Transcript: New Vital Signs Report The HIV Epidemic Remains Severe Among Gay and Bisexual Men – What Can Be Done to End the Epidemic for Everyone?

Moderator (00:00external icon):

Welcome, and thank you for standing by. Your lines have been placed on a listen only mode into the question and answer session. At that time, if you would like to ask a question, you may press, ‘star one’ . Today’s conference is being recorded. If you have any objections, you may disconnect at this time. And now turn the call over to Ben Haynes. You may begin, sir.

Ben Haynes (00:18external icon):

Thank you Shirley, and thank you all for joining us for today’s uh, new vital signs release. We are joined by CDC director, Dr. Rochelle Walensky and Dr. Demetre Daskalakis , Director of CDC’s Division of HIV, HIV Prevention. Both will provide opening remarks before taking your Vital Signs specific questions. I want to also note that this briefing is embargoed until 2:00 PM, when vital signs goes live on the CDC website. We’ll now turn the call over to Dr. Walensky.

Dr. Walensky (00:49external icon):

Thank you. Good afternoon, everyone and thank you so much for joining us today. Certainly, CDC has been focused on COVID for almost two years now, but we have not been ignoring the critical work we must do in areas like prevention of firearm violence, addressing disparities in maternal mortality, heart disease, mental health, opioid abuse, and the impact of climate on health, and importantly ending the HIV epidemic. Work that endures despite the pandemic, work that you may not be hearing as much about now, but work that is continuing every single day. I’m delighted we are relaunching CDC’s Vital Signs report today. Particularly with this issue, focusing on HIV. CDC’s Vital Signs reports spotlight serious health threats, and the science-based actions that can be taken to curb these threats. As many of you know, I have worked in the area of research in medicine since, um, my internal medicine residency in the mid-nineties in Baltimore, when HIV Aids epidemic was tearing through cities. I saw firsthand how the virus ravaged bodies, families, and communities.

Dr. Walensky (01:57external icon):

I would walk into patients rooms wanting desperately to ease their sufferings, but at the, pah, time we had few answers and there was little in a way of treatment. My desire to hear my patients suffering and to end the disparities that led to the disease’s disproportionate impact, led me to where I am today. Nearly three days, decades later, today, we can recognize the progress we have made, but we also that we have much more work to do to end this epidemic. We have more evidence, tools, and national and community led efforts to help stop the spread of HIV and it’s impact on our communities than we have ever had before. This has been possible because of the hard work done to improve HIV testing and diagnosis, access to treatment and prevention, and the community services needed to ensure comprehensive care for people with and at risk for HIV. In April, not long after becoming C-dah-C, CDC Director, I declared racism, a serious public health threat that directly affects the well being of millions of Americans

Dr. Walensky (03:03external icon):

and as a result affects the health of our entire nation. I made that declaration because it was important to publicly declare my advocacy for health equity. As I assumed the position of director of the agency charged with protecting the health of all of Americans. Of course, CDC has long recognized that racism is the root cause of many health disparities. That April declaration made it clear that we are recommitting ourselves to the work of addressing the challenges driven by structural factors, racism, discrimination, and historical disenfranchisement that deeply impacts the communities we live in. As an agency, we recognize the systemic nature of the inequities that exist in our nation’s healthcare infrastructure and we are working to address the many roadblocks that prevent equal access to care for all. This Vital Signs report is timed for World Aids Day, which is observed each year on December 1st. World Aids Day is an opportunity for people worldwide, to unite against HIV, to show their support for people at risk for, or with HIV,

Dr. Walensky (04:09external icon):

and to remember those who have succumbed to an HIV related illness. The report shows that despite overall progress in reducing new infections among gay and bisexual men, the HIV epidemic continued and was more severe among Black and Hispanic Latino, and gay men and bisexual men in the decade leading up to the federal ending the HIV epidemic in the U.S. initiative, or EHE. Through EHE, CDC is working with partners and communities to expand HIV prevention and care in ways that meet the needs of each local jurisdiction . Right now, EHE, is focused on the 57 jurisdictions that counsel more than half of all new HIV infections and about two of every three new HIV infections among Black and Hispanic Latino people. We must work together to deliver and expand prevention and care resources, so that to the communities that absolutely need the most. To achieve health equity and to sustainability, to sustainably address disparities in HIV prevention and care, now is the time to provide communities with the additional resources that they need. I wanna thank all of those CDC have worked tirelessly to prepare this much needed vital signs report and who continue to do the hard work every single day of bringing resources to these communities across the country. Now I’d like to turn things over to Dr. Demetre Daskalakis to share the important findings of this report. Dr. Daskalakis.

Dr. Demetre Daskalakis (05:42external icon):

Thank you, Dr. Walensky. About two thirds of all new HIV infections in the nation occur in gay and bisexual men, which represents one of the largest disparities that exist in public health. This new report shows that over the past decade, there was an 8% decrease in new HIV infections among gay and bisexual men. But the nation continued to experience major racial and ethnic inequities. From 2010 to 2019, new HIV infections de declined among white gay and bisexual men, but they remained high and relatively stable among Black and Hispanic Latino gay and bisexual men. New HIV infections went from 9,000 down to 8,900 among Black gay and bisexual men and from 6,800 up to 700, 7,900 among Hispanic Latino gay and bisexual men. Both are not statistically significant changes. Meaning infections remain relatively flat from the beginning of the decade to the end. At the same time, new infections among white gay and bisexual men dropped from 7,500 to 5,100, a 32% decline.

Dr. Demetre Daskalakis (06:57external icon):

Other findings provide insight into why we aren’t seeing the same progress. There is an unequal reach of HIV prevention and treatment and higher levels of HIV stigma in different communities. In 2019, the most recent year in the Vital Signs analysis, an estimated 83% of Black gay and bisexual men and 80% of Hispanic Latino gay and bisexual men with HIV, had been diagnosed, compared with 90% of white gay and bisexual men. And, 62% of Black gay and bisexual men and 67% of Hispanic Latino gay and bisexual men with diagnosed HIV were virally suppressed. And that compared with 74% of white gay and bisexual men. Furthermore, among gay and bisexual men, data from 2017, showed that just 27% of Black men and 31% of Hispanic Latino men used pre-exposure prophylaxis, known as PREP, compared with 42% of white men. While not nationally representative, these PREP data from CDC’s national HIV behavioral surveillance survey are collected in 23 cities where more than half of people with HIV in large urban areas live. HIV related stigma or negative attitudes and beliefs about a, about people with HIV, may have also contributed to these disparities. And an analysis of data from a nationally representative survey of people diagnosed with HIV, Back and Hispanic Latino gay and bisexual men with HIV were more likely to report experiencing HIV related stigma compared with white gay and bisexual men with HIV. It’s clear, that persistent factors like discrimination, healthcare access and use, education, income, housing, and transportation are contributing to continuing HIV disparities and standing in the way of our goals.

Dr. Demetre Daskalakis (08:57external icon):

There is no simple solution to achieving health equity. Our HIV program has identified an acronym, ROOT, that captures four key elements we believe are required to eliminate disparities in HIV. So ,we must get to the root of the problem by focusing on ,’R’, for resources delivered to the communities most in need because not all areas can implement the most recent advances in HIV prevention and care. ‘O’, for reaching people outside of traditional healthcare settings through innovations like HIV, self-testings and mobile service. The second, ‘O’, for overcoming systemic racism, homophobia, transphobia, HIV related stigma, and other ingrained barriers that contribute to disparities, and then, ‘T,’ which stands for a total person approach to care by addressing HIV along with interconnected epidemics, such as sexually transmitted infections and hepatitis. This approach also integrates HIV prevention and care into a health services that people are already seeking. In summary,

Dr. Demetre Daskalakis (10:02external icon):

HIV continues to disproportionately harm the health and wellbeing of certain groups, including Black and Hispanic Latino gay and bisexual men. To end the HIV epidemic, we will need to address the systemic factors that turn health differences into public health injustice. That starts with recognizing that HIV disparities are not inevitable. Right now, with EHE and the effective prevention and treatment tools at our disposal, we have a decades in the making opportunity to end our nation’s HIV epidemic and erase the glaring health disparity highlighted in this report. But working to achieve equity for gay and bisexual men of color requires tearing down barriers to testing, prevention and treatment. Now we’ll turn it back over to Ben, Ben.

Ben Haynes (10:48external icon):

Thank you. Shirley we have time for a couple of questions, please.

Moderator (11:01external icon):

(Pause) Thank you, one moment… For those participating on the phone, if you would like to ask a question, please press, ‘star one’ on your phone and record your name. I do need your name in order to introduce your question. If you choose to withdraw your question, please press, ‘star two’. Again, if you would like to ask a question at this time, please press, ‘star one’. It will take a few moments for questions to come through. Please stand by…(Pause) Again, for those participating on the phone, who would like to ask a question, please press, ‘star one’ and record your name…(Pause) There are no questions at this time.

Ben Haynes (12:18external icon):

Thank you Shirley. If there are no questions, I’d like to turn the call over back to Dr. Walensky for closing remarks.

Dr. Walensky (12:24external icon):

Thank you, Ben and thank you to everyone who’s joined us today. We’ve come a long way in the 40 years since CDC’s first report of what would become known as Aids. We now have better and more readily available testing. We have highly effective treatments that allows people with HIV to live long, healthy lives. We have the prevention tools we need to truly end the epidemic. Years of community activism and scientific discovery have brought us to this place. And to end the HIV epidemic, we must leverage our successes and our also our acknowledge opportunities for improvement and continued investment. The first CDC report showing that Aids was disproportionately affecting Black and Hispanic Latino people was published in 1986. Today’s Vital Sign confirms that unfortunately, those disparities continue today. And that is why we must finally close these gaps by bringing the tools and strategies we have discussed here today to scale. And ensuring they reach all of those who could benefit from them equally.

Dr. Walensky (13:30external icon):

Our efforts must be guided by approaches designed by and with the communities most impacted so that they can expand resources in ways that make the unique and comprehensive means of the population served. Community innovation is at the heart of our efforts to end the HIV epidemic. And each EHE jurisdiction has developed plans to address local needs and overcome barriers to care. The speed with which we can accelerate progress and reach the initiative goals will depend on expanded investments over time. To that end, the president has requested 275 million dollars in the fiscal year 2022 budget for CDC. A 100 million dollar increase compared to fiscal year 2021, to specifically work with state and local jurisdictions to further expand high impact HIV prevention strategies. Throughout my career, I have witnessed a transformation from those living with, and at risk for HIV. We have the scientific tools to end the HIV epidemic. However, to achieve this end, we must acknowledge that inequities and access to care continue to exist and are an injustice. We must address the root causes of these ongoing disparities and make proven HIV prevention and treatment intervention available to all. With innovation expansion and resolve, we can address these severe disparities and end the HIV epidemic once and for all. Thank you all for joining today.

Ben Haynes (15:02external icon):

Thank you Dr. Walensky, and thank you Dr. Daskalakis, and thank everyone for joining us. If you have further questions, please contact the media office at 404-639-3286 or email media@cdc.gov. Thank you for joining us and this will conclude our call.

Moderator (15:22external icon):

That does conclude today’s conference. Thank you for participating. You may disconnect at this time. Speakers, please allow a moment silence and stand by for your post conference.