On the eve of World AIDS Day, which raises global awareness of the 35-year epidemic of this illness, a milestone has been reached in America’s largest city, officials there say.

New York City Health Commissioner Dr. Mary Bassett announced that no babies were born anywhere in the five boroughs last year, that tested HIV-positive, a breakthrough without precedent in the huge metropolis.

“This is remarkable evidence that our prevention education programs are effective,” Bassett said, noting that in a related development, the citywide new-diagnosis rate for 2015 was 2,493, marking the first time fewer than 2,500 people became HIV-positive since 1981, when the AIDS epidemic started in the US. “Our work isn’t done,” Bassett cautioned, “and we must continue to work with advocates and the community, to reach the New Yorkers who bear the highest burden of HIV and AIDS”.

By Nathan James
By Nathan James

New York City has historically taken a very aggressive stance towards HIV and AIDS prevention and treatment, initiating bold, sometimes controversial programs.

Under former Health Commissioner Thomas Frieden, later director of the federal Centers for Disease Control (CDC), the city underwrote a massive free condom distribution project, which continues today as NYC SAFE, added HIV prevention to public school sex-ed classes, and explored the use of Pre-Exposure Prophylaxis (PrEP), becoming one of the first major cities to participate in this new preventative modality.

“We wanted to be at the forefront of the fight against HIV,” said Mayor Bill De Blasio, who also renewed his campaign pledge to end the epidemic in the Big Apple by 2020.

Tom Frieden

“We’ve authorized $23 million in the current city budget for more HIV health care programs,” the mayor said. Both Frieden and Bassett, however, were quick to note that HIV still impacts minorities disproportionately, pointing out that 78% of new cases in the city last year were Black and Latino patients.

CDC figures also show that Black gay men are still the most severely affected as a group; 47% were HIV-positive at the end of 2015.

This alarming trend is most noticeable in the cities of the Deep South, Frieden says, “where all of the cities with the highest new-diagnosis rates are.” These conurbations–Baton Rouge, LA, Miami-FL, New Orleans, LA, Jackson MS, Orlando, FL, Memphis, TN, Atlanta, GA, Columbia, SC, Jacksonville, FL, and Baltimore, MD–are the top 10 in the country, and all of the states in the former Confederacy, according to the CDC, are in the “highest risk” category for new HIV infections.

Political attitudes towards HIV/AIDS and the LGBT community play a major role in this, says Frieden. “Funding at the state level for prevention and treatment isn’t there, because the public support isn’t there.” States like Mississippi and Tennessee also have “Turn Away The Gays” laws on their books, making it hard for LGBT people to access care at the outset.

With the ascension of Donald Trump to the White House, observers say, funding for PrEP and other programs are likely to end up on the chopping block, as the real-estate mogul has vowed to end Obamacare and sign deep cuts to Medicare, the largest insurer of people living with HIV and AIDS.

“Despite our efforts in many areas, such as our programs to teach CDC PrEP treatment to doctors and hospitals,” Frieden said, “more than 1.2 million people in our country are HIV-positive, and of these, one in eight aren’t aware they have the virus.”

Overall in 2015, gay or bisexual men nationwide made up 67% of new diagnoses. The AIDS epidemic has killed almost 1,600,000 people this year around the world, and 38,607,903 people are living with HIV or AIDS today, according to the World Health Organization (WHO).