OP-ED: New York can end HIV, What’s missing is the political will

New York has long been a national leader in the fight against HIV. Through sustained investment, innovative public health programs, and a commitment to expanding access to care, our state bent the curve of the epidemic and demonstrated that ending HIV was within reach.

Today, however, that progress is at risk.

After years of steady gains, new HIV diagnoses are climbing again. That should alarm every New Yorker — not because we lack the medical tools to end this epidemic, but because too many people are being left behind.

The first cases of AIDS were reported 45 years ago and HIV remains an epidemic defined by inequity. The burden continues to fall disproportionately on LGBTQ New Yorkers and communities of color.

The disparities are stark. Black New Yorkers experience new HIV diagnoses at more than nine times the rate of white New Yorkers. Latino New Yorkers are diagnosed at more than five times the rate of white residents. In New York City, young Black and Latino gay and bisexual men account for roughly half of all new HIV infections. Nearly 90 percent of new HIV infections among women occur among Black and Latina women, while transgender New Yorkers account for 4 percent of all new infections.

These inequities extend beyond diagnosis to prevention. Black and Hispanic New Yorkers represent more than three-quarters of new HIV diagnoses statewide, yet account for just 22 percent of PrEP prescriptions. That gap represents more than a statistic — it represents missed opportunities to prevent infections that should never occur.

This backward slide is unacceptable because we know how to stop it.

Yet instead of strengthening the programs that have proven effective, we are seeing new barriers erected to affordable healthcare. At a moment when we should be expanding access to Medicaid and HIV services, federal policymakers are considering cuts and restrictions that threaten to undermine decades of progress.

The symbolism could not be more powerful. Last month, as New Yorkers celebrated both Pride and Juneteenth — commemorations rooted in the pursuit of freedom, dignity, and equality — advocates gathered outside Stonewall Inn for a die-in protesting proposed cuts to Medicaid and HIV funding. Their message was clear: healthcare is not an abstract budget line. It is the difference between life and death for many New Yorkers.

Fortunately, New York already has a blueprint for success.

Our state’s Special Needs Plans (SNPs) have demonstrated that comprehensive, wraparound care works. By addressing not only medical needs but also behavioral health, housing, pharmacy, and social support, these plans help people remain engaged in care and achieve better health outcomes.

Organizations like Amida Care partner with New York State and New York City to deliver this model to people living with HIV and those who could benefit from preventive services like PrEP. The results speak for themselves: fewer emergency room visits, fewer hospital admissions, shorter hospital stays, higher rates of HIV viral suppression, increased PrEP utilization, and more people cured of hepatitis C. These are not theoretical successes. They are measurable outcomes that improve lives while reducing healthcare costs.

The tragedy is that many more New Yorkers could benefit from this proven model if we made the necessary investments to expand access. Ending HIV is no longer primarily a scientific challenge. It is a political one.

We have the medications. We have effective prevention. We have care models that work. What we need now is the political will to ensure every New Yorker can benefit from them — regardless of race, income, gender identity, sexual orientation, or zip code.

Congress must protect and strengthen Medicaid, the backbone of HIV care in America, and fully fund the HIV programs that have helped New York become a national leader in public health and beyond. Retreating now would not only squander decades of progress but also deepen the very inequities that continue to fuel this epidemic.

New York has shown the nation what is possible. We cannot allow preventable infections to rise, proven programs to wither, or communities already bearing the greatest burden to be left behind once again.

The end of HIV remains within reach. Whether we achieve it depends not on whether we know what to do, but on whether we choose to do it.

Shirley Torho is president and CEO of the National Black Leadership Commission on Health.