Looking back, it’s staggering to realize how far we’ve come. But it’s also clear how much farther we have to go.
According to the CDC, approximately 1.1 million people in the U.S. are now living with HIV. This year, with a pledge from President Donald Trump to eliminate the HIV epidemic in the U.S. by 2030, we are taking a hard look at what it will take to achieve that final push. Is elimination of HIV in the U.S. even possible? How do we maintain the necessary momentum?
The challenges are daunting, especially in our own Atlanta region. Today, Atlanta sits at the epicenter of the HIV epidemic in the U.S. Some metro area zip codes report HIV/AIDS rates six to eight times higher than the national average. By the time patients in Atlanta are diagnosed with HIV, a number already have AIDS or advanced disease.
Carlos del Rio, professor and chair of the Hubert Department of Global Health at Emory’s Rollins School of Public Health and co-director of the Emory Center for AIDS Research (CFAR), has found that downtown Atlanta has a generalized HIV epidemic that actually mirrors what is seen in some African cities.
It is my conviction that effective public health measures combined with outstanding clinical medicine can help turn the tide. But finding this pairing takes a commitment to long-term partnerships in our communities.
Under the medical direction of Emory infectious disease physicians, the Ponce de Leon Center at Grady Health System provides care in downtown Atlanta to more than 6,000 persons living with HIV, making it one of the largest and most comprehensive clinics in the country. There, active research efforts have shifted the paradigm for antiretroviral therapy and brought life-saving scientific advances and treatments to some of the communities with the greatest need.
And in a landmark study published this year in The Lancet Medical Journal, researchers concluded that the risk of transmitting the HIV virus can be eliminated when a partner living with HIV is on effective antiretroviral therapy with levels of virus in blood that are undetectable by standard tests. That’s another area where we can make, and are making, real inroads into the future of this disease.
But even the best medicines are useless if patients can’t access them. And often those who need them most are hard to reach — particularly low-income and uninsured people who struggle to pay for care in states that refused federal Medicaid expansion under the Affordable Care Act. That includes the state of Georgia.
According to the CDC, the annual number of new HIV diagnoses has remained relatively stable at about 40,000 in recent years. Yet, within some demographics, those numbers are on the rise. About one in seven people still aren’t aware they have HIV, close to 50% are not engaged in care, and less than 50% are virally suppressed.
The urgency of HIV/AIDS is ever-present. We cannot afford to be complacent, not in Atlanta, and not in any hard-hit community around the United States or globally.
It has been a remarkable journey. We’ve come very far. And we’re not turning back now.
Claire E. Sterk is president of Emory University.