Reflecting on Equity on World AIDS Day

Every year the global community marks World AIDS day on December 1. It’s a painful reminder that sometimes there are no endings when it comes to fighting disease and protecting humanity. There are 38 million people living with HIV around the world, according to the Centers for Disease Control and Prevention. While new HIV diagnoses have declined significantly from their peak, U.S. progress to eradicate them has stalled with an estimated 38,000 Americans being newly diagnosed each year. Without intervention, nearly 400,000 more Americans will be newly diagnosed over 10 years even though we have the tools to prevent transmissions. Even more troubling is that in the U.S. 50 percent of new HIV infections are transmitted by people who are unaware of their status.

Health centers are working hard to counter those numbers by providing HIV prevention and treatment services tailored to the underserved. This is no small challenge as they enter the third year of fighting COVID-19 on the frontlines. In 2020, 190,000 health center patients received HIV care and 2.5 million HIV tests were administered. Health centers are also integrating care management and coordination services to boost health outcomes and make HIV screening part of a routine exam any patient receives. They are also trying to increase prescriptions of pre- (PrEP) and post- (nPEP) exposure prophylaxis for HIV to keep more community members safe from risk. At NACHC, the strategy underway is to move HIV prevention on two fronts, bringing in more partnerships, such as with rural clinics, to fight and improve screening in underserved populations. Also, to leverage the community of partners advanced in LGBTQ care and ensure other providers in other demographic areas have the biomedical tools and data they need to support patients, help them stay safe, and measure their progress and persistence in fighting HIV.

In fighting disease and pandemics, equity remains the North Star of the health center mission. Equity means that everyone receives access to early prevention, treatment and screening through a community-led and people-centered health infrastructure. It also means that we recognize and address the social challenges that block marginalized groups from equal access to services, medicines, vaccines and health technologies; and that we recognize the disproportional impact of HIV in Black and Latino gay and Bisexual communities, as well as the Trans community overall. Health centers strive to foster interventions and communications based on the unique circumstances of different populations, meeting people where they are in terms of language, culture and diversity.

Yet even as health centers dedicate themselves to the mission of caring for the underserved the larger problem of social and systemic health inequities is global. The UNAIDS warns that the world could face 7.7 million* AIDS-related deaths over the next 10 years unless transformative measures taken to end AIDs. We cannot act alone. Good public health and resiliency to pandemics require a transformative approach to dismantle the structural barriers that prevent equity within and beyond our borders.