For the New Year, I am pleased to share with you some words of encouragement about the incredible place that we are today with HIV prevention and treatment. Much of these ideas are what I spoke about during the wonderful World AIDS Day event at the Cathedral of Hope on December 1st of last year. I was asked to think boldly about what’s possible for our future and how we together can see the end of AIDS in our generation.
New discoveries will accelerate the already incredible pace for new HIV treatments and the rapid discovery so far continues to be humanity’s greatest public health success in the last 50 years. We have gone from little hope in 1996 to today where we explain to patients that a normal life is possible. What’s next? I believe we will see even safer medications, even more new and effective therapies, and even easier ways to take them—all in just a very short amount of time.
The big message at the 2018 International AIDS Conference, a conference which for the past 22 years has convened the world’s experts on HIV/AIDS, was that it was time for everyone to get behind the principle of U = U, undetectable equals untransmittable. Additional studies published last year confirm that if HIV medications are working for at least three months, and medications are continued without missing doses, a person cannot transmit HIV to his or her sexual partner. U = U needs to further galvanize efforts to treat everyone living with HIV. Elimination of one’s transmission risk can serve to empower patients to take steps not only to assure one’s own personal health, but for his or her loved ones as well. U = U already is demonstrating its impact in areas with relatively higher access to treatment such as Australia. In 2018, New York City reported a 60% decrease in the number of new HIV cases since 2000, and in 2016 nearly hit all of the 90-90-90 targets with 81% on medications and 73% of the entire population virally suppressed. Seattle has already reached its treatment targets, and San Francisco is not far behind. These milestones are just the beginning of what is possible.
The number of people using PrEP or pre-exposure prophylaxis against HIV continues to rise at steady rates. Gilead Sciences reports that roughly 136,000 people in the U.S. are now taking PrEP. The U.S. Preventive Services Task Force at the end of 2018 issued a draft “Grade A” recommendation that persons at high risk for HIV acquisition be offered PrEP. If approved, such a recommendation would carry the important benefit of lowering out-of-pocket costs which often have been barriers for too many people who are otherwise ready to start PrEP.
Better treatment, U = U, and PrEP – all of these are happening! I hope you continue to be a part of your community’s efforts to implement these so that we together can see even greater successes for the people we serve.