The Cherokee Nation is collaborating with the federal government on a pilot program for President Donald Trump’s “Ending the HIV Epidemic: A Plan for America,” according to a press release from the Indian Health Service (IHS), an agency of the Department of Health and Human Services.
The goal of the program is to determine which measures are most likely to be effective at ending the U.S. HIV epidemic. “The pilot project will reveal important insight into the HIV prevention and treatment activities that should be implemented early—and those that should be strengthened over time,” said IHS principal deputy director Rear Admiral Michael D. Weahkee in the press release. The results of the program will be shared with relevant communities.
The pillars of the program, which will last a year, are:
- Test: to encourage everyone between ages 13 and 65 to get tested for HIV at least once in their lives;
- Treat: to provide antiretroviral medication to people living with HIV;
- Prevent: to raise awareness among at-risk populations, including men who have sex with men, people who don’t use condoms, people who have multiple sexual partners and people who inject drugs;
- Respond: to molecularly test the virus for resistance and determine whether different strains are related to help officials get ahead of future outbreaks.
Another goal includes increasing PrEP, or pre-exposure prophylaxis, usage. When taken as prescribed, the tablet Truvada as PrEP reduces the risk of contracting HIV via sexual activity by 99% or more in men who have sex with men and 90% or more in women. (The risk reduction for women may very well be greater than 90%, but currently available research is insufficient to refine the estimate.) PrEP also reduces the risk of contracting HIV via use of contaminated needles by more than 70%.
Trump’s Ending the HIV Epidemic (EHE) initiative intends to reduce rates of new HIV infections by 90% in the next 10 years. To date, Trump has pledged $291 million of the federal budget to achieve this goal. EHE efforts will focus on 48 counties, seven rural states, Washington, DC, and San Juan, Puerto Rico, which together account for more than 50% of new diagnoses in the last decade.
The Cherokee Nation was a natural choice for the federal collaboration. The Southwestern tribe is headquartered in Oklahoma, one of seven states identified as HIV hot spots (the others are Alabama, Arkansas, Kentucky, Mississippi, Missouri and South Carolina). Additionally, Native Americans are more than twice as likely to contract HIV as whites, and the Cherokee Nation has a proven track record of success with similar programs.
“The Cherokee Nation was the first one to start a hepatitis C elimination program three years ago, almost four now,” Jorge Mera, MD, the tribe’s chief infectious disease control doctor, told the local newspaper The Express-Star. “We’ve been doing a lot of good work. We still have a long way to go, but we’ve been pretty successful in our intervention.”
However, Mera acknowledges that the short duration of the program imposes scientific limits. “I am not sure if in one year we’ll be able to get enough data to have big results,” he said, “but at least we’ll get a good glimpse of [whether] the intervention [was] feasible to deploy” nationwide.
To read more about the Ending the HIV Epidemic initiative, read “What Do We Know About Trump’s HIV Plan for America?”