President Donald Trump pledged in Tuesday’s State of the Union to “eliminate the HIV epidemic in the United States within 10 years.”
If he follows through on that promise, then Florida will be the epicenter of that fight.
Reported cases of AIDS and HIV are on the rise in this state. The Miami area — where 1 in 1,000 people have HIV — has the highest rate of new diagnosis of any metro area in the country, according to the Center for Disease Control and Prevention. The Orlando area ranks sixth on that list, Jacksonville is ninth and the Tampa Bay region cracked the top 25.
The Trump administration hopes to cut new cases of HIV by 75 percent in five years and 90 percent by 2030. To do so, the U.S. Department of Health and Human Services will focus on the 48 counties that accounted for half of the country’s 38,000 new cases of HIV in 2017.
Seven of those counties are in Florida, more than any other state except California. The counties are: Pinellas, Hillsborough, Orange, Duval, Miami-Dade, Palm Beach and Broward.
Federal health officials hope to stop new infections by working within those communities to identify people who have unknowingly contracted the disease and improve access to needle exchanges, pre-exposure drugs and other resources for at-risk populations.
The approach may differ in each community, agency officials said. They will also work with seven states where there are alarming new rates of the disease among rural residents and native tribes.
“It is not one size fits all and we realize that,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, on a phone call with reporters Wednesday.
Florida, a fast-growing and diverse state, poses unique challenges, officials with health agencies and the Center for Disease Control acknowledged on that call. The population fluctuates by the season. Millions of visitors stop by for a few days or a few months, and some may spread or contract the virus while here.
The state attracts retirees seeking sunshine and low taxes, unaware that some senior communities have become problematic for their sexual transmitted diseases. There’s also been an alarming increase of HIV cases — 20 percent over the last decade — among Floridians in their 20s. Among both demographics, condom use is down.
And each Florida region has its own characteristics and communities, said Michael Ruppal, executive director of the AIDS Institute, a national advocacy and research organization based in Tampa. Preventing the spread of AIDS in St. Petersburg is different than in Orlando.
“The personalities in those seven counties are so different,” Ruppal said. “It’s like going into different countries. You can’t treat disease like a cookie cutter.”
It’s difficult to gauge how serious Trump is about tackling this problem. Trump’s declaration Tuesday night was a brief aside in an hour-long speech. “Together, we will defeat AIDS in America,” he said, before pivoting to child cancer research.
It was also a surprising focal point for a president who last year proposed cutting tens of millions of dollars from federal HIV and AIDS programs. Still, on Wednesday, administration officials couldn’t say how much Trump’s 2020 budget would dedicate to tackling this public health crisis. They promised the investment would be significant and it wouldn’t take away from other public health programs.
Ruppal said the goals laid out by Trump’s administration to stop the spread of HIV are realistic. And he is cautiously optimistic that the president will follow through when he proposes his budget later this month.
“He barely said anything but the fact that he made a commitment in public at the State of the Union, it’s positive,” Ruppal said.
It will be up to Congress, though, to approve any new funding for HIV programs. Both of Pinellas County’s representatives in Washington — Republican Gus Bilirakis of Palm Harbor and Democrat Charlie Crist of St. Petersburg — said they would welcome new investments in fighting AIDS. Sen. Rick Scott did as well.
“More attention is needed to combat a condition that is 100 percent preventable and often stigmatized,” Crist said. “As a member of the House Appropriations Committee, increased funding requests from the administration would receive my full support.”