The Trump administration's goal to stop the spread of HIV is being hailed as "a unique moment in time" — but the obstacles are formidable, especially in the Deep South, The Washington Post reported.
According to the Post, in 2017, the South had 20,000 new HIV diagnoses — more than the rest of the United States combined — and a big reason is because it is hard for those at risk to find the medicine critical to protecting them and ending the 38-year-old epidemic.
Though Trump included in his budget request on Monday the first installment of cash for his plan, the proposal faces an uncertain fate in Congress. The Post reported the request comes as part of a budget request that, if enacted, would also make deep cuts to Medicaid, on which many people with HIV depend.
According to the Post, the virus is now concentrated in a very small number of places in the United States: the rural parts of seven states, including Mississippi; the District of Columbia; Puerto Rico, and 48 hot-spot counties scattered across the country.
If HIV transmission can be slowed there, the president's goal is within reach, the Post reported.
"We are really at a unique moment in time now," Health and Human Services Secretary Alex Azar told the Post. "We have got the right data, the right tools, and the right leadership to achieve this historic milestone in public health."
Two medications are vital to stopping the disease: antiretroviral therapy for those already infected and pre-exposure prophylactic medication, better known as PrEP or Truvada, for those at risk.
"A large part of this is the will to actually stop the HIV epidemic," Azar told the Post.
That will not be easy.
In Jackson, Mississippi, which has the fourth-highest rate of HIV infection among U.S. cities, recruitment for men to take the PrEP drug has been poor, according to research by Leandro Mena, the Post reported.
"The path to PrEP is full of little bumps," he told the Post. "And each little bump is an opportunity to drop off PrEP. My job is to smooth the road."
In small, rural towns, one of the problems is hesitation to seek the drug because of the stigma of having a same-sex partner, sometimes coupled with racial bias, experts say, the Post reported.
And poorer, rural communities also have significantly less access to healthcare.
Mena told the Post that 55 percent of the people who start on PrEP are uninsured, and 20 percent of men under 30 who seek care miss a meal once a week because they have no money.