Governor Andrew M. Cuomo today announced New York State is on track to end the AIDS epidemic by the end of 2020 and proposed new regulations that will remove barriers and expand access to care for uninsured or underinsured people living with HIV. These regulations build on New York’s reputation as a national leader in the fight against HIV. In New York, the number of people newly diagnosed with HIV continues to fall to historic lows, demonstrating that the State’s efforts to end the epidemic are making a significant impact. World AIDS Day is December 1st, and World AIDS day activities in New York will be held Tuesday, December 4th, with the NYS Ending the Epidemic Summit on December 5th.
“New York State has made tremendous progress in the fight against HIV/AIDS, and this new data demonstrates we’re on track to achieve our goal of ending the epidemic by 2020,” Governor Cuomo said. “As our fight to end the epidemic continues, these new regulations will ensure more individuals living with HIV have access to the care they need and in the process help stop further transmissions.”
“We are investing in patient care and treatment services for people with HIV/AIDS to ensure they lead healthy lives,” said Lieutenant Governor Kathy Hochul. “In honor of World AIDS Day, New York is expanding access to health care for people diagnosed with HIV, and continuing to break down barriers for individuals who are underinsured and uninsured. We’re leading the nation to break the stigma in the fight against HIV and make sure all New Yorkers have the resources and support they need and deserve.”
To expand access to HIV care for uninsured and underinsured people, the New York State Department of Health will modify regulations governing the HIV Uninsured Care Programs (HUCP) to update income criteria and eliminate the assets test. Currently, to be eligible for the HUCP, an applicant’s household income must be equal to or less than 435% of the Federal Poverty Level, and the applicant’s liquid resources must be less than $25,000. These new regulations will increase eligible income to 500% of Federal Poverty Level and eliminate the cap on resources. The proposed regulations will be published in mid-December, with adoption anticipated in early 2019.
The Department of Health’s HIV Uninsured Care Programs include five initiatives to provide health care services to uninsured and underinsured New Yorkers who are diagnosed with HIV. More information is available .
The new regulations build on the Governor’s Ending the Epidemic initiative, launched in 2014, to significantly reduce HIV infections by the end of 2020 and achieve the first-ever decrease in HIV prevalence. The initiative features a three-point plan, which includes identifying people with HIV who remain undiagnosed and linking them to health care, linking and retaining people diagnosed with HIV to health care and getting them on treatment to maximize HIV virus suppression, and providing access to Pre-Exposure Prophylaxis (PrEP) for people who engage in high-risk behaviors to keep them HIV negative.
Thanks to the initiative, new diagnoses of HIV are falling, while rates of enrollment in treatment for those diagnosed continues to climb. New HIV diagnoses in New York declined for a third consecutive year, reaching an all-time low of 2,769 in 2017, down 20 percent since 2014.
Notably, last year’s decrease in new HIV diagnoses was observable across nearly every demographic group, including sex, age group, race/ethnicity, transmission risk and region. While racial and ethnic disparities in HIV diagnoses are still present, new HIV diagnoses per 100,000 population are down 52 percent among non-Hispanic blacks and 42 percent among Hispanics since 2007. This is consistent with the gains realized among non-Hispanic whites, who have seen a 46 percent drop in their HIV case rate over this period.
New data shows great increases in the numbers of people who, though newly diagnosed and living with HIV, are receiving care. Further, as a result of increased access to care, the number of people living with diagnosed HIV who are virally suppressed has continued to climb.
The number of new HIV diagnoses in people with a history of injection drug use reached an all-time low of 110 during 2017, down 28 percent from 153 in 2014 when Governor Cuomo announced the three-point plan. At the height of the HIV epidemic in the early 1990s, several thousand diagnoses among persons with a history of injection drug use were made each year.
Over the past four years, New York State has committed more than $20 million to fund Health Department policies and programs designed to meet Ending the Epidemic goals. These policies include streamlining HIV testing; facilitating access to syringe exchanges; enabling minors to consent for HIV prevention and care services; expanding data sharing to enhance linkage to care; linkage and retention in care initiatives; and enhanced access to PrEP in clinical settings. In addition, harm reduction services are now a Medicaid benefit and New York State is the first state to offer such services.
The New York State Department of Health AIDS Institute is issuing a new policy on Rapid Initiation of Antiretroviral Treatment, stating that a new HIV diagnosis is an immediate call to action for every provider who engages with that individual, with the goal being rapid initiation. While same-day initiation of treatment may not always be possible, it is ideal that patients start treatment within three days. In the outpatient setting, in no instance should treatment initiation take longer than 30 days. The policy on rapid initiation supports the “Undetectable equals Untransmittable” (U=U) message that people with a sustained undetectable viral load cannot sexually transmit HIV.
Commissioner of Health Dr. Howard Zucker said, “Expanding access to care is crucial to ending the epidemic, and the new regulations announced today will ensure that people get the help they need. Treatment is only possible after a diagnosis, so I encourage everyone to get tested and know their status.”
Greg Olsen, Acting Director of the New York State Office for the Aging said, “I applaud Governor Cuomo for his ongoing commitment to Ending the Epidemic by expanding access to HIV care for people who are uninsured and underinsured. As more New Yorkers with HIV grow older, having increased access to care will help them better manage their condition and maintain their health as they age.”