IN THE LOOP

Officials from the CDC and HRSA Tour APLA Health and Meet with County Leadership to Advance President Trump’s Plan to End the HIV Epidemic

On July 18, APLA Health hosted federal officials from the Centers for Disease Control and Prevention (CDC) and the Heath Resources and Services Administration (HRSA) at its Gleicher/Chen Health Center in Baldwin Hills, as the Trump Administration’s “Ending the HIV Epidemic: A Plan for America” conducted its inaugural visit to Los Angeles County.

The visit was part of a national listening tour to health jurisdictions highly impacted by the HIV epidemic as identified in the President’s plan. CDC Director Dr. Robert Redfield, HRSA Deputy Regional Administrator Valerie Gallo and staff participated in a tour of the clinic followed by an afternoon meeting at APLA Health’s Education Center where two community panels discussed PrEP uptake, methamphetamine/opioid use, and syphilis rates among communities most at risk of HIV in Los Angeles County.

“APLA Health was pleased to welcome Dr. Redfield and other public health officials to Los Angeles to discuss the President’s plan to end the epidemic,” said Craig E. Thompson, APLA Health Chief Executive Officer. “The administration has an ambitious goal of ending the HIV epidemic by 2030 but this plan will only be effective if impacted communities are at the table through every step of the planning and implementation process.”

President Trump announced his Ending the HIV Epidemic plan during the State of the Union address in February. The goals of the plan include reducing new HIV transmissions by 75% within 5 years, and by 90% within 10 years. This will be accomplished by intensifying efforts to diagnose people with HIV, increasing the number of people living with HIV in treatment, and dramatically increasing uptake of pre-exposure prophylaxis (PrEP) – a daily medication that has been shown to reduce the risk of HIV by up to 99 percent.

The plan targets 48 counties, 7 rural states, Washington, D.C., and San Juan, Puerto Rico, as jurisdictions that are disproportionately impacted by HIV. Los Angeles, Orange, San Bernardino, Riverside, San Diego, Alameda, San Francisco, and Sacramento are the California counties that will receive additional funding to reduce new HIV diagnoses.

The Trump administration’s proposed FY 2020 budget includes $291 million to begin implementation of the plan. The new funding would support strategic HIV testing efforts in geographic hotspots, improved care and treatment of people living with HIV through the Ryan White HIV/AIDS Program, and increased PrEP uptake through the nation’s network of federally qualified health centers (FQHCs) – like APLA Health’s Gleicher/Chen, Long Beach and Olympic Health Centers.

While the administration’s proposed budget included new funding for some HIV programs and services, it also included steep cuts to other health, housing, and safety net programs, including a $63 million cut to the Housing Opportunities for People with AIDS (HOPWA) program, which provides critical housing support for people living with HIV and a $1.3 billion decrease in funding for the President’s Emergency Plan For AIDS Relief (PEPFAR). The administration also continues to undermine the Affordable Care Act, which remains a critical source of health coverage for both people living with and vulnerable to HIV.

“APLA Health supports increased funding for HIV programs, but that funding must not come at the expense of other critical health and safety net programs that serve people living with and affected by HIV both domestically and abroad,” Thompson said. “The Administration’s plan to end the HIV epidemic will not succeed unless it ends attacks on the Affordable Care Act and Medicaid expansion, and rescinds policies that are harmful to LGBTQ individuals, immigrants, and communities of color. This is a message we delivered on behalf of our clients and a message we hope the delegation will take back to the White House.”

APLA Health Clinic Director Vallerie Wagner led the CDC/HRSA delegation through the Gleicher/Chen Health Center, and APLA Health Director of Prevention Terry Smith briefed the group on the agency’s prevention programs (which are largely targeted at young gay men of color). The visiting officials participated in a morning meeting with county leadership from the Department of Public Health (DPH). DPH Director Dr. Ferrer reviewed local HIV/AIDS data, the goals and strategies of the Los Angeles County HIV/AIDS Strategy, progress to date, and how the local plan fits into the President’s plan.

During a lunchtime session, representatives of the Los Angeles County Commission on HIV emphasized the need to improve testing, linkage to and retention in care, prevention (especially PrEP uptake) in communities disproportionately impacted by the epidemic, and challenges specific to Los Angeles County. Commissioners also stressed the importance of implementing ‘ending the epidemic’ efforts through a ‘social determinants of health’ lens, focused on issues that included stigma, medical mistrust, and racism.

During the nationwide listening tour, CDC Director Dr. Robert Redfield and Assistant Secretary for Health Admiral Brett Giroir will visit 30 of the 48 counties identified in the plan. APLA Health and many other community leaders have welcomed the President’s plan and new funding to end the HIV epidemic, but remain vocal and opposed to the administration’s other policies on healthcare, including ongoing efforts to dismantle the Affordable Care Act and systemic efforts to remove civil rights and protections in health settings for LGBTQ and other marginalized communities.