The number of new HIV infections in Minnesota — 300 annually — has remained stubbornly unchanged for the last 15 years, prompting a bipartisan group of legislators to call for the first-ever statewide strategy to tackle the ongoing HIV epidemic and reduce infections to virtually zero.
If approved, the legislation would require the state health department to report to the Legislature next year, explaining how Minnesota can reduce new infections and provide care for the estimated 8,200 people living with HIV or AIDS in the state.
HIV, once considered a death sentence, has become akin to a chronic condition, manageable with regular care and treatment. For those receiving treatment, medical advances have made transmission from person to person next to impossible if viral loads are low enough.
“If you think about how far we’ve gone with medications, treatment, with the knowledge and tools we have around fighting the HIV epidemic, and preventing the spread of HIV today, it’s really surprising that we haven’t made a bigger impact,” said Matt Toburen, public policy director for the Minnesota AIDS Project.
“We have the knowledge, we have the tools to really make an impact on the epidemic,” Toburen said. “We’re lacking the leadership or just direction to get us there.”
The report would be an important step toward improving services and care for individuals living with HIV, Toburen said. Because HIV affects people across geography and demographics, Minnesota must find strategies to reach all types of individuals, Toburen said. Young gay men in Loring Park, for example, would need to be reached differently from African-born women in Brooklyn Park or an older, married man in Wright County.
Freshman GOP Rep. Keith Franke of St. Paul Park, who is sponsoring the measure in the House, said he was motivated partly because of personal connections to the epidemic. The former mayor said he has a relative living with the virus and a longtime constituent of Franke’s motivated the Republican lawmaker to spearhead the issue in the House.
The bill has cleared one House committee and is to be heard by a second panel Wednesday. It’s also expected to be heard in the Senate. The legislation seeks no money and instead would use existing state resources to pinpoint what health officials should do to stem the number of new cases.
“Before we start throwing money at things, let’s figure out where we need to throw it,” Franke said.
The bill would require the health commissioner to submit the report by Feb. 1. It would also require officials to recommend any policy or funding changes that they think necessary.
The push for a state strategy comes amid major advances in medical care for HIV patients, which, some advocates said, likely has contributed to reduced public attention to the epidemic.
“The drugs have gotten so good that people are able to live long healthy, sustainable lives,” Franke said. “I think that’s why it’s fell on the back burner some.”
Among the goals of the study is to find ways to ensure that HIV-infected individuals receive regular treatment, thereby reducing the spread of the virus, as well as suggesting how to reduce health care costs, said state Sen. Scott Dibble, DFL-Minneapolis.
The Minnesota AIDS Projects estimates that lifetime costs for someone living with HIV are around $400,000.
“Every new case of HIV is extraordinarily expensive to individuals, the health care system and the public sector,” Dibble said. “If we can manage to avoid even a few new cases of HIV, we’re money to the better.”
The bill has attracted broad bipartisan support. Dibble said he counts three Senate Republicans as cosponsors and both of the Legislature’s physicians, Drs. Scott Jensen of Chaska and Matt Klein of Mendota Heights.
In the House, a dozen House Republicans are co-sponsoring the legislation.
“It’s encouraging to see this kind of strong, bipartisan support,” Dibble said.
Annie Elmer, a 59-year-old personal fitness trainer, has lived with HIV for more than 20 years. A constituent of Franke’s, the Cottage Grove woman testified last week in support of the legislation. She said she’s a testament to medical advances that have allowed her to lead an active life.
Nevertheless, Elmer said, there’s still plenty of stigma that discourages people from pursuing treatment. Data from the Minnesota AIDS project indicate that some people do not receive care after receiving an HIV diagnosis.
“That’s why the study needs to be done,” Elmer said. “It will get the Department of Health thinking about what’s missing once those people get that test result: Why are some of them falling off the map and not going to the next step?”