Delayed by COVID-19, task force announces HIV/AIDS plan

LILO H. STAINTON, HEALTH CARE WRITER | NOVEMBER 26, 2021

NJ Spotlight News

AIDS virus (yellow) infecting human cell

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Expanding access to testing so everyone with HIV/AIDS in New Jersey knows they are infected. Ensuring nine out of 10 infected individuals benefit from effective treatment. Promoting medications and strategies to reduce new infections by three-quarters.

Those goals are at the heart of the state’s strategic plan to end the HIV/AIDS epidemic in New Jersey by 2025. They were developed by a task force based on extensive stakeholder input and released by state health officials last week. The proposal details the legal and policy changes, program additions and public outreach required to reach these goals and flags a dozen urban communities with high HIV/AIDS rates that could benefit from extra attention.

“For decades, the HIV epidemic has impacted our state and has had devasting effects, especially on our communities of color,” Gov. Phil Murphy said, commending the group’s work on the plan. “I look forward to working with advocates, health care providers, and my colleagues in the Legislature to continue this progress to end the HIV/AIDs epidemic in New Jersey.”

The number of new HIV/AIDS cases has been declining for years in New Jersey — falling 17% between 2010 and 2019, when 1,115 new diagnoses were reported — thanks to an increased awareness of risks, better access to condoms and clean needles and growing availability of medications that greatly reduce the risk of infection, before and after exposure. Women accounted for at least one in five new cases, the plan noted, and nearly one-third of the 38,000 state residents living with HIV/AIDS. Nearly eight out of 10 infected individuals are Black or Hispanic.

While new HIV/AIDS diagnoses have trended downward, they experienced a slight uptick between 2018 and 2019, something state officials attributed to better disease surveillance. Preliminary figures for 2020 suggest New Jersey could enjoy a sudden drop, to fewer than 900 new cases, but the state Department of Health said these are likely skewed by the pandemic restrictions that kept most people at home for much of the year.

Treatment during lockdown

The COVID-19 pandemic — responsible for more than 1 million infections and 28,000 deaths in New Jersey — also delayed the release of the HIV/AIDS plan, which advocates were eager to finish in December 2019. DOH spokesperson Dawn Thomas said the state continued to work to reduce HIV/AIDS infections — and keep safe those patients seeking treatment during the lockdown — by distributing protective equipment to AIDS organizations, ensuring they had permission to remain open and organizing testing, and later vaccines, for people served by these groups.

“After another pandemic — COVID-19 — created a hurdle for all of us, we are thrilled that Gov. Murphy released the (HIV/AIDS plan) ahead of World AIDS Day in this the 40th year of AIDS,” said Rutgers School of Public Health Dean Perry Halkitis, a task force member, noting the event recognized each Dec. 1.

“The plan intelligently recognizes that medications alone will not bring an end to the HIV epidemic,” Halkitis added. “Changes in policy, laws and initiatives that increase access to health care and that attend to all aspects of people’s lives will bolster the effectiveness of (pre-exposure medications) and treatment as prevention, which are the cornerstones of the plan.”

Murphy first outlined his commitment to end HIV/AIDS by 2025 in December 2018, when he announced New Jersey would be the ninth state at that point to join the international Prevention Access Campaign, also known as Undetectable = Untransmittable, or U=U. The initiative, which now involves more than 1,000 localities in 120 countries, seeks to end HIV infections, which can develop into AIDS, by reducing the stigma around the disease and encouraging the use of effective medications. When patients in treatment have so little virus that it can’t be detected, spread is not a concern, studies have shown.

That promise led to the task force, which worked with stakeholders to develop the 35-page proposal released last week. “Achieving these goals will not eliminate HIV/AIDS; rather, it will ensure that for the first time since the beginning of the HIV epidemic, HIV acquisition is effectively managed and the prevalence and incidence of HIV/AIDS in the state decreases over time,” the summary reads.

First steps

“The objectives and strategies detailed in the following pages are aspirational but wholly within our grasp,” the task force noted. But creating the plan is just the beginning, it wrote, while “successful implementation … will save lives.”

The proposal identifies the three primary goals — reducing new infections by 75%, ensuring 100% of those with HIV/AIDS know their status and connecting patients with treatment so that 90% see viral loads suppressed — and outlines dozens of steps regulators, providers, advocates and others can take to reach them. It also reviews years of data and details some of the barriers that individuals now face when seeking treatment.

“For those living with HIV, or at risk of transmission, a formal plan to end the epidemic that removes systemic barriers to care, fights stigma and addresses the social determinants of health is long overdue,” said task force co-chair Kathy Ahearn-O’Brien, executive director of the Hyacinth AIDS Foundation. She praised Murphy’s leadership on the issue, adding, “we look forward to working with the administration as we move forward with a focused implementation plan.”

Among other things, the strategy calls for ensuring emergency rooms and urgent-care centers have access to medications that can prevent infection after exposure to HIV/AIDS, training community medical providers in this protocol and urging federal regulators to expand the repertoire of drugs used for this purpose. It also recommends greater availability of pre-exposure, or prophylactic, medications that can be taken daily to reduce infection risk, by making them available at family-planning clinics that test for sexually transmitted diseases.

In addition, the plan calls for promoting better understanding of the U=U strategy among medical providers who may not be up to date in HIV/AIDS science, deploying case managers to help individuals stay on their medication schedules and creating culturally appropriate outreach campaigns to boost public awareness of new pharmaceutical options. And it urges the state to invest more in harm-reduction centers — currently New Jersey has just seven — which offer clean needles and other services to IV drug users and have been shown to help reduce the spread of HIV/AIDS and other blood-borne diseases.

The proposal also outlines strategies for expanding HIV/AIDS testing, especially among harder-to reach populations. This could involve a mobile-screening program dispatched to rural areas, homeless shelters or mental health care facilities. And it recommends greater coordination among government units, health care providers, social service organizations and advocacy organizations to help connect more people with effective treatment and keep them motivated to participate.

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published this page in News and Politics 2021-11-26 03:23:35 -0800