Cuomo announces blueprint to end AIDS epidemic

Gov. Andrew Cuomo announced on Wednesday the release of recommendations from his task force aimed at ending the AIDS epidemic.

The lengthy plan centers on the three points outlined by Cuomo in June of last year when he first announced that he wanted to reduce the number of new HIV infections statewide to just 750 and the rate at which HIV patients progress to AIDS by 50 percent by 2020. Included in the original proposal was identifying people with HIV who are undiagnosed and linking them to health care, getting HIV patients on anti-HIV therapy, and providing access to pre-exposure prophylaxis for high-risk people.

“Today, New York leads the way once again by raising the bar and saying, ‘We will not stop until the AIDS epidemic lis part of the past like tuberculosis and measles and polio and influenza,'” Cuomo said at a New York City event announcing the blueprint. He later added, “Once again New York is going to do what New York state does best, it is going to lead this nation toward a progressive future.”

According to the blueprint, reducing new HIV infections to 750 per year by 2020 would save $804.4 million in medical costs.

The blueprint also outlines steps to bring the number of new infections and AIDS-related deaths to zero at some point in the future, though it does not peg a timeframe to that goal.

Cuomo convened the HIV/AIDS task force in October of last year, and the blueprint to End the Epidemic comes after $10 million was earmarked in the state budget to implement recommendations.

A state Department of Health study released last year showed that a majority of New Yorkers living with HIV or AIDS reside in New York City. In Albany County, there were 1,020 HIV and AIDS cases, excluding the prison population. Rensselaer County had 240 cases, Schenectady County had 380 cases and Saratoga County had 169 cases, bringing the four-county total to 1,809.

Newly diagnosed HIV cases statewide fell to 3,316 in 2012 from 5,666 in 2000, the earliest recorded date in the study. New AIDS cases across New York decreased from a high of 14,636 in 1993 to 2,370 in 2012.

Organizations and officials immediately released statements lauding the blueprint as it was announced.

From VOCAL-NY community leader Reginald Brown:

We thank Governor Cuomo for endorsing our plan to end AIDS. All New Yorkers need access to condoms, syringes, PReP, PEP, treatment and housing. Today marks the start of the end of AIDS in New York State. We are now turning to all elected officials to fund this blueprint.

From New York Civil Liberties Union Executive Director Donna Lieberman:

The report released today by the governor’s task force only underscores the fact that respecting and promoting civil rights, individual autonomy and bodily integrity leads to better health outcomes for all New Yorkers. Ending the AIDS epidemic cannot happen without ensuring that transgender New Yorkers enjoy the same rights and protections against discrimination as everyone else; without teaching our kids about sex and giving them access to the tools they need to prevent sexually transmitted infections; and that accessing clean syringes and carrying condoms – the most basic safeguards against HIV transmission – does not result in the arrest of vulnerable New Yorkers. Today’s recommendations should be a wakeup call to the State Legislature to act quickly and stand up to improve the lives and health of all New Yorkers.

The full announcement from the governor is below. Below that is a copy of the blueprint:

Governor Andrew M. Cuomo today received the final Blueprint to end the HIV/AIDS epidemic in New York State by the end of 2020. The Blueprint was produced by members of the State’s Ending the Epidemic Task Force, and includes recommendations that support the Governor’s goal to reduce the annual number of new HIV infections to just 750 (from an estimated 3,000) by the end of 2020 and achieve New York’s first ever decrease in HIV prevalence. This would mark the first time there is a reduction in the pervasiveness of AIDS due to a drop in new cases. An epidemic is a widespread occurrence of an infectious disease in a community at a particular time. The Governor’s goal puts New York State in a leadership position in the national and global effort to end the HIV/AIDS epidemic.

”Once again, New York is a national leader by raising the bar and saying we will not stop until the AIDS epidemic is part of the past,” Governor Cuomo said. “We must add AIDS to the list of diseases conquered by our society, and today we are saying we can, we must and we will end this epidemic. The blueprint compiled by the Ending the Epidemic Task Force is smart, requiring an all-out comprehensive approach including more testing, more healthcare and more access to new drugs. We can do this by 2020 and end this nightmare once and for all.”

The Blueprint – which can be found here – includes recommendations to address the three-point plan announced by the Governor in June 2014 to decrease new HIV infections by:
1. Identifying people with HIV who remain undiagnosed and linking them to health care;
2. Linking and retaining people diagnosed with HIV to health care and getting them on anti-HIV therapy to maximize HIV virus suppression so they remain healthy and prevent further transmission; and
3. Providing access to Pre-Exposure Prophylaxis (PrEP) for high-risk people to keep them HIV negative.

The Task Force met on five occasions starting in October. In order to gather recommendations for consideration from across the state, a series of listening forums were held and an online recommendation form was made publicly available. A total of 294 recommendations were generated and reviewed by the Task Force. The Task Force’s four committees – Data, Care, Prevention, and Housing and Supportive Services – used this information to develop the final Blueprint document.

More information on the members of the Ending the Epidemic Task Force can be found here.

In 2015-16 budget, Governor Cuomo included $10 million to support End of the Epidemic in New York State. The budget also removed the requirement for individuals in correctional facilities to give written consent for HIV testing, encouraged high-risk populations to use condoms by prohibiting prosecutors from using them as evidence in prostitution cases, and made it legal to possess syringes obtained through a syringe access program.

Acting State Health Commissioner Howard Zucker, M.D., J.D., said, “The Blueprint document developed by the Task Force provides New York State with concrete next steps that will decrease new infections and improve the lives of all New Yorkers living with HIV/AIDS. It will help us move New York from a history of the worst HIV epidemic in the country to one where new infections will be rare and those living with the disease will have normal lifespans with few complications.”

Housing Works President & CEO Charles King, who also served as the Task Force’s Community Co-Chair, said, “Hundreds of people around the state participated in this process. This included many hours in listening sessions and other formal and informal conversations, brainstorming, criticizing, and helping us think through our ideas. I am proud to have served as the Community Co-Chair for the Task Force. We carried out this task in full consultation with hundreds of stakeholders around the state and we developed a Blueprint that provides a clear guide for ending the HIV epidemic here in New York State by 2020.”

GMHC CEO Kelsey Louie said, “Today marks the beginning of what could be one of the last chapters in the fight to end HIV and AIDS. We have the tools, we have the data and we have the unprecedented political will and partnership with Governor Andrew Cuomo. We now have a Blueprint to help make the plan to End AIDS as an epidemic by 2020 a reality.”

The Blueprint is structured first to include the three points of the Governor’s plan, but also includes other recommendations to minimize new infections and inhibit disease progression. The Task Force ensured that prioritizing the needs of key populations significantly impacted by HIV and AIDS became a central component of the final Blueprint document. Recommendations and strategies included in the Blueprint are intended to evolve with new technologies and policy advances so the document can remain useful and relevant over the years between its development and the end of 2020.

The Blueprint’s recommendations in support of the Governor’s plan to bend the curve include:
1. Make routine HIV testing truly routine
2. Expand targeted testing
3. Address acute infection
4. Improve referral and engagement
5. Continuously act to monitor and improve rates of viral suppression
6. Incentivize performance
7. Use client level data to identify and assist patients lost to care or not virally suppressed
8. Enhance and streamline services to support the non-medical needs of all persons with HIV
9. Provide enhanced services for patients within correctional and other institutions and specific programming for patients returning home from corrections or other institutional settings
10. Maximize opportunities through the Delivery System Reform Incentive Payment (DSRIP) process to support programs to achieve goals related to linkage, retention and viral suppression
11. Undertake a statewide education campaign on PrEP and nPEP
12. Include a variety of statewide programs for distribution and increased access to PrEP and nPEP
13. Create a coordinated statewide mechanism for persons to access PrEP and nPEP and prevention-focused care
14. Develop mechanisms to determine PrEP and nPEP usage and adherence statewide
15. Increase momentum in promoting the health of people who use drugs
16. Ensure access to stable housing
17. Reduce new HIV incidence among homeless youth through stable housing and supportive services
18. Ensure and protect health, housing, and human rights for LGBT communities
19. Institute an integrated comprehensive approach to transgender healthcare and human rights
20. Provide expanded Medicaid coverage for sexual and drug related health services to targeted populations
21. Establish mechanisms for an HIV peer workforce
22. Ensure access to care for residents of rural, suburban and other areas of the state
23. Promote comprehensive sexual health education
24. Remove disincentives related to possession of condoms
25. Promote treatment as prevention information and anti-stigma media campaign
26. Provide HCV testing to persons with HIV and remove restrictions to HCV treatment access based on financial considerations for individuals co-infected with HIV and HCV
27. Implement the Compassionate Care Act in a way most likely to improve HIV viral suppression
28. Ensure equitable funding where resources follow the statistics of the epidemic
29. Expand and enhance the use of data to track and report progress
30. Increase access to opportunities for employment and employment/vocational services

Additional information is available at health.ny.gov/ete.

The blueprint:

End the Epidemic Blueprint