The Rhode Island Department of Health (RIDOH) announced last month that it is joining other state health departments and organizations worldwide in supporting the international HIV prevention campaign Undetectable = Untransmittable, also known as U=U.
U=U describes the scientific consensus that people living with HIV who take antiretroviral therapy daily and have undetectable levels of HIV in their blood have effectively no risk of transmitting HIV to their sex partners. Routine HIV testing and timely treatment for those who are HIV positive are central to Rhode Island’s work to preventing further HIV transmission and ending the HIV epidemic. This concept is known as “treatment as prevention.”
“Everyone deserves an equal opportunity to be healthy, regardless of who they are, who they love, or where they live. Unfortunately, for too long factors like stigma and discrimination have been barriers to health for too many people,” said Director of Health Nicole Alexander-Scott, MD, MPH. “This campaign is about replacing stigma with science. By taking their medication daily, a person living with HIV can have a long, healthy life without any fear of transmitting HIV to their partner.”
“Twenty years ago, we learned treatment would save lives. Today we know that it also prevents transmission to others,” said Rhode Island native Bruce Richman, Executive Director of Undetectable = Untransmittable. “This is a gamechanger that underscores the need for everyone to have access to treatment to stay healthy and stop new transmissions.”
RIDOH’s endorsement of the U=U campaign was announced on Dec. 2 by RIDOH Consultant Medical Director Philip A. Chan, MD at a World AIDS Day event in Pawtucket, sponsored by the Rhode Island HIV/STI Prevention Coalition. The Rhode Island HIV/STI Prevention Coalition is an umbrella organization of community groups, service providers, and state agencies that are working together to prevent HIV and sexually transmitted infections (STIs) through education, advocacy, partnerships, and public awareness.
Rhode Island measures its HIV progress using the benchmarks of the International 90 90 90 Campaign, which Providence and Rhode Island joined in 2015. This is a campaign to ensure that, by 2020, 90% of people living with HIV know their status; to ensure that 90% of people living with HIV are engaged in care; and to ensure that 90% of people living with HIV have viral suppression. As of 2018, Rhode Island has met the first target (92.3% of people living with HIV know their status). However, the targets for having people engaged in care and achieving viral suppression in Rhode Island have not yet been met.
In the last 10 years, there has been an overall reduction in the number of newly diagnosed cases of HIV in Rhode Island. There were 73 new cases diagnosed in 2018, compared to 117 in 2009. In addition to stigma and discrimination, other community level factors that impact HIV rates and health outcomes for people living with HIV including housing, employment, and community level support.
Rhode Island’s work on the community level factors that affect health is bolstered by the Ryan White HIV/AIDS Program at the Executive Office of Health and Human Services (EOHHS). The Ryan White HIV/AIDS Program provides access to HIV/AIDS medications, outpatient healthcare services, oral healthcare, health insurance premium and cost-sharing assistance, housing services, medical nutrition therapy, food bank/home delivered meals, mental health counseling, case management, transportation to medical appointments, and emergency financial assistance. RIDOH and EOHHS partner closely in overseeing HIV work at the state level in Rhode Island.
The theme of the 2019 World AIDS Day is Communities Make the Difference. This theme has prompted organizations across the globe to highlight the efforts of communities in responding to the AIDS epidemic in terms of leadership and advocacy. More information about the Rhode Island HIV/STI Prevention Coalition and the organizations that participated in Rhode Island’s World AIDS Day event is available online [facebook.com].
Rhode Islanders can learn more about HIV prevention, testing, and treatment options and find health services by visiting health.ri.gov/hiv.
RIDOH’s RIghtTime sexual health app (righttimeapp.com [righttimeapp.com]) offers people information, resources, and videos on sexual health topics like healthy relationships; prevention, testing, and treatment of HIV/STDs; sexual health and family planning services and locations; where to find free condoms; information on birth control options; PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis), which are medications to prevent HIV, and much more.
Information about how to access free condoms in Rhode Island can also be found at health.ri.gov/findcondoms. It is very important for sexually active people to use condoms. Condoms are the best way to prevent other sexually transmitted diseases, which continue to surge in Rhode Island and nationwide.
- The Centers for Disease Control and Prevention (CDC) has endorsed the treatment as a prevention model. More information from the CDC on this model is available online. [cdc.gov]