We asked 5 experts to weigh in on his expected State of the Union announcement.
Many American presidents have used the State of the Union address as an opportunity to make grand pronouncements about beating back health scourges. Barack Obama in 2016 called for a “moonshot” to cure cancer. George W. Bush in 2003 announced his intention to “turn the tide against AIDS” with the creation of PEPFAR, the global health program to fight AIDS.
And though health has not been a particular focus of his time in office, President Donald Trump is expected to highlight a new major medical pledge in his speech Tuesday night: ending the HIV epidemic in America by 2030. As Politico first reported, the administration’s goal is to “stop new infections over a 10-year period.”
There are currently more than a million Americans livingHIV, and about 40,000 new infections are diagnosed here every year. African-American gay and bisexual men are the group most affected by HIV in the US, and diagnoses in the mid-20s to mid-30s age cohort have been rising in recent years. But Trump’s reported proposal is not at all as far-fetched as it may seem.
That’s because we actually know what needs to be done to stop the spread of HIV, even in those high-risk groups. Antiretroviral treatment can now suppress the virus to the point that it’s undetectable in the blood, so people on treatment are unlikely to pass the virus to others. We also have a drug — PrEP, sold by the brand name Truvada — that can prevent people at risk of infection from contracting the virus. (The drug has also recently been linked to riskier sexual behaviors.) Together with basic public health measures — like diagnosing cases and messaging on safe sex — ending HIV is truly within reach.
For now, the details of the administration’s plans are still scant (both HHS and the White House declined Vox’s request for comment). But we asked five HIV and public health experts to weigh in on what Trump’s plan to end HIV in the US should include if the administration is serious about tackling the ongoing epidemic. Here’s what they told us. Their answers have been lightly edited for clarity.
Jennifer Kates, vice president and director of global health and HIV Policy at the Kaiser Family Foundation
One of the big challenges in the US right now is that only about half of people living with HIV are virally suppressed [meaning they’re on medication that reduces their risk of spreading HIV to almost zero]. If 90 percent of people were virally suppressed, we’d have a different story. So that’s a key part of this: getting people on treatment and virally suppressed. When people are durably virally suppressed, there’s no risk of transmission to an HIV-negative partner.
The second piece is PrEP, [the pill that prevents HIV].
