World AIDS Day: Oregon Announces Plan to End HIV

"This is not a lofty, pie-in-the-sky goal. We know what it takes, and we have what it takes to get there."

That was Lillian Shirley, director of the Public Health Division of the Oregon Health Authority talking about a new plan to eliminate new HIV infections in Oregon in the next five years.

"We look forward to a new reality in Oregon – the elimination of HIV transmission as we know it."

Shirley made the announcement on World AIDS Day while standing in front of three AIDS memorial quilts.

The plan focuses on testing, prevention, and treatment.

The health authority says that:

• Testing is easy. Every Oregonian has an HIV status, but too few get tested for HIV. Confidential testing IS simple, convenient and fast. It is available throughout Oregon as part of a routine medical visit and is covered by most health insurance plans. Only 35 percent of adult Oregonians report having ever been tested for HIV. An estimated 1,100 people in Oregon are infected with HIV but don’t know it. If most or all of these people were tested for HIV and entered into HIV medical care, Oregon could prevent 150 new infections over the next three years alone.
• Prevention works. Core prevention programs such as syringe exchange, prevention education, and condom distribution must be maintained and expanded, and use of new tools, such as pre-exposure prophylaxis (PrEP), a daily pill that prevents infection, must be accelerated. When taken consistently, pre-exposure prophylaxis has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92 percent. OHA estimates that if 1,000 Oregonians at the highest risk of HIV infection started taking PrEP, the state could prevent eight new infections a year.
• Treatment saves lives. With early testing and treatment, people infected with HIV are leading long, healthy lives. Effective treatment, called viral suppression, among HIV-positive people has the potential to prevent the largest proportion of new HIV infections. Only 68 percent of people with HIV in Oregon are taking a daily viral suppression pill that prevents infection. But effective HIV viral suppression treatment can reduce transmission by up to 96 percent. If 100 percent of Oregonians who know they are HIV infected were virally suppressed, more than two-thirds of new HIV infections could be prevented, health officials say.

"We want to focus attention on the fact that we already have the tools to permit us to effectively eliminate HIV in Oregon and to challenge ourselves collectively to do it," said Sean Schafer, MD, medical director for HIV programs, OHA Public Health Division.

The health authority says that the End HIV Oregon initiative’s first year will be crucial to the effort. Oregon will increase the proportion of Oregonians who test for HIV by implementing statewide early intervention services.

They say that there will also will be a focus on increasing collaborations among local public health departments, coordinated care organizations, private health systems and partners such as AIDS Education and Training Center to increase testing in health care settings. And grants will be used to support strategies that promote culturally competent testing to underserved and other priority communities.

Also during year one, OHA will maintain foundational prevention programs and initiate new activities specific to PrEP, including improving channels through which the drug is provided to those most in need, and increasing health care providers’ assessment capacity to prescribe PrEP.

The authority will also partner with community-based agencies to educate individuals who could most benefit from PrEP and help them navigate services.

"There is a light at the end of the tunnel," Schafer said. "We can end new HIV transmission in Oregon by going full-steam on these new efforts, and doubling down on what has been proven to work so far."