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Trump plan to stop spread of HIV will target ‘hot spot’ areas, including Atlanta

WASHINGTON — President Donald Trump’s plan to stop the transmission of HIV in the United States will focus on 48 counties where about half of new infections occur, administration officials said Tuesday.

The goal is to reduce new infections by 75 percent over five years and to “end the HIV epidemic in America” by 2030, said Alex Azar, the secretary of health and human services, who coordinated development of the ambitious plan, outlined by Trump in his State of the Union address.

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New infections in recent years have remained at roughly the same level, around 40,000 a year.

Officials have been planning an offensive against HIV with the precision of a military campaign. They intend to deploy platoons of community health workers to step up the prevention, diagnosis and treatment of infections.

Azar said Trump would seek substantial new funds for the effort, but he refused to say how much.

Of the 48 counties, the top 10 — ranked by the number of HIV diagnoses in 2016 and 2017 — are the counties that include Los Angeles; Miami; Houston; Chicago; Dallas; Fort Lauderdale, Florida; Atlanta; Phoenix; and the Bronx and Brooklyn boroughs of New York City.

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Other targets include Las Vegas; Queens County and Manhattan in New York; Washington, D.C.; Detroit; Newark, New Jersey; Prince George’s and Montgomery counties in Maryland; San Francisco; Baltimore; and San Juan, Puerto Rico.

Azar said new infections were “highly concentrated among men who have sex with men; minorities, especially African-Americans and American Indians and Alaska Natives; and those who live in the Southern United States.” The South accounted for 52 percent of new HIV diagnoses in 2017, according to the Centers for Disease Control.

“Almost 90 percent of new infections are transmitted by people who do not know they are infected or who are not being retained in treatment,” Azar said.

Half of people with HIV have the virus at least three years before diagnosis, and 1 in 4 people with HIV have the virus at least seven years before the infection is diagnosed, Azar said.

Dr. José M. Zuniga, president of the International Association of Providers of AIDS Care, hailed the new initiative.

“The goal to end the U.S. HIV epidemic is more than aspirational — it is achievable,” Zuniga said.

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