President Donald Trump plans to announce a campaign to halt transmission of HIV in the United States by 2030 in his State of the Union speech Tuesday night, a goal some experts believe is within reach, according to people inside and outside the administration.
The U.S. Health and Human Services Department is expected to roll out the plan within days of Trump’s address, the sources said. Greg Millett, director of public policy for the American Foundation for AIDS Research, said the initial plan may focus on wiping out HIV transmission in 46 U.S. counties responsible for about half of all new HIV cases in the United States, based on information he has seen.
“I think it’s definitely possible to end HIV transmission in specific places in the United States,” Millett said. “And the reason I say that is that we’re already on a trajectory to do that.”
Few other details were available Monday, but any effort to eradicate new HIV diagnoses would almost certainly have to focus on black and Hispanic men who have sex with other men, people between the ages of 25 and 34 and residents of Southern states. Those groups have for years borne a disproportionate share of new HIV diagnoses, according to the Centers for Disease Control and Prevention.
Last year, there were 38,739 new HIV diagnoses in the United States, according to the CDC. An estimated 1.1 million people had the virus in 2015, the CDC said, with about 15 percent of them undiagnosed.
Politico first reported the president’s HIV plan Monday.
In another part of his speech, Trump is expected to discuss efforts to rein in prescription drug prices, a top health-care priority for his administration.
HHS proposed a major rule last week to end a system of drug rebates to middlemen. Instead, drugmakers would be allowed to provide discounted prices only to consumers – a change the administration and drugmakers say would end incentives for high list prices and expensive medicine that comes with large, hidden rebates in Medicare and Medicaid managed care.
Trump also is likely to bring up efforts to curtail late-term abortion, capitalizing on the backlash to New York and Virginia’s moves to pass state protections, according to a former presidential transition adviser. Trump regards late-term abortion as a “radical left” issue he can raise in a speech intended to attract bipartisan support, the former adviser said.
On HIV, the development of powerful drugs, coupled with safe sex practices, could make a public health campaign against the virus successful. Treatments for HIV – once considered a death sentence – now can reduce the virus in the blood so effectively that transmitting it to another person is essentially impossible.
Medication to protect people at risk of contracting HIV, known as pre-exposure prophylaxis (PrEP), is also considered highly effective if they adhere to a daily pill regimen. The difficulty is ensuring that the people who need the drugs get them at an affordable price, and stay on them, experts said.
Overall, just 90,000 prescriptions for the drug were filled in 2015, while 1.1 million people were at risk for contracting HIV, according to the CDC. The numbers of blacks and Hispanics on PrEP are even lower.
Residents of Southern states received 52 percent of the new HIV diagnoses in 2017 but have far less access to the drug. Marketed as Truvada, it costs between $1,600 and $2,000 per month, although insurance and the medication’s manufacturer, Gilead Sciences, cover the cost for some people.
Millett said the HIV initiative has been pushed by CDC Director Robert Redfield, Surgeon General Jerome Adams and Brett Giroir, assistant secretary for health at HHS.
Redfield told staff last March that he believed the epidemic could be ended “in the next three to seven years if we put our mind to it.”