The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content-sharing agreement.
A recent report from an Ohio-based health institute emphasizes the importance of prevention and testing after decades of study and treatment on HIV, calling it a “pressing public health concern in the United States” as the Trump administration proposes eliminating research and programs on the disease.
According to the Equitas Health Institute’sstudy on HIV research, the pressing public health concern is being faced by young adults the most, with the age group ranging from the early teens to early 30s accounting for 58% of the estimated 32,100 new HIV diagnoses in 2021.
The importance of sex education and awareness of HIV status is always important, researchers said, but in the current political climate, “HIV is often caught in the crossfire of health care debates and shifting policies.”
“Access to funding resources, education and prevention programs is inconsistent and, in many areas, highly inadequate,” the study found. “Navigating sexual health is about building resilience and showing young adults that they are not defined by a diagnosis, the politics surrounding sexual health, or the uncertainty of living with HIV.”
The study comes as the Trump Administration sets its sights on HIV research as part of vast funding cuts within the federal government. Funding is already gone for HIV-related research grants within the National Institutes of Health, including research at U.S. universities and international efforts.
Of the terminated grants, two went to the Ohio State University for studies on “the influence of developmental assets on intersectional stigma and HIV prevention in Black (men who have sex with men)” and a study on “client and clinician priorities” regarding two HIV prevention medications.
Cuts to research and funding
But more chops may be coming as the Trump administration plans to restructure the U.S. Department of Health & Human Services could include elimination of federal HIV prevention and research programs. Those cuts could include the “Ending the HIV Epidemic: A Plan for America” initiative, a government move that aimed to reduce new HIV infections by 90% by 2030.
The initiativewas started under the previous Trump administration, but the CDC web page on the initiative now mentions a court order requiring the U.S. Department of Health and Human Services to restore the website as of Feb. 14. Text at the top of the page then claims any information on the page “promoting gender ideology is extremely inaccurate and disconnected from the immutable biological reality that there are two sexes, male and female.”
“The Trump Administration rejects gender ideology and condemns the harms it causes to children,” the page now states, adding that it “does not reflect biological reality and therefore the Administration and this department rejects it.”
HIV is a disease that attacks the immune system by going after white blood cells, which can develop into the Acquired Immunodeficiency Syndrome, or AIDS. Symptoms don’t always present with HIV, so testing is necessary to identify it, according to Equitas Health.
AIDS wasn’t formally identified in the U.S. until the 1980s, and even then, researchers said governmental response was “minimal,” and then-President Ronald Reagan wouldn’t use the term until 1985.
Community response came in the form of a grassroots effort called ACT UP in 1987, and in 1990, the Ryan White HIV/AIDS program was established for low-income individuals living with HIV, an organization that exists to this day, currently housed under the U.S. Health Resources & Services Administration. The Ohio Department of Health still houses a Ryan White Part B Program for HIV-related services, funded through federal grants, according to the state.
The first treatment method for AIDS was approved in 1996, and cases of the disease began decreasing after the first antiretroviral therapy was released, addressing a disease that was then the leading cause of death for all American adults ages 25-44.
Though the HIV/AIDS epidemic was connected to gay men from the moment it was officially identified, data from the early 1990s showed the disease was present in other groups, including members of various genders, sexualities, races, socio-economic levels and health statuses, according to Equitas Health.
Prevention efforts were started at the local and state public health level, as well as in partnerships between the CDC and national minority organizations.
Testing is an “essential component of HIV prevention, treatment and care,” according to the report, and a lack of awareness about the illness “contributes to the spread of HIV, as individuals who are unaware of their infection statues are more likely to engage in behaviors that can transmit the virus to others.”
“Barriers to testing include stigma, lack of awareness and limited access to testing services,” the report stated. “Stigma may occur within the patient, their community or health care providers.”
Ohio law effective since 2012 requires the Ohio Department of Health to develop and administer AIDS and HIV-related programs, including a system to determine the number of cases, development of counseling and testing programs, risk reduction/education programs to at-risk groups and pilot programs for long-term care.
A treatment now exists to prevent HIV transmission, and the FDA approved the first HIV home-testing kit in 2012, with the CDC funding nearly 2 million tests per year, according to 2021 data.
“Despite medications improving lives and reducing transmission, there is still no cure for the disease,” researchers at Equitas Health stated. “There are two objectives in HIV research: sustained viral suppression without medication and total eradication of the virus.”
Even with improved treatment and testing, HIV rates began to increase during the 2010s, researchers stated, pointing to young adults as a disproportionately affected group.
Sex education
A lack of required sex education also has impacts, according to the report. Sex education in Ohio has been seen as lacking in many ways, with advocates for sex education increasing the push for requirements after Roe v. Wade, the U.S. Supreme Court decision that legalized abortion in the 1970s was overturned, andthe discussion of reproductive rights and sexual health was put to individual states.
Ohio law regarding education curricula including sex education has been changed numerous times over the years, with the most recent change enacted in October 2024. That change came via the Republican-led Senate Bill 168, which, among other education-related changes, amended references in Ohio law from “venereal disease” education to “sexually transmitted infection” education.
A bill passed last year was harshly criticized for forcing school districts to notify parents if a child identifies as LGBTQ+ and allowing parents to opt out of “sexuality content.” During the committee process in the Senate, however, an amendment was added to the bill to specify that content the bill deemed objectionable was not targeting STI education.
While STI education is in Ohio law, advocates for more sexual education say abstinence-focused instruction and the other provisions currently in law aren’t enough.
The non-profit Sexuality Information and Education Council of the United States said Ohio’s sex education curriculum”is not required to be comprehensive, medically accurate or include instruction on topics such as consent, sexual orientation or gender identity, or contraceptive options.”
“This leaves local school districts to decide what sex education curriculum they provide,” the group stated.
The research from Equitas Health recognized the resilience of young adults, despite being a population that is understudied among HIV study.
“Young adults with marginalized identities require diverse and targeted approaches within HIV care,” the report concluded. “However, adults within sexual, gender and racial minority groups are often excluded from HIV discourse. The unique needs of young adults must be considered.”
