If Donald Trump really wants to end the US HIV epidemic by 2030, as he announced in Tuesday’s State of the Union speech, he will have to stop stigmatizing immigrants and trans people, according to health care experts.

About 1.2 million people nationwide have HIV, and every year another 40,000 are infected. One in 2 has the virus for at least three years before they're diagnosed.



"Together, we will defeat AIDS in America. And beyond," Trump said in the speech, lauding scientific advances in the treatment and prevention of HIV. "My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years."

On Wednesday, federal health officials released more details of the "Ending the HIV Epidemic: A Plan for America" proposal, which calls for reducing US HIV infections by 75% by 2025, and by 90% by 2030. They will focus on the 48 US counties with the highest infection rates and seven southern states with high rates of widely distributed infection rates. The goal is to get everyone infected there on treatment to reduce the amount of virus in their bloodstreams to non-transmissible levels and get everyone at high risk of becoming infected on medication that prevents infection.

"The time to end this epidemic is now," CDC chief Robert Redfield said on a phone briefing for reporters.

Such a plan is very doable, HIV prevention experts told BuzzFeed News, applauding recent speeches by Health and Human Services Secretary Alex Azar advocating wider use of drugs that prevent HIV transmission. But groups with highest rates of the virus include gay, trans, black, and Latino men, drug users, and people living in Southern states without public health care — constituencies not exactly embraced by the Trump administration, which is trying to build a wall on the Mexico border and kick trans people out of the military, and disbanded its Office of National AIDS Policy in 2017.



“Ending the HIV epidemic matches the scientific reality — we can do this,” Treatment Action Group project director Jeremiah Johnson told BuzzFeed News. “But it doesn’t match the political reality of our era.”

In January, National Institute of Allergy and Infectious Disease officials released study results confirming that antiretroviral treatments that drive the virus to undetectable levels in the bloodstream prevent people from transmitting the disease to their partners. What’s more, a daily preventive drug, taken by people who haven’t been infected, reduces their risk of acquiring HIV through sex by more than 90%.

Such advances have driven “roadmap” plans by public health experts to reduce HIV infections nationwide in the next decade, saving some $57 billion in long-term health care costs. But experts worry that the Trump administration’s hostility toward trans people and immigrants, in particular, could do more harm than good.

“Many recent immigrants are afraid to access HIV prevention and medical care, out of fear of deportation,” a 2018 AIDS United report noted. “These barriers have the potential to drive dramatic increases in new HIV cases among Latinx gay and bisexual foreign-born men.”