On this World AIDS Day, we are assessing the status of the 90/90/90/50 goals and impact of the Plan. Our assessment, Ending the HIV Epidemic in DC: 2018 Progress Report (PDF) is available online now.
The District of Columbia’s strategic plan for “Ending the Epidemic” was released on World AIDS Day, December 1, 2016. DC Appleseed stood at a press conference with the Washington AIDS Partnership, Mayor Muriel Bowser, and Dr. LaQuandra Nesbitt of the DC Department of Health (DC Health) to release the 90/90/90/50 Plan – the blueprint to end the HIV epidemic in DC.
DC Appleseed committed then to issue a Report and update on each successive World AIDS Day concerning progress being made under the Plan and to offer recommendations concerning further steps needed to ensure successful implementation of the Plan.
In our 2018 Report, we discuss the fact that progress towards implementing the Plan is, at this point, mixed. The primary goal of the Plan and its 42 tasks is to reduce the number of new HIV infections by 50% by the end of 2020. Unfortunately, now that the District is almost two years into the four-year duration of the Plan (2017-2020), it is clear that the city is not on track to meet the projected 50% reduction of new infections by the end of 2020.
The District had significant and steady declines in the number of new infections during the years prior to the Plan, that has not been the case since the Plan’s adoption. In 2015, the year before the Plan’s adoption, the number of new infections was 401; to reduce that number by 50% means the number of new infections in 2020 should be approximately 200.
The District is not reducing infections at a pace to reach that goal: new infections in 2016 were 369; in 2017 they were 368; and preliminary numbers for the first six months of 2018 indicate 176 new infections, which suggests an annualized rate of 352 new infections for the year. Roughly speaking, this means that halfway through the Plan, new infections have been reduced by only 12% -- a long way from the 50% goal.
What should be the focus going forward to ensure successful implementation of the Plan?
First, there needs to be a significant increase in efforts focusing on young people. This includes, as explained in this Report, the adoption of regulations ensuring comprehensive HIV education in all DC Public Schools–something that is not occurring, even though it is required by the Health Schools Act.
Second, there needs to be greatly increased efforts to make PrEP available in the District, particularly considering the recent report from the U.S. Preventive Services Task Force which recommends that the drug be available to all persons at high risk of acquiring HIV. The District should not have 350 new infections per year when PrEP is available to prevent most, if not all, of them.
Third, a detailed analysis of progress on the 42 tasks in the Plan is needed, and specific steps must be taken to fully implement the tasks which will have the highest impact on preventing new infections. DC Appleseed intends to undertake that analysis over the next several months, in consultation with HAHSTA, the Washington AIDS Partnership, and other partners to issue a supplemental report on the issue in 2019.
We will also include at that time an update to the Plan from HAHSTA incorporating new tasks and removing or replacing tasks that are considered not relevant or achievable.
We believe the goals of the Plan can be met; but redoubled efforts will be required to do so. DC Appleseed is proud to be part of this collaborative work and will continue to report on the District’s progress toward ending the HIV epidemic.