The H.I.V. outbreak in Scott County, Ind., which began in late 2014 and ultimately resulted in some 200 new infections, was almost entirely avoidable. As far back as 2008, health officials had advised the state to implement needle exchange programs in light of growing injection drug use. Those calls went unheeded. By 2011, it was clear that an H.I.V. outbreak was brewing in the region, but elected officials did not change course. Nor did they take other basic steps — like expanding access to evidence-based treatment programs for opioid use disorder, or increasing government funding for H.I.V. testing — that might have brought the problem under control.
Then, in 2013, state budget cuts forced the region’s lone H.I.V. testing provider (a Planned Parenthood clinic) to close its doors.
By early 2015, scores of residents were newly infected with the virus, and even the local sheriff was pushing the state to lift its ban on needle exchange programs. Mike Pence, then Indiana’s governor, balked. Despite scientific consensus to the contrary, Mr. Pence worried that such a program would only encourage more injection drug use.
By the time the governor finally relented, federal health officials were estimating that more than 100 people in Scott County had already been infected with the virus. Mr. Pence’s response was tepid: He signed a bill temporarily allowing needle exchanges in the outbreak’s epicenter, but he provided no state funding for that program and made the requirements for participation strict and burdensome. For good measure, he also upgraded needle possession without a prescription from a misdemeanor to a felony.
According to a study published in September in the scientific journal The Lancet H.I.V., nearly all of the 215 H.I.V. infections that resulted from the outbreak could have been prevented — if the state’s elected officials had more quickly heeded the advice of public health experts.
Mr. Pence’s slow, own-foot-shooting response to the H.I.V. crisis in his home state bears many lessons for his current boss, President Trump, who recently announced a plan to eradicate H.I.V. in the United States by 2030.
Mr. Trump’s plan has some promising features. Developed by career civil servants with decades of experience combating H.I.V., it would provide the first new funding for the domestic fight against this disease in many years. And it would deploy a majority of those dollars to communities where the virus is most prevalent and resources most urgently needed.
But as The Times reported this week, the president’s proposed budget for the initiative — 1 million for the first year — falls far short of what’s needed to reach the stated goal. And like Mr. Pence’s efforts in Indiana, many of the Trump administration’s other policies stand to undermine this initiative.
Roughly one million Americans live with H.I.V. today; one million more are at risk of contracting it. A vast majority of those who are infected live in marginalized communities, and 15 percent of them have not been diagnosed. Conquering the disease will require making health care as widely accessible as possible. But the same budget proposal that would offer new money for fighting H.I.V. seeks to cut funds for Medicaid, a program that health officials say is a bedrock for people living with the virus. (It’s no surprise that the region of the country with the highest H.I.V. burden — the South — also has the lowest participation in Medicaid expansion under the Affordable Care Act.)
Stopping the infection from spreading — as it still does to some 40,000 previously uninfected Americans each year — will require evidence-based sex education and a large, concerted effort to test everyone who is at risk of contracting the virus. But the administration has worked aggressively to undermine Planned Parenthood, one of the few organizations to provide easily accessible H.I.V. testing in low-income communities around the country. And the Department of Health and Human Services has pushed abstinence-only programs that experts say severely undermine disease-prevention efforts.
Nudging those who are infected into treatment, and helping them stay the course, will require active campaigns to help remove the stigma, shame and fear of a diagnosis. Instead, the Trump administration has repeatedly supported or enacted policies that result in further marginalization of L.G.B.T.Q. communities, which still suffer a disproportionate burden of H.I.V. infection.
To eliminate H.I.V., the cost of medications capable of treating and preventing the disease will have to be sharply reduced (they currently cost tens of thousands of dollars a year per person). But so far, the administration has shown no appetite for using existing laws to override the patents of these drugs and produce them at cost — a move that may offer the best chance of getting these lifesaving medications to the two million or so people who need them.
More than two decades have passed since scientists first developed these medications. The latest plan might enable the United States to finally realize their full potential, but only if elected officials resolve the incongruities in their own policies.
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“【慕】【容】【将】【军】，【天】【边】【那】【坠】【落】【的】【水】【仙】【花】【好】【像】【是】【玲】【珑】【姑】【娘】？”【有】【只】【妖】【揉】【了】【揉】【眼】【睛】，【忍】【不】【住】【好】【奇】【说】。【还】【有】【句】【话】【这】【只】【妖】【没】【敢】【说】【出】【来】——【那】【朵】【花】【儿】【可】【真】【漂】【亮】。 【慕】【容】【邪】【闻】【言】，【眨】【了】【眨】【惺】【忪】【的】【双】【眼】，【下】【一】【瞬】【他】【人】【就】【不】【在】【原】【地】【了】！【一】【条】【巨】【龙】【冲】【天】【而】【起】，【朝】【着】【那】【流】【光】【婉】【转】【逐】【渐】【绽】【放】【的】【水】【仙】【花】【儿】【飞】【去】。 【玉】【玲】【珑】【骤】【然】【离】【开】【舒】【适】【的】【保】【护】【圈】，【被】
“【什】【么】？【你】【们】【要】【去】【古】【堡】【里】？【那】【里】【可】【是】【很】【危】【险】【的】，【据】【说】【里】【面】【封】【印】【者】【远】【古】【的】【邪】【恶】【契】【约】，【就】【连】【光】【明】【教】【会】【的】【人】【都】【不】【敢】【轻】【易】【进】【去】。”【谢】【尔】【曼】【紧】【张】【的】【提】【醒】【道】。 “【嗯】，【所】【以】，【我】【不】【会】【让】【你】【们】【冒】【险】【的】。”【菲】【雅】【点】【点】【头】，【跟】【谢】【尔】【曼】【说】【道】。 “【不】【是】，【殿】【下】，【我】【不】【是】【那】【个】【意】【思】，【只】【是】【说】，【现】【在】【事】【情】【还】【没】【有】【调】【查】【清】【楚】，【不】【如】【我】【们】【先】【回】【村】【子】【了】
【发】【生】【的】【一】【切】【都】【被】【加】【百】【列】【看】【在】【眼】【里】，【作】【为】【这】【儿】【的】【监】【狱】【长】，【作】【为】【执】【掌】【这】【儿】【大】【权】【的】【存】【在】，【他】【忽】【然】【意】【识】【到】【葛】【震】【还】【真】【的】【挺】【厉】【害】。 【虽】【然】【泰】【戈】【尔】【不】【是】【这】【里】【最】【厉】【害】【的】【犯】【人】，【但】【绝】【对】【不】【弱】，【葛】【震】【能】【在】【十】【分】【钟】【之】【内】【把】【对】【方】【打】【晕】，【已】【经】【相】【当】【不】【错】【了】。 “【普】【洛】【斯】，【你】【觉】【得】【我】【跟】【兵】【者】【葛】【震】【单】【挑】【谁】【会】【赢】？”【加】【百】【列】【问】【道】。 【普】【洛】【斯】【站】【在】【那】【里】【想】香港马经全年彩图【反】【正】【也】【没】【人】【看】，【今】【天】【就】【暂】【停】【更】【新】
【生】【活】【一】【旦】【没】【有】【烦】【恼】，【日】【子】【就】【会】【过】【得】【飞】【快】。 【和】【陆】【子】【嘉】【也】【算】【曲】【折】【地】【彼】【此】【见】【过】【父】【母】【了】。 【虽】【然】【她】【爸】【从】【没】【表】【示】【过】【承】【认】【他】【们】【俩】【之】【间】【的】【恋】【情】。 【陆】【子】【嘉】【妈】【妈】【那】【边】，【听】【陆】【子】【嘉】【说】【她】【不】【反】【对】【他】【们】【了】，【只】【要】【别】【耽】【误】【了】【高】【考】。 【但】【一】【直】【到】【高】【考】【结】【束】，【她】【都】【没】【有】【勇】【气】【去】【见】【陆】【子】【嘉】【妈】【妈】【第】【二】【次】。 【高】【考】【结】【束】【的】【那】【天】【并】【没】【有】【比】6【月】【的】【其】【他】
【第】516【章】【菲】【特】VS【吉】【尔】【伽】【美】【什】 【轰】，【轰】，【轰】。 【暗】【淡】【结】【界】【中】【的】【轰】【鸣】【声】【在】【沉】【寂】【的】【楼】【宇】【间】【不】【断】【响】【起】，【一】【道】【道】【激】【流】【宛】【如】【陨】【石】【般】【带】【着】【长】【长】【的】【尾】【焰】【自】【天】【而】【降】，【轰】【鸣】【大】【地】，【水】【泥】【如】【波】【浪】【板】【掀】【起】，【冲】【击】【波】【一】【圈】【又】【一】【圈】【的】【猛】【然】【扩】【散】，【地】【表】【一】【片】【狼】【藉】。 【烟】【尘】【迷】【雾】【中】，【一】【道】【黑】【色】【的】【影】【子】【飞】【速】【移】【动】，【跨】【越】【狂】【风】【骤】【雨】【般】【的】【攻】【击】，【菲】【特】【移】【动】
“【火】【灵】【之】【力】？”【九】【婴】【略】【微】【一】【怔】，【它】【倒】【是】【想】【起】【了】【这】【多】【年】【来】【一】【直】【散】【发】【的】【火】【灵】【气】【息】。 【不】【日】【前】【海】【底】【火】【山】【齐】【齐】【喷】【发】，【也】【是】【因】【为】【火】【灵】【之】【气】【被】【人】【引】【动】。 【海】【底】【炼】【狱】【乃】【是】【阿】【鼻】【地】【狱】【透】【露】【火】【灵】【之】【气】【时】【直】【击】【的】【场】【所】。【尤】【其】【是】【南】【海】【和】【西】【海】【的】【炼】【狱】，【更】【是】【与】【阿】【鼻】【地】【狱】【相】【通】。【所】【以】【九】【婴】【自】【然】【不】【会】【感】【觉】【不】【到】【那】【域】【外】【火】【灵】【的】【力】【量】。 【想】【到】【这】【里】，【九】