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Health Brief

Federal Budget Constraints May Hurt Older Americans With HIV

Researchers say that by the end of the decade,Ā 70 percentĀ of people in the United States living with HIV will be older than 50. Thanks to advances in medicine, the diagnosis is no longer a death sentence.

ā€œI’ve been fortunate to take care of some people with HIV for over 30 years,ā€ saidĀ Melanie Thompson, a physician in Atlanta who said she is frequently told by patients, ā€œYou’re my longest relationship.ā€

But there’s a catch:Ā People living with HIV are at increased risk for other health problems, such as diabetes, depression and heart disease.

As their health needs increase, more is required of theĀ , the comprehensive federal system that provides HIV primary medical care, medications and essential support services for low-income people living with the virus.

But core funding for the national network of clinics hasn’t changed much in the past decade.

According toĀ , inflation-adjusted spending has dropped from a peak in the early 2000s, despite the program serving tens of thousands of new patients.

Laura Cheever, who oversees the Ryan White program, said budget constraints make it hard to prioritize the needs of older people with HIV, especially when many people with the virus haven’t been diagnosed or aren’t receiving services at all.

ā€œWhen a lot of people aren’t getting care, how do you decide where that next dollar is spent?ā€ Cheever said.

President Biden’sĢżĀ for fiscal 2025 asks for a funding bump of less thanĀ 1 percentĀ for the program.

The latest infusion of funding for Ryan White — aboutĀ $466 millionĀ since 2019 — came as part of aĀ federal initiative to end the HIV epidemicĀ by 2030.

But that program, launched by the Trump administration in 2019, was targeted by House Republicans last year inĀ their push to slashĀ the budget of theĀ Centers for Disease Control and Prevention.

Their argument? The initiative, launched just a year before the globalĀ Ā pandemic drew resources and attention from other public health priorities, wasn’t meeting its goal to cut new HIV infections dramatically by 2030.

Around the same time, Republicans were threatening a different HIV program from a different GOP administration: theĀ President’s Emergency Plan for AIDS Relief, orĀ PEPFAR, launched byĀ George W. Bush.

, which has helped millions around the world, over rumors its dollars funded abortions.

Advocates worry these cases signal a larger erosion in bipartisan support for HIV prevention and treatment that threatens to undermine years of progress lowering transmission and mortality rates — especially if older people with the virus don’t get adequate care.

ā€œIt’s tragic and shameful that elderly people with HIV have to go through what they’re going through without getting the proper attention that they deserve,ā€ saidĀ Jules Levin, executive director of theĀ National AIDS Treatment Advocacy Project, who, at age 74, has been living with HIV since the 1980s.

ā€œThis will be a disaster soon without a solution.ā€


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