Program to keep patients’ HIV ‘undetectable’ saved in NYC budget

Last-minute cuts to HIV services that New York City’s health department announced in May will be reversed in the city’s new budget, protecting a program that helps HIV patients keep their viral loads low and avoid spreading the virus to others.

The move means some HIV services that already started turning away new patients can open up their rolls once again. It follows swift pushback from city councilmembers and activists, who protested against the cuts outside City Hall earlier this month.

The budget heralded by Mayor Eric Adams and the City Council on Friday reverses many of the service cuts his administration initially said were needed. While the $5.3 million that was on the chopping block for HIV services was just a fraction of the funding that Adams tried to slash from some other city services, it would have affected programs that advocates say are crucial to public health — including the Undetectables, the program to suppress patients’ HIV viral loads.

Callen-Lorde, a health clinic serving LGBTQ+ patients, was already preparing to wind down its Undetectables program and had stopped accepting new patients in anticipation of the cuts, said Kimberleigh Smith, the clinic’s senior director of public policy and advocacy.

Callen-Lorde signed a three-year contract with the city for $243,000 a year to adopt the program in 2022 and currently has about 70 patients enrolled. But that contract would have been cut short if the budget cuts went through.

“It’s a very successful program, so we would just want to keep growing it,” Smith said.

The Undetectables provides additional assistance to HIV patients who are struggling to manage their health and gives them extra incentives if they follow their medication regimens and succeed in suppressing the amount of the virus in their bloodstreams. It’s virtually impossible for patients to transmit the virus when their viral load is low enough, according to the U.S. Centers for Disease Control and Prevention.

Housing Works, the nonprofit that launched the Undetectables program a decade ago, celebrated the news that the HIV cuts would be restored, saying it “ensures that our most vulnerable and impacted populations receive the support they need to live healthy lives.”

In recent years, the city signed new contracts with a range of providers to expand the Undetectables. Advocates say the program is especially needed now, since the city’s progress toward reducing the number of new HIV cases reported each year has plateaued.

The originally proposed $5.3 million in cuts had put health care providers and advocates on edge just as budget negotiations were winding down this month.

Jason Cianciotto, vice president of public policy and external affairs at GMHC, an organization that was set to lose funding for the Undetectables and other programs, said he was grateful that advocates made enough noise to get the money restored. But he added that he didn’t see the point of the budget maneuverings that put the cuts on the table.

“Why did we have to go through this?” said Cianciotto. “What purpose did it serve?”

He said cuts to HIV funding would have amounted to “a small rounding error in a huge, multibillion-dollar budget,” while affecting services for the “most marginalized communities in the city.”

Gov. Kathy Hochul also took action to improve access to HIV services on Friday, just before the end of Pride Month. She signed bills clarifying that insurers cannot make patients pay copays for PrEP and PEP, which help prevent people from contracting HIV, and prohibiting insurers from delaying care by requiring prior approval for HIV medications and treatments.

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