Hopeful Signs of Progress in Ending HIV in the United States: New Biden Strategic Plan & Congressional Bills to Establish National PrEP Programs

Washington DC… “As we mark World AIDS Day on December 1st, despite all the recent setbacks due to the ongoing COVID-19 epidemic, there is hope on the horizon for ending HIV in the United States,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “President Biden is set to release an updated National HIV/AIDS Strategic Plan and several bills have been or are about to be introduced in Congress to establish a national PrEP program to prevent HIV.  Additionally, Congress is poised to increase funding  for domestic HIV programs for the year ahead. Taken together, these are hopeful signs. However, for these well-intentioned plans to be implemented, much work still needs to occur.”  

On World AIDS Day, President Biden is planning to release at a White House event an updated strategic plan that builds on the current plan released by the Trump administration to end HIV in the United States by 2030. It is expected to continue to focus on efforts to increase treatment for people living with HIV, prevent new HIV infections, reduce disparities and health inequities, and address syndemics. The plan will be modified to include an emphasis on the priorities of the Biden administration such as the importance of the Affordable Care Act, an acknowledgment of racism as a public health threat, the need to end HIV homelessness, and a greater emphasis on harm reduction programs, including syringe service programs. 

The updated strategy will include for the first time a section that describes how the private sector can be included in our nation’s effort to end HIV. Other sections that will be enhanced include the role of people living with HIV, along with their quality of life, the impact of aging with HIV, the role of the social determinants of health, the number of federal departments involved in implementing the strategy, and the need to address LGBTQ supportive school programs. The updated strategy, just like the current one, is expected to run through 2025 and set a goal of reducing HIV by 75 percent by then.

One important component of ending HIV is the greater use of PrEP (pre-exposure prophylaxis), which are drugs that prevent HIV. While there are established government programs that are funded for the treatment of HIV and other prevention programs conducted by the CDC, there does not exist a comprehensive nationwide program dedicated for the provision of PrEP. PrEP uptake has been limited, particularly in communities most at risk of HIV, including Black and Latino gay men and Black women. Additionally, in the months and years ahead, new long-acting forms of PrEP are expected to be brought to market.

The “PrEP Assistance Program Act” (HR 5605), recently introduced by Rep. Bonnie Watson Coleman, along with her colleagues Reps. Barbara Lee, Adam Schiff, and Mondaire Jones, would help fill that void by providing $400 million annually to states, community-based organizations, community health centers, and others to establish and support PrEP programs. Not only would these programs provide PrEP and associated medical services, but also the community and provider outreach needed to carry out successful PrEP programs. The bill currently has 40 cosponsors and has been referred to the Energy and Commerce Committee.

On World AIDS Day, Sen. Tina Smith, Rep. Adam Schiff, and colleagues are planning to introduce the “PrEP Access and Coverage Act,” an update of a bill authored by current Vice President Kamala Harris when she was in the Senate. Like the Rep. Watson Coleman bill, it would establish grant programs to pay for PrEP and its ancillary services, and additionally establish separate grant programs for public and provider outreach. It would also ensure comprehensive coverage and eliminate out-of-pocket costs for PrEP for individuals who have private insurance, Medicare, and Medicaid.

“We thank these members of Congress for leading these efforts to increase PrEP coverage in the United States and call on more members to co-sponsor the bills. Hopefully, they can soon be considered by the committees of jurisdiction and passed. Additionally, we urge the Biden administration to support them and to provide the necessary funding in its upcoming budget so that these important efforts can be rapidly implemented,” added Schmid.

“Finally, it is important that Congress come together and pass a final appropriation bill for fiscal year 2022 that includes the proposed increases by both the House and Senate for ending HIV. Without the additional resources, the hopeful signs of progress to end HIV will disappear,” Schmid concluded.

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The HIV+Hepatitis Policy Institute is a national, non-profit organization whose mission is to promote quality and affordable healthcare for people living with or at risk of HIV, hepatitis, and other serious and chronic health conditions.