By Deondre B. Moore
After the nation’s longest government shutdown in history, the president of the United States was finally able to give his State of the Union address. The purpose of this address, as prescribed by the US Constitution, is to give the United States Congress information on the state of our nation and to “recommend to their consideration such measures as he shall judge necessary.” Essentially, this is the president’s chance to state where we are currently as a country, as well as to roll out his ideas and plans for our future as a nation. One of the topics of this year’s address was HIV/AIDS. To his credit, the president did put slightly more emphasis on HIV/AIDS this year than he has in the past. However, his plan to “end the HIV epidemic by 2030” was a mixture of ambiguity and empty words with no apparent plan of action. After seeing discussion of the plan on social media, I further researched the proposal on the federal government’s website only to find that there are numerous problems with this plan of action, as well as with the Trump administration’s overall consistency as it relates to ending the HIV/AIDS epidemic.
The federal government’s aforementioned plan is entitled “Ending the HIV Epidemic: A Plan for America.” It starts out by noting that the “HHS is proposing a once-in-a-generation opportunity to eliminate new HIV infections in our nation. The multi-year program will infuse 48 counties, Washington, D.C., San Juan, Puerto Rico, as well as seven states that have a substantial rural HIV burden with the additional expertise, technology, and resources needed to end the HIV epidemic in the United States.” Taken at face value, this seems like a positive path forward. The problem, however, is that HIV/AIDS is prevalent in significantly more regions than those mentioned in the plan. Only targeting specific rural, “HIV–burdened” areas won’t stop or end the epidemic. But, because the Trump administration has repeatedly slashed funding to HIV–related services such as Ryan White, the CDC, and various preventative measures, more comprehensive targeting may not be an option.
As a whole, the plan is also very stigmatizing. It continuously uses stigmatizing language like “infected” as opposed to “newly diagnosed.” Word choice can have a huge impact on how the general public views those living with HIV. By choosing stigmatizing words such as “infected,” the government is fueling the misconception that people who are HIV-positive pose great risks to those around them. Additionally, this language discourages folks from getting tested, as it heightens the fear that a positive diagnosis will lead to automatic stigmatization.
The federal government has also failed to mention that HIV can be transmitted through injection drugs and other substances. There is no plan of action to address the transmission of HIV through needles or to establish better resources to prevent HIV transmissions that occurs as a result of drug use. Without such an action plan, HIV/AIDS in America will not be ended by 2030.
I do agree with some parts of this plan, such as the need to educate healthcare providers and patients on HIV prevention options such as PrEP and U=U (undetectable equals untransmittable). The fact is, this still doesn’t go far enough. Not once does the federal government’s plan mention inclusive, comprehensive sex education for youth in public schools—the ultimate first step in seeing a reduction in the number of new HIV diagnoses—nor does it prescribe the reallocation of funds to prevention programs or healthcare support systems such as Ryan White, which thousands of HIV-positive individuals rely on each and every day.
Lastly, the government’s steps to better address social determinants of health—such as employment status, housing status, social environments, education, and access to healthcare services—are largely absent from this plan. Without addressing these issues, we will absolutely not see an “end to the epidemic” any time soon.
There is much work to be done before we see the end of HIV/AIDS and, put simply, this plan won’t cut it. We deserve and demand more.
