“Ramp Up the Resources”: Increased Effort and Funding Needed to End HIV

Congress recently released their omnibus appropriations bill. The $1.5 trillion spending bill increased funding for HIV testing, treatment, and prevention by $70 million. However, this is drastically less than the Biden Administration’s promise of a $245 million increase.

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, sat down with Contagion to discuss how the reduction in expected funding will affect the work they are doing to promote viral suppression and end HIV transmission.

One area with reduced funding is pre-exposure prophylaxis (PrEP), which had an expected increase of $50 million but received $20 million. Schmid emphasized that PrEP has been a major factor in HIV reduction. Previously taken orally once a day, new long-acting PrEP treatments can be administered as infrequently as once every 2 months.

Schmid noted that the HIV+Hepatitis Policy Institute was “very pleased” that the Biden Administration had continued to fund and support the Ending the HIV Epidemic in the U.S. initiative started by the Trump Administration. The White House hopes to ramp up their efforts, looking to end HIV earlier than the previous goal of 2030.

Though HIV diagnoses have been decreasing overall, “Any new diagnosis of HIV is too many,” Schmid said. “It’s an infectious disease.” As a deadly infectious disease, HIV treatment is vital to ensure the best possible prognosis. Because HIV treatment lasts a lifetime, burdening both the patient and the healthcare system, Schmid said it is much better to prevent HIV than treat it.

“Treatment is prevention,” Schmid said, as HIV therapies like post-exposure prophylaxis (PEP) help an infected person achieve viral suppression, thus inhibiting the virus from remaining infectious and spreading. “It’s just remarkable,” Schmid said, “the same drugs that can use to treat HIV are also used for prevention.”

Schmid describes the Institute’s mission as advocating for people who have or are at risk of HIV or hepatitis. “Much of our focus is on PrEP these days,” Schmid said, but the HIV+Hepatitis Policy Institute also supports the Ryan White Program, which cares for low-income, uninsured people living with HIV in the US.

In particular, the HIV+Hepatitis Policy Institute is working to focus on Black and Latino gay men, who are disproportionately affected by HIV. These populations, despite having relatively high HIV incidence, are less likely to be on PrEP.

“People are already hurting,” Schmid said. “If we’re gonna end HIV, and we’re gonna be serious about it…we’re really going to have to ramp up the resources to get the job done.”