 2.

Signatories to the community letter include Advocates for Youth, AIDS United, Equality California, Fenway Health, Human Rights Campaign, and the National Coalition of STD Directors, among others.

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AIDS and HIV

Tennessee Agrees To Remove Sex Workers With HIV From Sex Offender Registry

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The Tennessee government has agreed to begin scrubbing its sex offender registry of dozens of people who were convicted of prostitution while having HIV, reversing a practice that federal lawsuits have challenged as draconian and discriminatory.

For more than three decades, Tennessee’s “aggravated prostitution” laws have made prostitution a misdemeanor for most sex workers but a felony for those who are HIV-positive. Tennessee toughened penalties in 2010 by reclassifying prostitution with HIV as a “violent sexual offense” with a lifetime registration as a sex offender — even if protection is used.

At least 83 people are believed to be on Tennessee’s sex offender registry solely because of these laws, with most living in the Memphis area, where undercover police officers and prosecutors most often invoked the statute, commonly against Black and transgender women, according to a lawsuit filed last year by the American Civil Liberties Union and four women who were convicted of aggravated prostitution. The Department of Justice challenged the law in a separate suit earlier this year.

Both lawsuits argue that Tennessee law does not account for evolving science on the transmission of HIV or precautions that prevent its spread, like use of condoms. Both lawsuits also argue that labeling a person as a sex offender because of HIV unfairly limits where they can live and work and stops them from being alone with grandchildren or minor relatives.

“Tennessee’s Aggravated Prostitution statute is the only law in the nation that treats people living with HIV who engage in any sex work, even risk-free encounters, as ‘violent sex offenders’ subjected to lifetime registration,” the ACLU lawsuit states.

“That individuals living with HIV are treated so differently can only be understood as a remnant of the profoundly prejudiced early response to the AIDS epidemic.”

In a settlement agreement signed by Tennessee Gov. Bill Lee on July 15 and filed in both lawsuits on July 17, the Tennessee Bureau of Investigation said it would comb through the state’s sex offender registry to find those added solely because of aggravated prostitution convictions, then send letters alerting those people that they can make a written request to be removed. The language of the settlement suggests that people will need to request their removal from the registry, but the agency said in the agreement it will make “its best effort” to act on the requests “promptly in the order in which they are received.”

The Tennessee attorney general’s office, which represents the state in both the ACLU and DOJ lawsuits and approved the settlement agreement, said in an email statement it would “continue to defend Tennessee’s prohibition on aggravated prostitution.”

In an email statement, the ACLU celebrated the settlement as “one step toward remedying the harms by addressing the sex offender registration,” but said its work in Tennessee was not done because aggravated prostitution remained a felony charge that it would “fight to overturn.”

Molly Quinn, executive director of LGBTQ+ support organization OUTMemphis, another plaintiff in the ACLU lawsuit, said both organizations would help eligible people with the paperwork to get removed from the registry.

“We would not have agreed to settle if we did not feel like this was a process that would be extremely beneficial,” Quinn said. “But, we’re sad that the statute existed as long as it did and sad that there is any process at all that folks have to go through after living with this extraordinary burden of being on the sex offender registry for really an irrelevant reason.”

Michelle Anderson, a Memphis resident who is one of the plaintiffs in the ACLU lawsuit, said in court records that since being convicted of aggravated prostitution, the sex offender label has made it so difficult to find a home and a job that she was “unhoused for about a year” and has at times “felt she had no option but to continue to engage in sex work to survive.”

Like the other plaintiffs, Anderson said her conviction kept her minor relatives at a distance.

“Ms. Anderson has a nephew she loves, but she cannot have a close relationship with him,” the lawsuit states. “Even though Ms. Anderson’s convictions had nothing to do with children, she cannot legally be alone with her nephew.”

The Tennessee settlement comes months after state lawmakers softened the law so no one else should be added to the sex offender registry for aggravated prostitution. Lawmakers removed the registration requirement and made convictions eligible for expungement if the defendant testifies they were a victim of human trafficking.

State Sen. Page Walley (R-Savannah), who supported the original aggravated prostitution law passed in 1991 and co-sponsored the recent bill to amend it, said on the floor of the legislature that the changes do not prevent prosecutors from charging people with a felony for aggravated prostitution. Instead, he said, the amendments undo the 2010 law that put those who are convicted on the registry “along with pedophiles and rapists for a lifetime, with no recourse for removal.”

“Having stood, as I mentioned, in 1991 and passed this,” Walley said, “it is a particular gratifying moment for me to see how we continue to evolve and seek what’s just and what’s right and what’s best.”

KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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AIDS and HIV

Young gay Latinos see rising share of new HIV cases, leading to call for targeted funding

Fernando Hermida diagnosed four months after asking for asylum

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Fernando Hermida drives to Orlando, Fla., to attend a medical appointment for HIV care on May 27, 2024. (Associated Press photo by Laura Bargfeld)

Four months after seeking asylum in the U.S., Fernando Hermida began coughing and feeling tired. He thought it was a cold. Then sores appeared in his groin and he would soak his bed with sweat. He took a test.

On New Year’s Day 2022, at age 31, Hermida learned he had HIV.

“I thought I was going to die,” he said, recalling how a chill washed over him as he reviewed his results. He struggled to navigate a new, convoluted health care system. Through an HIV organization he found online, he received a list of medical providers to call in D.C., where he was at the time, but they didn’t return his calls for weeks. Hermida, who speaks only Spanish, didn’t know where to turn.

By the time of Hermida’s diagnosis, the U.S. Department of Health and Human Services was about three years into a federal initiative to end the nation’s HIV epidemic by pumping hundreds of millions of dollars annually into certain states, counties, and U.S. territories with the highest infection rates. The goal was to reach the estimated 1.2 million people living with HIV, including some who don’t know they have the disease.

Overall, estimated new HIV infection rates declined 23 percent from 2012 to 2022. But a KFF Health News-Associated Press analysis found the rate has not fallen for Latinos as much as it has for other racial and ethnic groups.

While African Americans continue to have the highest HIV rates in the U.S. overall, Latinos made up the largest share of new HIV diagnoses and infections among gay and bisexual men in 2022, per the most recent data available, compared with other racial and ethnic groups. Latinos, who make up about 19 percent of the U.S. population, accounted for about 33 percent of new HIV infections, according to the Centers for Disease Control and Prevention.

The analysis found Latinos are experiencing a disproportionate number of new infections and diagnoses across the U.S., with diagnosis rates highest in the Southeast. Public health officials in Mecklenburg County, North Carolina, and Shelby County, Tennessee, where data shows diagnosis rates have gone up among Latinos, told KFF Health News and the AP that they either don’t have specific plans to address HIV in this population or that plans are still in the works. Even in well-resourced places like San Francisco, HIV diagnosis rates grew among Latinos in the last few years while falling among other racial and ethnic groups despite the county’s goals to reduce infections among Latinos.

“HIV disparities are not inevitable,” Robyn Neblett Fanfair, director of the CDC’s Division of HIV Prevention, said in a statement. She noted the systemic, cultural, and economic inequities — such as racism, language differences, and medical mistrust.

And though the CDC provides some funds for minority groups, Latino health policy advocates want HHS to declare a public health emergency in hopes of directing more money to Latino communities, saying current efforts aren’t enough.

“Our invisibility is no longer tolerable,” said Vincent Guilamo-Ramos, co-chair of the Presidential Advisory Council on HIV/AIDS.

Lost without an interpreter

Hermida suspects he contracted the virus while he was in an open relationship with a male partner before he came to the U.S. In late January 2022, months after his symptoms started, he went to a clinic in New York City that a friend had helped him find to finally get treatment for HIV.

Too sick to care for himself alone, Hermida eventually moved to Charlotte to be closer to family and in hopes of receiving more consistent health care. He enrolled in an Amity Medical Group clinic that receives funding from the Ryan White HIV/AIDS Program, a federal safety-net plan that serves over half of those in the nation diagnosed with HIV, regardless of their citizenship status.

His HIV became undetectable after he was connected with case managers. But over time, communication with the clinic grew less frequent, he said, and he didn’t get regular interpretation help during visits with his English-speaking doctor. An Amity Medical Group representative confirmed Hermida was a client but didn’t answer questions about his experience at the clinic.

Hermida said he had a hard time filling out paperwork to stay enrolled in the Ryan White program, and when his eligibility expired in September 2023, he couldn’t get his medication.

He left the clinic and enrolled in a health plan through the Affordable Care Act marketplace. But Hermida didn’t realize the insurer required him to pay for a share of his HIV treatment.

In January, the Lyft driver received a $1,275 bill for his antiretroviral — the equivalent of 120 rides, he said. He paid the bill with a coupon he found online. In April, he got a second bill he couldn’t afford.

For two weeks, he stopped taking the medication that keeps the virus undetectable and intransmissible.

“Estoy que colapso,” he said. I’m falling apart. “Tengo que vivir para pagar la medicación.” I have to live to pay for my medication.

One way to prevent HIV is preexposure prophylaxis, or PrEP, which is regularly taken to reduce the risk of getting HIV through sex or intravenous drug use. It was approved by the federal government in 2012 but the uptake has not been even across racial and ethnic groups: CDC data show much lower rates of PrEP coverage among Latinos than among white Americans.

Epidemiologists say high PrEP use and consistent access to treatment are necessary to build community-level resistance.

Carlos Saldana, an infectious disease specialist and former medical adviser for Georgia’s health department, helped identify five clusters of rapid HIV transmission involving about 40 gay Latinos and men who have sex with men from February 2021 to June 2022. Many people in the cluster told researchers they had not taken PrEP and struggled to understand the health care system.

They experienced other barriers, too, Saldana said, including lack of transportation and fear of deportation if they sought treatment.

Latino health policy advocates want the federal government to redistribute funding for HIV prevention, including testing and access to PrEP. Of the nearly $30 billion in federal money that went toward things like HIV health care services, treatment, and prevention in 2022, only 4% went to prevention, according to a KFF analysis.

They suggest more money could help reach Latino communities through efforts like faith-based outreach at churches, testing at clubs on Latin nights, and training bilingual HIV testers.

Latino rates going up

Congress has appropriated $2.3 billion over five years to the Ending the HIV Epidemic initiative, and jurisdictions that get the money are to invest 25 percent of it in community-based organizations. But the initiative lacks requirements to target any particular groups, including Latinos, leaving it up to the cities, counties, and states to come up with specific strategies.

In 34 of the 57 areas getting the money, cases are going the wrong way: Diagnosis rates among Latinos increased from 2019 to 2022 while declining for other racial and ethnic groups, the KFF Health News-AP analysis found.

Starting Aug. 1, state and local health departments will have to provide annual spending reports on funding in places that account for 30 percent or more of HIV diagnoses, the CDC said. Previously, it had been required for only a small number of states.

In some states and counties, initiative funding has not been enough to cover the needs of Latinos.

South Carolina, which saw rates nearly double for Latinos from 2012-2022, hasn’t expanded HIV mobile testing in rural areas, where the need is high among Latinos, said Tony Price, HIV program manager in the state health department. South Carolina can pay for only four community health workers focused on HIV outreach — and not all of them are bilingual.

In Shelby County, Tennessee, home to Memphis, the Latino HIV diagnosis rate rose 86 percent from 2012 to 2022. The health department said it got $2 million in initiative funding in 2023 and while the county plan acknowledges that Latinos are a target group, department director Michelle Taylor said: “There are no specific campaigns just among Latino people.”

Up to now, Mecklenburg County, North Carolina, didn’t include specific targets to address HIV in the Latino population — where rates of new diagnoses more than doubled in a decade but fell slightly among other racial and ethnic groups. The health department has used funding for bilingual marketing campaigns and awareness about PrEP.

Moving for medicine

When it was time to pack up and move to Hermida’s third city in two years, his fiancé, who is taking PrEP, suggested seeking care in Orlando, Fla.

The couple, who were friends in high school in Venezuela, had some family and friends in Florida, and they had heard about Pineapple Healthcare, a nonprofit primary care clinic dedicated to supporting Latinos living with HIV.

The clinic is housed in a medical office south of downtown Orlando. Inside, the mostly Latino staff is dressed in pineapple-print turquoise shirts, and Spanish, not English, is most commonly heard in appointment rooms and hallways.

“At the core of it, if the organization is not led by and for people of color, then we’re just an afterthought,” said Andres Acosta Ardila, the community outreach director at Pineapple Healthcare, who was diagnosed with HIV in 2013.

“¿Te mudaste reciente, ya por fin?” asked nurse practitioner Eliza Otero. Did you finally move? She started treating Hermida while he still lived in Charlotte. “Hace un mes que no nos vemos.” It’s been a month since we last saw each other.

They still need to work on lowering his cholesterol and blood pressure, she told him. Though his viral load remains high, Otero said it should improve with regular, consistent care.

Pineapple Healthcare, which doesn’t receive initiative money, offers full-scope primary care to mostly Latino males. Hermida gets his HIV medication at no cost there because the clinic is part of a federal drug discount program.

The clinic is in many ways an oasis. The new diagnosis rate for Latinos in Orange County, Florida, which includes Orlando, rose by about a third from 2012 through 2022, while dropping by a third for others. Florida has the third-largest Latino population in the U.S., and had the seventh-highest rate of new HIV diagnoses among Latinos in the nation in 2022.

Hermida, whose asylum case is pending, never imagined getting medication would be so difficult, he said during the 500-mile drive from North Carolina to Florida. After hotel rooms, jobs lost, and family goodbyes, he is hopeful his search for consistent HIV treatment — which has come to define his life the past two years — can finally come to an end.

“Soy un nómada a la fuerza, pero bueno, como me comenta mi prometido y mis familiares, yo tengo que estar donde me den buenos servicios médicos,” he said. I’m forced to be a nomad, but like my family and my fiancé say, I have to be where I can get good medical services.

That’s the priority, he said. “Esa es la prioridad ahora.”

KFF Health News and The Associated Press analyzed data from the U.S. Centers for Disease Control and Prevention on the number of new HIV diagnoses and infections among Americans ages 13 and older at the local, state, and national levels. This story primarily uses incidence rate data — estimates of new infections — at the national level and diagnosis rate data at the state and county level.

Bose reported from Orlando, Fla.. Reese reported from Sacramento, Calif. AP video journalist Laura Bargfeld contributed to this report.

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is responsible for all content.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

A Project of KFF Health News and the Associated Press co-published by Univision Noticias

CREDITS:

Reporters: Vanessa G. Sánchez, Devna Bose, Phillip Reese

Cinematography: Laura Bargfeld

Photography: Laura Bargfeld, Phelan M. Ebenhack

Video Editing: Federica Narancio, Kathy Young, Esther Poveda

Additional Video: Federica Narancio, Esther Poveda

Web Production: Eric Harkleroad, Lydia Zuraw

Special thanks to Lindsey Dawson

Editors: Judy Lin, Erica Hunzinger

Data Editor: Holly Hacker

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AIDS and HIV

Researchers announce using gene editing tool, HIV cut out of cells

The team eliminated HIV from cells in a laboratory raising hopes of a cure, but cautioned that for now their work represents proof of concept

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HIV virus in the bloodstream. (Photo Credit: National Institutes of Health)

BARCELONA, Spain – Researchers from the Amsterdam University Medical Center made a groundbreaking announcement this week of the results of a major study to be presented at the 2024 European Congress of Clinical Microbiology and Infectious Diseases, which will be held April 27-30 in Barcelona.

A team led by Dr. Elena Herrera-Carrillo using a gene-editing tool known as Crispr-Cas, were able to eliminate HIV DNA, removing all traces of the virus from infected cells. In the press release Tuesday, Dr. Herrera-Carrillo alongside team members Yuanling Bao, Zhenghao Yu and Pascal Kroon, said that utilizing the gene-editing tool they focused on parts of the virus that stay the same across all known HIV strains.

“These findings represent a pivotal advancement towards designing a cure strategy,” the team said.

Herrera-Carrillo’s team works in developing a cure for HIV infection based on novel CRISPR-Cas methods.  CRISPR-Cas is a powerful gene editing tool working like genetic scissors but can also be used to selectively attack and inactivate integrated HIV DNA genomes in infected cells.

Herrera-Carrillo’s team eliminated HIV from cells in a laboratory, raising hopes of a cure, but cautioned that for now their work represents proof of concept, and will not become a cure for HIV tomorrow. According to the researchers the next steps involve optimizing the delivery route to target the majority of the HIV reservoir cells within the body.

The hope the research team points out, is to devise a strategy to make this system as safe as possible for future clinical applications, and achieve the right balance between efficacy and safety. “Only then can we consider clinical trials of ‘cure’ in humans to disable the HIV reservoir,” they stated adding, “While these preliminary findings are very encouraging, it is premature to declare that there is a functional HIV cure on the horizon.”

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AIDS and HIV

Gilead Sciences awards grants to HIV/AIDS groups in Caribbean, Latin America

Stigma, criminalization laws among barriers to fighting pandemic in region

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Free condoms in a São Paulo Metro station. Gilead Sciences has announced it has given grants to 35 organizations in Latin America and the Caribbean. The groups will use the funds to fight HIV/AIDS in the region. (Washington Blade photo by Michael K. Lavers)

FOSTER CITY, Calif. — Gilead Sciences this week announced it has given $4 million in grants to 35 organizations in Latin America and the Caribbean that fight HIV/AIDS.

A press release notes Asociación Panamericana de Mercadeo Social (Pan-American Association of Social Marketing) in Nicaragua, Fundación Genesis (Genesis Foundation) in Panama, Fundación por una Sociedad Empoderada (Foundation for an Empowered Society) in Argentina, Associação Nacional de Travestis e Transexuais (National Association of Travestis and Transsexuals) in Brazil and Caribbean Vulnerable Communities are among the groups that received grants. Gilead notes this funding through its Zeroing In: Ending the HIV Epidemic in Latin America and the Caribbean will “improve access to care, increase health equity and reduce HIV-related stigma for populations most affected by HIV.”

“The HIV prevention and care needs of people throughout Latin America and the Caribbean are incredibly diverse, and each of these programs addresses a unique community challenge,” said Gilead Vice President of Corporate Giving Carmen Villar. “Our grantees are deeply embedded in their communities and best positioned to provide needed HIV care and support services.” 

“Their expertise will be essential to achieve the Zeroing In program’s goals of improving access to comprehensive care among priority populations, decreasing HIV-related stigma and reducing HIV and broader health inequities,” she added.

The pandemic disproportionately affects Transgender people and sex workers, among other groups, in the region. Activists and HIV/AIDS service providers in the region with whom the Washington Blade has previously spoken say discrimination, stigma, poverty, a lack of access to health care and criminalization laws are among the myriad challenges they face.

First Lady Jill Biden in 2022 during a trip to Panama announced the U.S. will provide an additional $80.9 million in the fight against HIV/AIDS in Latin America through the President’s Emergency Plan for AIDS Relief. 

Cuba in 2015 became the first country in the world to eliminate mother-to-child transmission of HIV. The Cuban government until 1993 forcibly quarantined people with HIV/AIDS in state-run sanitaria.

Antigua and Barbuda, St. Kitts and Nevis, Barbados and Trinidad and Tobago in recent years have decriminalized consensual same-sex sexual relations. 

The Inter-American Commission on Human Rights in 2021 ruled Jamaica must repeal its colonial-era sodomy law. The country’s Supreme Court last year ruled against a gay man who challenged it.  

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Local, national events to mark 35th annual World AIDS Day

HIV disproportionately affects certain populations. Men who have sex with men accounted for 70% of 32,100 estimated new HIV infections

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(Washington Blade photo by Michael Key)

WASHINGTON – UNAIDS dubbed this year’s World AIDS Day theme as “Let Communities Lead.” This is how conversations around HIV and AIDS should be structured, Duante’ Brown said, who manages two programs at NMAC — a nonprofit dedicated to working to end the AIDS epidemic. People living with HIV need to be considered the subject matter experts, he said. 

“Bringing those people into the room, showing them that they have a voice and that there’s not just this group of people who are making a decision for them … is definitely the way that you go about this.”

Brown manages the ESCALATE program at NMAC, which aims to empower people to address HIV stigma, and the ELEVATE program, which is a training program for people with HIV to be more involved in the planning and delivery of the Ryan White HIV/AIDS Program, which is the largest federal program designed specifically for people with HIV. 

In the United States, it’s estimated 1.2 million people are living with HIV, according to HIV.gov. About 13% are unaware they have HIV.

HIV also continues to disproportionately affect certain populations. Men who have sex with men accounted for 70% of the 32,100 estimated new HIV infections in 2021. And Black individuals accounted for 40% of the new infections that year, while only comprising 12% of the population of the United States, according to the CDC

In 2023, stigma is a key inhibitor to ending the epidemic, Brown said. When stigma gets out of the way, there could be a day when there are no new cases of HIV transmissions, he said. To get around that stigma, people need to have meaningful and productive conversations about AIDS. 

“Not treating it as taboo, making sure that we are empowering people living with HIV and AIDS to tell their stories and to be empowered to feel that it’s OK,” Brown said. “And that nothing is wrong with you.”

And there are events in the locally and nationally to recognize World AIDS Day, many of them aimed at abolishing the stigma that comes with talking about HIV.

Icon Janet Jackson headlines the World AIDS Day Concert on Dec. 1 in Houston.

At a national level, Janet Jackson is set to headline the World AIDS Day concert on Dec. 1 — an annual fundraiser sponsored by the AIDS Healthcare Foundation. The concert will be at the NRG Arena in Houston, and will also honor actor and activist Blair Underwood with its lifetime achievement award. 

“[The concert] really is a way to commemorate World AIDS Day in a way that is both remembrance of those that we’ve lost, recognizing where we’re at, but also really celebrating and connecting the work that’s yet to be done. And having folks still leaving uplifted and elevated about what the future could hold,” said Imara Canady, AHF’s national director for communications and community engagement. 

Jackson has long been an outspoken advocate for people living with HIV. Her song, “Together Again,” is a tribute to a friend she lost to AIDS, as well as a dedication to patients around the world. 

The AIDS Healthcare Foundation, the largest nonprofit HIV/AIDS service organization and advocacy group, has several health care centers in the region and many across the nation and world. AHF also has a free HIV test locater online at freehivtest.net

AIDSWatch, the electronic memorial to people lost to HIV and AIDS, will be viewable on www.AIDSWatch.org and on the City of West Hollywood’s WeHoTV broadcast and streaming channels, including Spectrum Channel 10 within West Hollywood, beginning at 12:01 a.m. on Thursday, Dec. 1, for 24 hours.

The City of West Hollywood will join STORIES: The AIDS Monument and APLA Health in a World AIDS Day event on Friday, Dec. 1. The evening will begin at 5:30 p.m. with a reception at the West Hollywood Park Aquatic and Recreation Center (ARC) Respite Deck, located at 8750 El Tovar Place.

After a short program with refreshments, attendees will descend the grand staircase of the ARC at 6:30 p.m. in a candlelight procession through West Hollywood Park and along N. Robertson, Santa Monica, and N. San Vicente Boulevards to the City’s Council Chambers/Public Meeting Room, located at 625 N. San Vicente Boulevard. There, the evening will continue with a screening of the award-winning 2023 documentary “Commitment to Life.” Doors will open at 7 p.m. and the screening will begin promptly at 7:15 p.m. 

Events are free to attend and open to the public. Limited validated parking will be available at the West Hollywood Park 5-Story structure. 

Advance RSVP is requested by reserving a spot on Eventbrite.

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Maxine Waters criticizes House GOP over proposed cuts to HIV/AIDS programs

Calif. Democrat spoke at U.S. Conference on HIV/AIDS in D.C.

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U.S. Rep. Maxine Waters (D-Calif.) speaks at the U.S. Conference on HIV/AIDS on Sept. 6, 2023, in Washington. (Washington Blade photo by Michael Key)

WASHINGTON — U.S. Rep. Maxine Waters (D-Calif.) on Wednesday sharply criticized House Republicans over their proposed cuts to HIV/AIDS prevention programs.

The California Democrat who represents the state’s 43rd Congressional District in a speech she delivered at the U.S. Conference on HIV/AIDS noted the House Appropriations Committee’s Fiscal Year 2024 Labor, Health, Human Services, Education and Related Agencies Appropriations Bill would cut $767 million from domestic HIV/AIDS programs.

Waters said the bill would cut funds to fight HIV/AIDS among underrepresented groups by 53 percent and “completely eliminates” funding for “Minority AIDS Initiative activities within the Substance Abuse and Mental Health Services Administration.” Waters also noted the appropriations measure “eliminates funding” for the Centers for Disease Control and Prevention’s Ending the HIV Epidemic Initiative, the Ryan White HIV/AIDS Program and community health centers.

“The cuts to the Minority AIDS Initiative will exacerbate racial disparities and the elimination of the (Ending the) HIV Epidemic Initiative,” said Waters.

Waters also criticized House Republicans for “refusing to authorize” the President’s Emergency Plan for AIDS Relief.” The California Democrat said ending PEPFAR “would endanger the lives of millions of people around the world who are living with HIV and endanger the lives of millions more who are at risk.” 

“Moreover, it would compromise United States leadership on global health issues,” added Waters. “These programs used to have widespread support. It’s shameful that House Republicans are now trying to eliminate them. We cannot allow these cuts to pass. We cannot compromise. We will not give up.”

U.S. Reps. Jim Jordan (R-Ohio) and Marjorie Taylor Greene (R-Ga.) are among those who Waters criticized by name in her speech.

“I will speak truth to power. I want to use words that they will understand. Hell no! We won’t go! We are not going to give up,” said Waters. “That’s the people’s money. You can’t decide who you’re going to spend it on and not who you’re going to spend it on.”

More than 3,000 people are expected to attend the National Minority AIDS Council-organized conference that will end on Saturday. This year’s theme is “A Love Letter to Black Women.”

“We need a love letter to Black women,” said Waters. “We need it not only from this conference. We need it from our families often times. We need it from our communities. We need it from the churches that we give so much attention to and give our resources to and don’t really get it back. We need a love letter coming from all over this country for what we have suffered, for what we have endured, for the way that we have been denied and for the way that we have been ostracized.” 

Waters in her speech specifically praised former Massachusetts Congressman Barney Frank and the late U.S. Sen. Ted Kennedy (D-Mass.) for their work in support of LGBTQ+ rights and efforts to combat HIV/AIDS. Waters also thanked Jewel Thais-Williams, who opened Catch One, a bar and restaurant on Pico Boulevard in Los Angeles that became a refuge for people with HIV/AIDS.

“They had nowhere to gather, nowhere to go, nowhere to be recognized as people who needed support,” said Waters.

B. Kaye Hayes, deputy assistant secretary for infectious disease in the Office of the Assistant Secretary for Health who is also the executive director of the Presidential Advisory Council on HIV/AIDS, is among those who are expected to speak at the conference. Mark S. King, an HIV/AIDS activist and blogger who published “My Fabulous Disease: Chronicles of a Gay Survivor” on Sept. 1, is scheduled to talk on Thursday.

Cal Benn contributed to this story.

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AIDS and HIV

American Red Cross ends ban on blood donations by gay men

Many healthy individuals who previously could not give will now be able to support their community through the gift of blood donation

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Photo Credit: American Red Cross

WASHINGTON – The American Red Cross announced a historic change in the organization’s policies regarding blood donations by gay and bisexual men. Under this new donor screening process, all donors answer the same eligibility questions regardless of gender or sexual orientation and will be assessed for blood donation based on individual risk factors, not on sexual orientation.

This change by the Red Cross falls within the U.S. Food and Drug Administration finalized guidelines for blood donation issued this past May that will use a uniform individualized risk assessment questionnaire for respondents regardless of their sexual orientation, sex, or gender.

In a statement the Red Cross noted:

“This change means many healthy individuals who previously could not give will now be able to support their community through the gift of blood donation.

Andrew Goldstein, a cancer researcher from Los Angeles, was a regular blood donor in his younger years before the FDA’s previous policies made him ineligible to donate as a gay man. His desire to influence change compelled him to register as a participant in the FDA funded ADVANCE Study in 2021, which sought to gather data to evaluate the possibility of moving to an individual donor assessment. He is proud he was able to be part of the study that led to this change and is excited to finally be able to give blood again.

“There’s so much in the world that you can’t help with, and you sometimes have to see people going through difficult times, but something like giving blood feels like something so small that you can do, and it means a lot to me that I’ll be able to do that again,” said Andrew. Now, Andrew and many others are able to share their good health with patients in need of lifesaving transfusions.”

The FDA’s new protocols issued in May note that prospective donors who have had a new sexual partner, or more than one sexual partner in the past three months, and anal sex in the past three months, would be ineligible.

So would those who are “taking medications to treat or prevent HIV infection (e.g., antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP),” because these drugs can delay the detection of HIV.

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Elton John AIDS Foundation launches ambitious new initiative

Throughout Pride Month, Sir Elton John and the co-chairs of The Rocket Fund are challenging supporters to let their #InnerElton out

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Elton John & David Furnish at Oscars Viewing Party 2021 (Screenshot/YouTube Hollywood TV)

NEW YORK – The Rocket Fund is the Elton John AIDS Foundation’s latest transformative $125 million campaign to redouble the fight against AIDS everywhere. Growing levels of stigmatization, marginalization, and poverty have led to high rates of HIV and low access to healthcare globally. 

“For years, HIV/AIDS has caused enormous pain across the world, but I pray that soon this epidemic will be a thing of the past” said Sir Elton John. “More than 30 years after I launched the Elton John AIDS Foundation, my passion for reaching everyone, everywhere with education and compassionate care is still as strong as ever. The Rocket Fund will turbo-charge our mission and reach those most at risk from this terrible disease. Now is the time. This epidemic has gone on too long. We must all act together to see AIDS defeated in our lifetimes.”

Money from the fund will go towards supporting access to HIV prevention and treatment services, including providing access to HIV tests, antiretroviral therapies, and Pre-Exposure Prophylaxis (PrEP), according to the press release. Donatella Versace, one of the Rocket Fund’s co-chairs — alongside Furnish, Tani Austin, and David Geffen — has also pledged to match donations to the fund up to $300,000 during the month of June.

Throughout Pride Month, Sir Elton John and the co-chairs of The Rocket Fund are challenging supporters to let their #InnerElton out. Letting your #InnerElton out is about proudly expressing your authentic self, showing love for others and taking compassionate action. Supporters are encouraged to join the movement by posting photos of themselves on social media wearing their own take on Elton’s signature looks – or whatever makes them feel their true self – with the hashtag #InnerElton. Many notables are joining to let their #InnerElton out, including Dolly Parton, Michaela Jaé Rodriguez, JoJo Siwa, Heidi Klum, Smokey Robinson and more. Learn more here. The Let Your Inner Elton Out campaign was created by advertising agency Invisible Man and produced in partnership with global communications agency BCW.

The Foundation launched this critical initiative on June 5, the day in 1981 when the Centers for Disease Control released its first report on what would become the AIDS epidemic. This inaugural Rocket Day commemorates the early days of the fight against HIV/AIDS, while committing to accelerate progress towards ending AIDS for all.

“The end of the HIV/AIDS epidemic is within sight, and The Rocket Fund is the push we need to finally cross the horizon,” said David Furnish, Chairman of the Elton John AIDS Foundation. “To end AIDS, we must make targeted investments that can level the playing field, by tackling the inequalities and stigma that prevent people from accessing the care they desperately need. By joining The Rocket Fund and our mission, you can help transform the future for millions of people globally.”

“As we’ve learned through the global fight to stop COVID-19, epidemics do not recognize state borders, economic or cultural differences. If left unchecked, they only worsen with devastating impacts on the most vulnerable,” said Anne Aslett, Chief Executive Officer of the Elton John AIDS Foundation. “It is critical that we meet this moment to connect vulnerable people with the care and resources they need to live vibrant, healthy lives and we welcome all who want to see an end to this disease to join us.”

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AIDS and HIV

New data shows HIV infections dropped- mostly among whites

Significant decline in new HIV infections, but impact of prevention efforts far less substantial for Black and Hispanic-Latino populations

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Centers for Disease Control and Prevention headquarters in Atlanta. (Photo Credit: CDC/GSA)

ATLANTA – Data published Tuesday. by the Centers for Disease Control and Prevention shows a significant decline in new HIV infections, but suggests the impact of prevention efforts was far less substantial for Black and Latino populations.

From 2017 to 2021, as rates of HIV testing, treatment, and the use of pre-exposure prophylaxis (PrEP) medication rose, new cases dropped by 12 percent overall and by as much as 34 percent among gay and bisexual males aged 13 to 24.

The numbers show a “move in the right direction,” CDC Director Rochelle Walensky said in a press release.

However, when broken down by race, the CDC found new infections were down by 27 percent and 36 percent, respectively, among Black and Hispanic-Latino populations, compared with 45 percent of whites.

Similarly, by 2021 about one third of those who are considered eligible were taking PrEP for HIV prevention, but the CDC noted this number includes “relatively few Black people or Hispanic/Latino people” despite the significant increase in prescriptions up from just 13 percent in 2017.

“Longstanding factors, such as systemic inequities, social and economic marginalization and residential segregation,” Walensky noted, continue to act as barriers “between highly effective HIV treatment and prevention and people who could benefit from them.”

She added, “Efforts must be accelerated and strengthened for progress to reach all groups faster and equitably.”

Robyn Neblett Fanfair, acting director of the CDC’s Division of HIV Prevention, said that “At least three people in the U.S. get HIV every hour—at a time when we have more effective prevention and treatment options than ever before.”

“These tools must reach deep into communities and be delivered faster to expand progress from some groups to all groups,” she said.

The HIV+Hepatitis Policy Institute issued a press release following the CDC’s announcement of the new data, noting both the encouraging progress and need for improvement.

“It appears that our investments in HIV prevention are providing some positive results, but the persistent high number of new diagnoses and the low usage of PrEP among the communities most impacted by HIV point to the need for increased resources, particularly for a national PrEP program,” said the group’s executive director, Carl Schmid.

President Joe Biden’s FY24 budget requested $237 million for a national PrEP program along with $850 million to support the U.S. Department of Health and Human Services’ “Ending the HIV Epidemic in the U.S.” initiative.

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