Biden AIDS strategy declares racism “public health threat”

WASHINGTON — President Joe Biden unveiled Wednesday his new HIV/ AIDS strategy to end the more than 40-year-old epidemic, calling for a renewed focus on vulnerable Americans — including gay and bisexual Black and Hispanic men, who his administration says are too often stigmatized even as they are disproportionately affected.

The new strategy, which declares racism a “public health threat,” was released on the annual commemoration of World AIDS Day. It is meant to serve as a framework for how the administration shapes its policies, research, programs and planning over the next three years.

But Biden acknowledged that the country still needs to work to destigmatize HIV/ AIDS and noted that lesbian, gay, bisexual, transgender and racial minority groups have “endured the brunt” of the epidemic that’s killed more than 36 million worldwide, including 700,000 Americans.

“I want to make sure that everyone in the United States knows their HIV status, and everyone with HIV receives high-quality care and treatment that they deserve and that we end the harmful stigma around HIV and AIDS,” Biden said.

The new strategy asserts that over generations “structural inequities have resulted in racial and ethnic health disparities that are severe, far-reaching, and unacceptable.”

New HIV infections in the U.S. fell about 8% from 201519, but Black and Hispanic communities — particularly gay and bisexual men within those groups — continue to be disproportionately affected, according to Centers for Disease Control and Prevention data.

African Americans make up about 13% of the U.S. population but accounted for more than 40% of new infections. The Latino population accounted for nearly 25% of new infections but makes up about 18.5% of the U.S. population.

Historically, gay and bisexual men have been the most disproportionately affected group. They account for about 66% of new HIV infections, even though they are only 2% of the population, according to the CDC.

Disparities also persist among women. Black women’s HIV infection rate is 11 times that of white women and four times that of Latina women.

To reduce the disparities, the strategy includes calls for focusing on the needs of disproportionately affected populations, supporting racial justice, combating HIV-related stigma and discrimination and providing leadership and employment opportunities for people with or at risk for HIV.

Besides addressing racism’s impact on Americans battling the virus or at risk of contracting it, the new strategy also puts greater emphasis on harm reduction and syringe service programs, encourages reform of state laws that criminalize behavior of people with HIV for potentially exposing others and adds focus on the needs of the growing population of people with HIV who are aging.

Biden expressed disbelief that some states have laws on the book that criminalize spitting in public by HIV-positive people even though it has long been proven that the virus can’t be transmitted through saliva. Thirty-five states have laws that criminalize various forms of HIV exposure, according to the CDC.

“We have to follow science and that means eliminating laws that perpetuate discrimination, exacerbate disparities, discourage HIV testing and take us further away from our goal,” Biden said.

Dr. Anthony Fauci, the top U.S. infectious disease expert, said Tuesday the covid-19 pandemic has diverted scientific and financial resources from the fight against AIDS, seriously impeding global efforts to achieve the U.N. goal of ending AIDS by 2030.

Fauci told the U.N. General Assembly that tackling covid-19 has also disrupted supply chains and increased the risk for people with HIV, the virus that causes AIDS, of being infected with another deadly virus.

“To confront these challenges, we must intensify our collaborative research efforts and unclog supply chains through investment and regulatory action,” he said. “We also must assure that people with HIV in all countries have early access to effective covid-19 vaccines and therapeutics while their supply of anti- HIV drugs also is maintained.”

Fauci said he has been “deeply engaged” in responding to both the HIV/AIDS and covid-19 pandemics, and “they have stimulated responses we all can be proud of including remarkable scientific progress, global cooperation and widespread compassion, particularly in the distribution of life-saving AIDS medications.”

“On the other hand,” he said, “they also reveal that as a global society, we still are struggling with long-standing inequities in health care access, and very real health communication challenges linked in some countries to waning trust in core institutions.”

Fauci said in a recorded speech that much of what scientists and public health experts learned from their long investment in HIV/AIDS research “has been successfully applied to the covid-19 pandemic.” He pointed to the design of drugs and the potential impact on survival of monoclonal antibodies, which can fight infections.

“Important discoveries stimulated by covid-19 may also help us make progress against HIV/AIDS,” he said, singling out messenger RNA vaccines and the pool of substances that are effective in vaccines.

MRNA vaccines work by using a piece of genetic code from the spike protein of the coronavirus to train the immune system to generate a response. Both the Pfizer-BioNTech and the Moderna vaccines rely on mRNA.

Fauci said covid-19 also showed how quickly scientists and public health officials can respond to counter a pandemic when there is substantial and sustained financial investment, “and perhaps most importantly, when governments and the private sector work together” and provide incentives for production.

Now, he said, the challenge for scientists, funders, and supporters of research “is to apply these lessons to fight against HIV/AIDS.”

The Biden administration recently announced it will host the Global Fund to Fight AIDS replenishment conference next year. The United States has contributed about $17 billion to the fund, about a third of all donor contributions.

A giant red ribbon, a symbol of support for people living with HIV, was displayed on the North Portico of the White House to mark World AIDS Day. The two-story ribbon display has become an annual tradition at the White House since 2007.