By Adam Searing | Nov. 30, 2020

As we live through the COVID-19 pandemic, our other challenging health problems haven’t gone away. In recognition of World AIDS Day and in honor of all those whose lives have been affected by HIV/AIDS, I would like to focus attention on public policy options that could help finally eliminate HIV in the United States.

Long years of effort from both the public health and medical community have given us the tools to eliminate HIV infection. Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) combined with outreach, public health campaigns and better access to health care mean HIV can now be effectively treated and controlled. People with HIV can manage the infection as a chronic condition and prevention treatment for those at high risk is now 99% effective in stopping new infections. Unfortunately, no matter how effective the treatment and successful the outreach, if people are unable to access quality, effective health care, we cannot finally end the epidemic.

Lack of health coverage is a major barrier to success in the fight to end HIV. The HIV epidemic is now concentrated in states in the South, precisely where access to health care is the most limited. One major reason is that Southern states are also the center of resistance to expanding health coverage through Medicaid under the Affordable Care Act. The final twelve states still refusing to accept the federal funding available to expand Medicaid are mostly in the south.

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