Trump Aims to Cut New HIV Infections 90% in 10 Years

The administration outlined a strategy to target geographic "hot spots" and demographic groups at heightened risk of infection, without addressing expected costs.

President Donald Trump outlined an ambitious public health goal in broad terms Tuesday during his second State of the Union Address, calling on Congress to commit "to eliminate the HIV epidemic in the United States within 10 years."

The administration's health officials added some specificity to the plan, saying they would target the demographic groups and geographic areas at greatest risk.

More than half of the new HIV diagnoses documented in recent years have been concentrated in 48 counties; Washington, D.C.; and San Juan, Puerto Rico. These urban areas and seven states facing a high HIV burden in rural areas are identified in a Health and Human Services fact sheet.

HHS Secretary Alex Azar said in a blog post Tuesday that the goal is to end the HIV epidemic by reducing new infections by 75% in five years and 90% in 10 years.

"Since the late 1980s, enormous progress has been made in the fight against HIV, but there is still work to be done," Azar wrote, noting that the number of new infections has dropped to about 40,000 annually.

Azar said the federal government spends more than $20 billion per year in direct health expenditures for HIV care and prevention. Officials said Wednesday that they could not provide an estimated additional investment that the administration intends to seek. That figure will have to wait for the president's budget proposal to be released in a few weeks.

The coordinated effort across several agencies will seek to diagnose everyone with HIV as quickly as possible and connect people at heightened risk—such as men who have sex with men—with pre-exposure prophylaxis, or PrEP.

During a briefing with reporters Wednesday, officials acknowledged the Trump administration is looking to put into practice many of the principles outlined in the 90-90-90 plan devised by UNAIDS.

"The concept of that is very, very similar to what we are doing," Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said.