The Future of Pediatric HIV Care in the U.S.: Post-2024 Presidential Election Outlook
Presidential elections play a pivotal role in shaping healthcare by redefining priorities related to access, funding, and public awareness. As the new U.S. administration takes office this January, its leaders and policy agenda will determine whether the U.S. continues to lead in HIV prevention or risks falling behind in the fight, both domestically and globally.
Progress and Persistent Challenges in Pediatric HIV Care
Recent years have seen significant progress in pediatric HIV care, with political action and advocacy fueling advancements in treatment and prevention.1 These efforts have reduced mother-to-child transmission (MTCT) of HIV and expanded access to antiretroviral therapy (ART), bringing the U.S. close to eliminating perinatal transmission.2 However, significant barriers remain in the pursuit of domestic pediatric HIV eradication:
- Access Inequalities: HIV is more common among low-income individuals, not excluding children, in the U.S., who often face socioeconomic barriers that hinder their ability to access comprehensive care.3
- Healthcare Disparities: Black children represent 58% of pediatric HIV cases in children under 13, despite comprising only 14% of the U.S. population, highlighting the disproportionate impact of the virus by race.4
- Vertical Transmission Risks: Approximately 100-200 cases of MTCT occur annually in the U.S., with a portion of cases stemming from women who receive inadequate prenatal care or are unaware of their HIV status.5
How the New Administration Following the 2024 Election Could Reshape Pediatric HIV Care
The next administration will play a crucial role in determining whether we can close the final gap toward eradicating pediatric HIV. Key policy areas that could shape the future of pediatric HIV care include:
- Expanding Healthcare Access: An administration committed to Medicaid expansion could improve ART access for underserved populations, reducing treatment gaps. Improving maternal healthcare access and HIV testing during pregnancy could also further reduce MTCT cases.
- Securing Federal Funding: Programs like the Ryan White HIV/AIDS Program depend on federal support. Increased funding could enhance prevention, early diagnosis, and comprehensive care.
- Prioritizing Pediatric Care: Policies focused on children’s health could introduce universal pediatric ART coverage, school-based HIV testing, and public campaigns that address stigma and promote early detection.
As the new administration takes charge, the stakes are particularly high due to the ongoing challenges posed by the COVID-19 pandemic, widespread criticism of government and private insurance practices, and the need for reauthorization of critical programs like PEPFAR and the Ryan White Program.6,7
Key Programs in Pediatric HIV Care
- The Ryan White HIV/AIDS Program: Established in 1990, this program is the largest federally funded initiative in the U.S. dedicated to providing care and support to people living with HIV. It serves over 50% of all individuals diagnosed with HIV in the U.S.8
- The President’s Emergency Plan for AIDS Relief (PEPFAR): Launched in 2003, PEPFAR is a global U.S. government program that has invested over $110 billion in HIV prevention, treatment, and research worldwide. Although primarily focused on low- and middle-income countries, PEPFAR’s breakthroughs in prevention and treatment often shape domestic policies and priorities.9
Federal support for these initiatives is critical not only for sustaining domestic progress but also for preserving the U.S.’s global reputation as a leader in HIV prevention and treatment.
Looking Ahead to 2025
As we look ahead to 2025, the Trump administration has yet to release specific priorities for pediatric HIV and AIDS. However, his previous presidency introduced a 10-year plan to end the HIV epidemic in the U.S. by 2030, aiming to reduce new infections and improve care.10 With a post-pandemic focus on healthcare inequities and new scientific breakthroughs in HIV treatment and prevention, the next administration has a crucial opportunity to expand healthcare access, secure funding for essential programs, and strengthen prevention efforts aimed at finally eliminating pediatric HIV and AIDS.
These efforts rely on strong political will to push pediatric HIV initiatives across the finish line and a commitment to the government’s role in funding public health programs. However, proactive policymaking cannot occur without strong public advocacy.
Conclusion: A Call to Action
Although the goal of eliminating domestic pediatric HIV is within reach, it remains crucial to hold public officials and agencies accountable for ensuring equitable access to early diagnosis, effective treatment, and support services for all children living with HIV/AIDS. By prioritizing pediatric HIV care and engaging with local organizations like the Junior Council, we can make meaningful strides toward eliminating pediatric HIV and creating a healthier, more equitable future for all children.
Your support can make a lasting impact in the fight against pediatric HIV and AIDS this year. Please consider supporting the Junior Council and Lurie Children’s Hospital with your donations and time as we work toward a brighter future for children living with HIV/AIDS.
Sources:
1,2https://pmc.ncbi.nlm.nih.gov/articles/PMC6355361/
3https://www.apa.org/pi/ses/resources/publications/hiv-aids
4https://www.cdc.gov/hiv/data-research/facts-stats/age.html
5https://pmc.ncbi.nlm.nih.gov/articles/PMC2650837/
7https://ryanwhite.hrsa.gov/about/legislation
9https://www.state.gov/pepfar/
10https://www.cnn.com/2019/02/06/health/hiv-trump-plan-sotu-address-bn/index.html