Ending AIDS In New York, One Step At A Time

This week, Governor Andrew Cuomo took a bold and important step forward in combatting the HIV epidemic in New York State. In remarks given before the New York City Pride Parade on June 29, the governor announced his plan to “bend the curve” of the disease, decreasing new HIV infections while ensuring that people with HIV receive the care they need to remain healthy. This announcement was the culmination of a statewide effort led by ACRIA in conjunction with Housing Works, Treatment Action Group and other community, state and city partners to strengthen and re-envision New York’s approach to HIV prevention and treatment, as we now have the science and means to end AIDS if we smartly commit the resources. We applaud Governor Cuomo’s announcement and urge him to establish a high-level Taskforce to End AIDS in New York to oversee its implementation and ensure that we are reaching communities most affected by HIV.

The Governor’s three-point plan includes:
- Identifying people with HIV who do not know their status and linking them to care;
- Ensuring that people with HIV are receiving quality health care and anti-retroviral treatment that keeps them healthy and suppresses viral loads, significantly decreasing the ability to spread the virus; and
- Providing access to Pre-Exposure Prophylaxis (PrEP) for those at highest risk to keep them HIV-negative.

New York has been the epicenter of the HIV epidemic in this country over the past three decades, and it is now within our reach to be the first state to end it. We have seen an almost 40 percent decrease in new HIV diagnoses in the last decade, with fewer new infections each year, while nationally there has been no decline in the number of new HIV infections diagnosed each year. In addition, infection through injection drug use has been reduced by over 90 percent, and mother-to-child transmission is down 99 percent. There is still no cure at hand, but we now have the knowledge and means to dramatically reduce new HIV infections and promote optimal health for those with HIV. We are on the brink of making the end of AIDS possible in New York, and with this important step by the Governor we have taken significant leap forward.

For many who lived through the worst days of the AIDS crisis, it is nothing short of astounding that we are living in a time when HIV does not equal a death sentence. Thanks to the development of highly effective HIV medications in the mid-90s—in which ACRIA played part—people with HIV are now living decades longer than was ever thought possible. In fact, by 2015 half of all people living with HIV in the U.S. will be over the age of 50.

We were among the first organizations to recognize that this would lead to an aging HIV-positive population with new, unique challenges. Ten years ago, ACRIA began conducting groundbreaking research on the lives and special needs of older adults with HIV. That research—the first of its kind—led to our partnership with the City of New York to promote HIV testing and provide prevention and treatment education at senior centers throughout the five boroughs. Today, we are the leading global authority on HIV and aging, and have expanded our work across the country and abroad.

Unfortunately, while people with HIV are living longer, healthier lives, the epidemic continues to plague the most vulnerable people within our communities. Young African American and Latino men—especially those who have sex with men—continue to become infected at alarming rates. High rates of poverty, low education levels, homophobia, racism, and HIV stigma are only exacerbating the epidemic by keeping young men of color from knowing their HIV status and being connected to medical care. ACRIA’s HIV educators have seen this first-hand in their work throughout New York State and across the country in communities hardest-hit by the disease. It is these people that we must reach together to combat this disease and make New York State a model for HIV prevention and treatment.

While meeting the goals of the plan will be an extraordinary accomplishment, it will also be essential to provide quality education about HIV to those who test positive or are newly connected to care so they can make the best choices about their treatment and stay healthy. ACRIA’s HIV educators have repeatedly been confronted with the rampant misinformation that persists regarding HIV and its treatment. Unfortunately, few medical care providers have the time to fully explain this complex disease to their patients, address myths and fears, or answer questions; many lack the training and skill necessary to explain HIV in a way that is readily understood by their patients.

During one of our recent “HIV 101” workshops—one of the only ongoing educational sessions for New Yorkers with HIV—a man who had been HIV-positive for 14 years told us that he had learned more in two sessions than he had during his entire time living with the disease. Another participant was surprised to learn that his HIV medication needed to be taken with a 400-calorie meal, and that the failure to do so could lead to drug resistance. These are just a few examples that highlight why education will be a key component to ending AIDS in New York.

For the first time since this devastating epidemic began, we have the ability to combat and defeat it. We thank the Governor for his leadership on this issue and look forward to working with him and our partners across New York to finally eradicate this disease.

BENJAMIN BASHEIN is the acting executive director of ACRIA, the New York City-based international HIV research and education organization. He provides overall leadership and vision for the organization, and has most recently held leadership positions at Doctors of the World-USA and Planned Parenthood.