HEALTH
2020 Target for Ending Epidemic is a Long Shot
New city HIV infections would have to decline by more than 60 percent in two-year span
BY DUNCAN OSBORNE
While the de Blasio
administration is
celebrating a record
low number of new
HIV diagnoses in New York City
in 2018, the city is faced with the
daunting task of producing a substantial
reduction in new HIV infections
over the next two years to
get to its goal of 600 new HIV infections
a year by 2020.
“New HIV diagnoses are DOWN
to record lows in New York City!”
the mayor’s press offi ce wrote in a
November 22 tweet. “This is fantastic
news, but there’s more work
to be done.”
The city health department’s
annual HIV surveillance report
for 2018 disclosed that there were
1,917 new HIV diagnoses in New
York City in 2018. That is an 11
percent decrease in reported new
HIV diagnoses over 2017 and the
fi rst time that such diagnoses fell
below 2,000.
Mayor Bill de Blasio and Governor
Andrew Cuomo endorsed the
Plan to End AIDS in 2014. That
ambitious proposal seeks to reduce
the number of new HIV infections
to 750 a year statewide in 2020.
With most new HIV infections occurring
in the city, the city health
department proposed to reduce
new HIV infections to 600 in the
city in 2020. While the plan’s progress
is measured with a number of
metrics — and a good number of
those are showing success — ending
the epidemic requires a large
reduction in new HIV infections.
New diagnoses result from infections
that occurred in the year
they are reported and those from
any earlier year not previously diagnosed.
New infections that occur
in a year are always estimated.
The 2018 report estimated that
there were 1,600 new HIV infections
in the city last year. Getting
to 600 new HIV infections in 2020
would require the city to reduce
new HIV infections by 63 percent in
just two years. Going back to 2015,
the city has seen year-over-year
reductions in new HIV infections
Dr. Oxiris Barbot, the New York City health commissioner.
ranging from a high of 17 percent
to a low of 12 percent, indicating
that a reduction of more than half
in a two-year period is unlikely.
In October, the Cuomo administration
released data that touted
a decline in new HIV diagnoses
in 2018. A story in The New York
Times read, “State health offi cials
say they believe they are on track
to lower the number of new HIV diagnoses
to a little more than 1,500
per year by 2020,” which suggested
that the state had changed its goal.
In an October interview, however,
Johanne Morne, the director of the
state AIDS Institute, a unit of the
state health department, told Gay
City News that getting to 750 new
HIV infections in 2020 remains a
goal.
The complete 2018 data for the
state was released on December
MARK DOLINER/ FLICKR
1, World AIDS Day, and the state
health department reported that
there were 2,019 new HIV infections
in New York last year.
The city report illustrates a continuing
struggle — reducing new
HIV infections among African-
American and Latino men who
have sex with men. Among the
1,917 new HIV diagnoses in 2018,
1,484, or 77 percent, were among
men. Among men, 1,191, or 80
percent, of the new HIV diagnoses
were among African-American and
Latino men. Sixty-seven percent of
the new diagnoses in men, or 997,
were attributable to men who have
sex with men. Another 375, or 25
percent, had an unknown transmission
risk.
The city has been successful
in reducing new HIV infections in
every other risk category or demographic,
including among white
gay men, to the point that the city
will not get to 600 new HIV infections
in 2020 if it does not signifi -
cantly reduce infections among
African-American and Latino gay
and bisexual men.
In the press statement that accompanied
the report, Dr. Oxiris
Barbot, the city’s health commissioner,
recognized that.
“We take a data-driven, sex-positive
approach to HIV prevention
that is fi rmly grounded in equity
and we are proving that it works,”
Barbot said in that November 22
statement. “New York City can end
the epidemic if we continue to fi ght
against the stigma, bias, and discrimination
that continue to be
signifi cant drivers of HIV, particularly
among Black and Latino men
who have sex with men.”
The Plan to End AIDS calls for
treatment for people who are HIVpositive
so they remain healthy
and cannot infect others. The plan
also supplies nutrition, housing,
and other services that make staying
on HIV medications easier. For
prevention among people who are
HIV-negative, the plan offers preexposure
prophylaxis (PrEP) and
post-exposure prophylaxis (PEP),
among other services. PrEP and
PEP are anti-HIV drugs used to
keep people uninfected. Both drug
regimens are highly effective when
used correctly.
While the data on PrEP use is
limited, it suggests that obstacles
remain among African-American
and Latinx men and women to
PrEP uptake. Some advocates fault
the efforts to deliver PrEP to communities
of color.
“To an extent not seen before,
HIV has become a disease of poverty
disproportionately affecting
communities of color,” Ritchie Torres,
an out gay member of the City
Council who represents part of the
Bronx, told Gay City News . “The
Bronx alone is home to 24 percent
of New Yorkers living with HIV.
The focus of public policy should
be on breaking down the barriers
to accessing PrEP that continue to
plague communities of color.”
December 5 - December 1 4 8, 2019 | GayCityNews.com
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