New York State Embraces 3-Point Plan to Reverse HIV Epidemic

New York State adopted a three-point plan to cut the number of new HIV infections to 750 yearly, below the number of AIDS deaths, according to a statement from the office of Governor Andrew Cuomo. The strategy aims to lower the number of people living with HIV infection in New York State for the first time since the epidemic began in 1981. 

Called "Bending the Curve," the initiative has three goals:

— Identify people with HIV who remain undiagnosed and link them to health care.

— Retain diagnosed people in care and start treating them with combination antiretroviral therapy to maximize viral suppression and prevent HIV transmission.

— Provide preexposure prophylaxis (PrEP) to people at high risk of HIV infection to protect them from the virus.

HIV incidence—the new infection rate—has remained around 40,000 yearly for several years across the United States. But over the last decade New York State has cut the annual number of new HIV cases by 40% across all categories of race, ethnicity, gender, age, and HIV risk group. Still, the number of people living with HIV in New York State continues to rise, largely because people with HIV are living much longer through treatment.

"Bending the Curve" seeks to lower annual HIV incidence from the current 3000 cases yearly to 750 by 2020, below the number of annual HIV deaths and similar to the number of new tuberculosis cases.

Anthony Fauci, a leading US government HIV researcher, praised the New York plan, telling the New York Times that "if you aggressively seek out people who are infected, get them into voluntary testing, care and treatment, the mathematical model shows a sharp deflection in the curve of people ultimately getting the infection. Ultimately you can end the pandemic."

The state has directed $5 million to the three-point plan through Medicaid and the state's AIDS Institute, and the Cuomo administration will make "Bending the Curve" a priority in the next budget cycle. New York State has already secured bulk discounts on key antiretrovirals from AbbVie, Bristol-Myers Squibb, and Gilead Sciences and is negotiating with other drug makers.

The state will also set a 30% cap on the proportion of an HIV-positive person's income that can be spent on rent to ensure stable housing and improve their ability to remain in care and on treatment.

Sources:

Andrew M. Cuomo, Governor. Governor Cuomo announces plan to end the AIDS epidemic in New York State. 29 June 2014.

Anemona Hartocollis. Cuomo plans seeks to end New York's AIDS epidemic. New York Times. 28 June 2014

Written by Mark Mascolini on behalf of the International AIDS Society