A future without AIDS on LI is in sight

Each year, World AIDS Day on Dec. 1 provides an opportunity for people to unite around the goal of ending the HIV epidemic, show support for people living with HIV, and remember those we have lost. Although we can see the finish line, the fight is not over.

Options for Community Living, Inc. has been a significant force in the effort to end the HIV epidemic on Long Island. In the early 1990s, as HIV spread here, Options began an intensive case management program for people living with HIV and AIDS, and developed supportive housing as homelessness among this population increased.

Back then, AIDS was the leading cause of death for Americans 25-to-44 years old. Thankfully, by 1997, AIDS-related deaths in New York declined by 30% as highly active antiretroviral therapy became the standard of HIV care. From 2011 to 2021, new diagnoses of HIV statewide decreased by 46%. As of December 2021, 103,900 New Yorkers were living with HIV. Prevalence is higher among sex workers, men who have sex with men, transgender persons, IV drug users, and prisoners. Key populations like these continue to need support because most new HIV infections and deaths occur where certain high-risk groups are unaware, underserved or neglected.

President Joe Biden's National HIV/AIDS Strategy sets bold targets for ending the HIV epidemic in the U.S. by 2030, including a 75% reduction in new infections by 2025. The strategy focuses on preventing new infections, improving HIV-related health outcomes of people with HIV, reducing HIV-related disparities and health inequities, and better coordinating efforts to address the epidemic among all partners and stakeholders.

Like Options, programs need to address unmet needs with HIV education and testing, access to affordable health care, and prevention resources and strategies like condom distribution. HIV is not “over” simply because of medical advances. To ensure we connect to target populations, outreach to high-risk groups requires better communication to overcome barriers and improve health literacy. Empathetic employees and strong partnerships for client care are key. At Options, “peer” workers with lived experience inspire, empower, and support clients in their recovery. Our programs promote prevention and provide education about pre-exposure prophylaxis. Partnerships with local providers including needle exchange help those at high risk for HIV. This model can be duplicated and expanded to reach more people at risk.

Services for marginalized/underserved populations such as racial/ethnic minorities, homeless, prisoners, and substance users must be provided in a manner that acknowledges their journey with empathy and sensitivity and without judgment or assumptions. We need to recruit, hire, and retain staff from the most prevalent cultural group of consumers with lived experience. This is not to say that staff need to have been formerly incarcerated or a sex worker, but they may have related experience that helps them understand that sensitivity in communication could be key to someone choosing prevention measures and living a healthier life. To ensure inclusion, we must develop workgroups that focus on reducing disparities in access, quality, and treatment outcomes for marginalized populations.

Options houses more than 100 Long Islanders living with HIV and AIDS and helps more than 400 access medical care and benefits through case management services and vital health education and resources. If we can ensure that high-risk populations have fair access to testing and treatment without judgment, and continue to focus efforts on prevention through education and communication, we will end AIDS. Together, we will get there.

This guest essay reflects the views of Allison Covino, program director at Options for Community Living, Inc. overseeing all HIV and AIDS-related programs and care management programs for adults and children.