HIV transmissions dropped 71% in the UK. But don’t expect a similar drop in the US.

HIV transmissions among gay and bisexual men are on the decline in the U.K.
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The number of new HIV diagnoses among gay and bisexual men in the U.K. has dropped 71% since 2012, according to the U.K.’s Department of Health and Social Care. The department says pre-exposure prophylactics (PrEP) is the main cause.

Sadly, health care barriers in the U.S. may make the same thing hard to replicate in America.

Related: Meet the group of white guys Trump has tasked with ending HIV transmissions

According to data provided by the BBC, HIV transmissions among gay and bi men dropped from 2,800 in 2012 to 800 in 2018.

Of the 103,800 U.K. residents living with HIV, 93% have been diagnosed and 97% are receiving medical treatment that has rendered them undetectable and therefore incapable of transmitting the virus to another person.

U.K. HIV advocates say that PrEP and regular testing have both contributed to the decrease and that the U.K. must now focus on making PrEP even more widely available and reaching older straight men and people over the age of 50 rather than the queers and communities of color stereotypically associated with the virus.

But while the U.K. Health Secretary Matt Hancock said the U.K. was “on track to achieve its goal of ending HIV transmission by 2030,” several barriers could prevent the U.S. from achieving the same goal.

In his 2019 State of the Union address this year, Trump pledged to end HIV transmissions by 2030. His plan involves allocating nearly $300 million in domestic funding towards HIV programs under the Centers for Disease Control and the Ryan White Care Act, which helps support people living with HIV. These programs would spend the next five years focusing on communities with the most new HIV transmissions in 20 states.

Experts agree Trump’s plan could dramatically cut HIV transmission rates in the U.S. by 2030, but there are reasons to be skeptical.

In 2017, Trump fired his HIV/AIDS commission without explanation and replaced it with a pale imitation. He stole money from AIDS programs to pay for his policy of separating migrant children from their parents and he also shut down HIV-related fetal tissue research to appease the religious right.

Trump and Republican-led legislatures have also cut back on Medicaid funding, decreasing funds for HIV-prevention medications. At the same time, Trump has paved the way for making HIV a pre-existing condition that insurance companies can choose not to cover.

All hope isn’t lost though. HIV diagnoses in New York City have dropped 67% since 2001 and California is currently considering ambitious legislation to eradicate HIV statewide. Success there could encourage legislators in other U.S. cities and states to emulate their HIV-reduction strategies.

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