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World AIDS Day, observed annually on December 1, celebrates
accomplishments in combating the disease, remembers those
who have lost their lives to HIV and AIDS, and refocuses
efforts on what is still needed to end the epidemic.
Advances in testing technologies and biomedical
interventions have expanded and transformed the way we
approach HIV prevention and care, but disparities remain.
This year's World AIDS Day theme, "Know Your Status," aims
to address this by encouraging people to get tested and, in
the event of a positive diagnosis, engage in care. Local
health departments are on the forefront of these efforts,
working on initiatives to address the prevention and
treatment of HIV and AIDS. This update is provided by the
National Association of County and City Health Officials
(NACCHO), representing the nation's nearly 3,000 local
health departments.
Status of the Epidemic
·
The annual
number of new HIV infections has declined
over the last decade. Still, more than 1.1 million people
are estimated to be living with HIV in the U.S., and
one
in seven
are unaware of their status.
·
Progress in the HIV epidemic is uneven
across populations and regions.
o
Black populations account for nearly half – 44% – of HIV
diagnoses, despite representing just 12% of the U.S.
population.
o
Men who have sex with men (MSM) remain most affected,
representing 67% of new diagnoses in 2016. However, white
MSM are seeing decreases of 10% in HIV diagnoses, while
black and Latino MSM have experienced increases of 4% and
14%, respectively. The Centers for Disease Control and
Prevention analysis suggests that if current HIV diagnosis
rates persist, one in two black MSM and one in four Latino
MSM will be diagnosed with HIV in their lifetime.
o
Youth ages 13-24 make up
20%
of all new HIV diagnoses
and are the least likely of any age group to be linked to
care in a timely manner.
o
Nearly one in ten new HIV diagnoses are
among
people who inject drugs,
reflecting the severity of the opioid epidemic.
o
Southern states account for more than half of new HIV
diagnoses and 44% of all people living with HIV, while
making up 38% of the national population.
·
Medical and community-based interventions are making a
difference.
o
Antiretroviral therapy (ART) significantly extends and
improves the quality of life for people living with HIV, and
there is now
conclusive scientific evidence
that people living with HIV who are on ART and virologically
suppressed do not sexually transmit HIV.
o
Pre-exposure prophylaxis (PrEP), as well as post-exposure
prophylaxis (PEP), uptake is a critical intervention for
decreasing the risk of HIV transmission.
The Role of Local Health Departments and NACCHO
Local health departments are key leaders in providing and
assuring access to HIV prevention, care, and treatment for
the communities they serve. As community health strategists,
local health departments facilitate collaboration among
public health, healthcare, and social services
organizations, among others, to achieve more integrated,
evidence-based, culturally competent systems for HIV
prevention and care. They are uniquely positioned to
provide data
and are leaders in broader efforts to fight stigma and
address the root causes of health inequities and structural
barriers to effective HIV prevention and care. These local
efforts are critical to address disparities in the impact
and reach of the epidemic. Local health departments are also
addressing the intersecting threats of sexually transmitted
infections, viral hepatitis, tuberculosis, and the opioid
crisis.
NACCHO works closely with its members to help advance
the National HIV/AIDS Strategy goals:
·
NACCHO's
Southern Initiative
seeks to improve HIV outcomes among minority populations in
the south through the use of Community Health Workers.
·
Projects in rural areas of Kentucky, Virginia, and West
Virginia are increasing local capacity to
respond to the infectious disease consequences of the opioid
epidemic
and offer comprehensive harm reduction programs to address
the needs of people who inject drugs.
·
NACCHO recently completed an
action planning project
focused on building local health department capacity to
collaborate with schools and other key stakeholders to
implement school-based prevention programs that reduce HIV/STIs
among adolescents.
·
This year, NACCHO also signed the
U=U
Consensus Statement,
published the findings of a survey about
PrEP
implementation among LHDs,
presented findings from an
evaluation of local implementation of Health is Power,
a campaign to promote sexual health among heterosexual black
men ages 18-30, and updated its
HIV
Prevention, Care, and Treatment policy statement.
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