The Free Press, Mankato, MN

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December 2, 2013

6 ways health-care reform can help end America's AIDS epidemic

With politicians, public health experts and epidemiologists announcing that the United States is at the beginning of ending the AIDS epidemic and that we will soon usher in an AIDS-free generation of youths, each World AIDS Day, on Dec. 1, takes on increasingly special significance, especially for African-Americans.

Because the nation's HIV/AIDS epidemic is unfolding disproportionately in black communities, black America has the most to gain by ending it. Getting there requires that more HIV-positive people are diagnosed (currently, almost 20 percent of black people with HIV don't know it) and then linked to care, retained in care and prescribed HIV-fighting medications (called anti-retrovirals). Ultimately, they also must get their virus under control (viral suppression), a sequence called the HIV care continuum, or HIV treatment cascade.

Although African-Americans are more likely to get tested than whites, once they do test positive, many don't get the health care they need. And a mere 21 percent of black people who have been diagnosed with HIV have their virus under control, fewer than whites and Latinos. That is critical, because people whose virus is suppressed both protect their own immune systems and are 96 percent less likely to transmit HIV to others, meaning that treatment is also prevention.

Each step along the HIV care continuum involves going to the doctor. But while black people make up 13 percent of the population, 19 percent of us don't have health insurance, and scores of Americans — of all backgrounds — have health insurance policies that don't offer prescription coverage or aren't worth the paper they're printed on. This remains a serious problem, considering that HIV meds can easily cost upward of $12,000 per year.

The Patient Protection and Affordable Care Act (ACA) addresses many of these problems, bringing us closer to ending America's HIV/AIDS epidemic. Here's how:

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