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'Getting to Zero' aims for no new HIV cases by 2030
by Noah McCarthy

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Getting to Zero is an Illinois community engagement initiative that aims to eliminate new cases of HIV by 2030.

The initiative held a kickoff event June 20 that featured multiple government representatives and HIV researchers who outlined a path toward this goal. One such speaker was state Rep. Camille Lilly, a Democrat representing the 78th District in the Illinois General Assembly and Vice-Chairperson of the Health and Healthcare Disparities Committee. Lilly emphasized that this initiative will improve quality of life for all society, not just those affected by the virus, and warned that programs like Getting to Zero only receive funding when legislators hear loudly from all of their constituents. Specifically, Lilly cited the large disparity between the Chicago rates of HIV infections versus the statewide rates as the result of preventable political stalemates.

Around 62 percent of HIV positive people live in Chicago, despite the city only representing 21 percent of the state population. Later in her talk, she addressed the racial issues at play in combating HIV, noting that people must face the reality sooner than they might realize that since certain communities will reach zero faster than others. She also said it is the responsibility of those communities with superior health services to recognize HIV as a societal problem which transcends personal concerns.

Dr. Aditya Khanna, director of network modeling at the University of Chicago, acknowledged some of the same challenges which lie between activists and their goal. He began on a positive note, stating that for the first time in more than two decades, there are now fewer than 1,000 new cases of HIV annually. Khanna's work centers on Black men who have sex with men ( MSM ) aged 18 to 34. This demographic is of particular importance because of the increased prevalence of HIV in the Black community, where more than 40 percent of new cases occur.

Khanna's work predicts the effects of pre-exposure prophylaxis ( PrEP ) and antiretroviral therapy ( ART ) on reducing the number of new HIV cases after the 10th year of a certain treatment program. The model's preliminary data suggests that with an increase of 20 percent in both ART and PrEP use, new cases of HIV in the young Black MSM demographic would drop substantially.

Dr. George Greene, from the Northwestern University Feinberg School of Medicine, followed Khanna's presentation with a talk on the importance of evaluation in the goal of getting to zero by 2030. The Evaluation Center at Northwestern ( "Center" ) works with HIV-prevention agencies in Chicago to improve their outcomes. The Center has also worked with Chicago's Project PrIDE to collect data on areas of potential intervention in the HIV treatment process. Physicians hope to understand the points in patient's journeys, for example, between being tested and receiving a positive result, where patients fall off the recovery wagon. Currently, the largest area for improvement is between the prescription of PrEP and the filling of that prescription. Additionally, this data can be analyzed across demographics, and shows comprehensively more positive results for white than for Black patients.

According to Greene and the Center's team, evaluation is crucial in the movement toward zero new cases of HIV by 2030.

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