Dr. Leana S. Wen: Fast tracking Baltimore's fight against AIDS

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This week, Baltimore celebrates World AIDS Day, honoring the memories of those lost to HIV/AIDS and recommitting to the fight to eliminate this tragic disease.

For decades, Baltimore City has been on the frontlines of the nation’s HIV/AIDS epidemic. In our City, there are an estimated 13,000 residents diagnosed with HIV/AIDS.

For us, HIV/AIDS is not just a health issue—it is one of justice and equity. It also requires innovative, community-driven approaches to save lives.

More than two decades ago, Baltimore became the first jurisdiction in Maryland—and one of the first in the country—to operate a syringe exchange program as a strategy to prevent HIV and other infections among injection drug users. This strategy has proven remarkably effective, as the percentage of people with HIV from intravenous drug use has plummeted from 63 percent in 1994 to 7 percent in 2014

Thanks in part to the more than 50,000 HIV tests the Baltimore City Health Department performs per year—as well as the amazing efforts of organizations across Baltimore—we have seen new diagnoses drastically decline in our city, putting us on pace to potentially see as few as 200 new diagnoses in 2020.

Meanwhile, thanks to advances—including antiretroviral medications and the development of Pre-exposure Prophylaxis, or PrEP, a scientific advancement that can provide 92 percent protection from HIV infection—the disease once thought as a death sentence continues to transform into a clinically manageable chronic disease, like diabetes.

These efforts have potentially prevented hundreds, if not thousands, of infections in Baltimore—reversing tragic trends—and saving countless lives in our city.

Despite this progress, HIV continues to serve as one of Baltimore’s most consistent public health challenges—as well as one of our most glaring health disparities. While African-Americans comprise 64 percent of Baltimore’s population, they make up 85 percent of those living with a diagnosis of HIV. In fact, one in 16 African-American men will contract HIV over his lifetime. These rates are even higher among African-American men who have sex with men (MSM) and transgender populations.

Stigma and misconception remain major challenges. Far too many individuals are still not getting tested. In 2014, it was estimated that 5,700 people in Baltimore City have HIV and don’t know it, and are spreading the disease unintentionally. Although we have seen new HIV infections consistently decline across the city—and nationwide—new infections continue to increase at alarming rates among MSM and transgender women in Baltimore.

This is unfair, unjust, and unacceptable. And it’s why we are amplifying our efforts.

Following a major award from the Centers for Disease Control and Prevention, we have begun to implement new strategies to curb stigma, reduce the number of new HIV infections, and improve care for individuals living with HIV across Baltimore.

As part of this project, BCHD has launched Baltimore in Conversation, a collaboration of LGBTQ community members and allies which uses visual storytelling to address social stigma surrounding sexual identity and sexual health.

A few weeks ago, the Health Department held its 7th annual “Know Your Status” Ball. This year’s event was another huge success, as more than 600 people attended the event and over 80 were tested for HIV and STDs Moreover, attendees were given access to other critical resources, including dental care, medical care, education information, and housing opportunities. These balls are another example of Baltimore City’s ongoing commitment to go to where people are to provide care and to nurture the relationship between local government and the LGBT community.

Under Baltimore’s leadership, and through the commitment of a range of public and private partners, we have continued to expand access to innovative, live-saving care in Baltimore. By comprehensively expanding access to PrEP, we are bringing this life-saving protection to more Baltimoreans, shielding those at risk of becoming HIV infected. By deploying peer navigators who come from the communities that they serve, we are employing trusted messengers to assist those most vulnerable to HIV and reduce the disparities that African-American and other minority communities continue to face.

As we recognize World Aids Day this week, we acknowledge that while Baltimore has made much progress, much more must be done. We must continue to do the critical work of public health to tear down the barriers that divide us as we build the ties that strengthen our city.

A year ago, Baltimore was invited to join the Fast-Track Cities Initiative, a world-wide declaration to end the HIV/AIDS epidemic  that aligns with the UNAIDS Fast-Track Strategy for ending the AIDS epidemic by 2030. Becoming a Fast-Track City not only recognizes Baltimore’s progress, but emphasizes our ongoing commitment to ending AIDS-related deaths in our city.

We are a city that believes that when there is injustice, when there is inequality, when there are problems that threaten hope and opportunity, we are obligated to call out the problems we see and take urgent action to address them.

Baltimore is ready to fast track our efforts to end AIDS by 2030.

Together, we reaffirm our citywide commitment to continuing to bend the arc away from distrust and disparity, and towards equity, justice, and hope.

Dr. Leana Wen is the Baltimore City Health Commissioner. Her email is ; Twitter: @DrLeanaWen and @BMore_Healthy.

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