WASHINGTON — In a State of the Union address that often predictably divided along party lines, President Donald Trump's proposal to end the spread of HIV by 2030 drew bipartisan praise Tuesday night, particularly from South Carolinians in a state that has struggled to combat new infections of the deadly virus.
Trump laid down a deadline of 10 years to eliminate a health care crisis that has lingered across the nation and globe since the 1980s.
"In recent years we have made remarkable progress in the fight against HIV and AIDS," Trump said. "Scientific breakthroughs have brought a once-distant dream within reach. My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years."
He closed that portion of his speech by saying, "Together, we will defeat AIDS in America."
Trump's effort would especially be relevant in the South and South Carolina. While the annual rate of HIV infection in the U.S. decreased between 2012 and 2016, data published by the Centers for Disease Control and Prevention show the problem is persistently worse in the South than anywhere else in the country. In 2017, an average 16.1 out of 100,000 people in the South were living with an HIV diagnosis. The national rate was 11.8.
New diagnoses are particularly high in Columbia. A CDC surveillance report, published in November, shows the South Carolina capital ranked 9th among other metropolitan regions in the country for new HIV diagnoses in 2017 and 5th for HIV cases that progressed to AIDS.
The Charleston and North Charleston metro area, by comparison, ranked 26th in the country for new HIV diagnoses and 27th for AIDS.
U.S. Sen. Lindsey Graham, R-S.C., said Trump's plan reminded him of former President George W. Bush's global efforts with the President's Emergency Plan for AIDS Relief, known as PEPFAR, which he credited for "saving millions of lives" in Africa and around the world.
Bush announced PEPFAR during one of his own State of the Union addresses, in 2003.
"A domestic version of that I think would go over well," Graham said.
Democratic U.S. Rep. Joe Cunningham of Charleston noted the South "is affected by HIV at higher rates than the rest of the United States, especially among the LGBTQ community and people of color." He added, "I am hopeful that the president’s announcement means he takes this issue seriously and I am willing to work with him towards this noble goal in any capacity.”
While House Majority Whip Jim Clyburn, D-Columbia, said he disagreed with much of Trump's remarks, he cited the president's promise to defeat the spread of HIV as one of a few issues "where we can find common ground."
U.S. Rep. William Timmons, R-Greenville, said he hopes Trump will flesh out more details about his proposal in the days ahead, which White House officials have suggested he will do.
"The premise of it seems a worthy endeavor, but I would just need to get more information," Timmons said. "Ending the spread of HIV and ending childhood cancer — two things it's tough not to stand up and clap for."
Public health experts in the Palmetto State were surprised to learn this week that Trump would discuss HIV rates in his State of the Union address.
To the best of her recollection, Megan Weis, a senior director at the S.C. Institute of Medicine & Public Health, said she couldn't recall Trump ever addressing HIV prevention during his candidacy or presidency.
"It’s not something that’s been talked about in the past," Weis said. "That said, if the nation is really able to focus on prevention, we can make great strides."
South Carolina and other Southern states face myriad public health problems, including obesity, diabetes and an opioid epidemic, she said.
Weis was hesitant to call one problem more pressing than any other. Federal money flowing into South Carolina to address HIV rates could potentially help alleviate other issues, too, she said.
"All of the health problems we are facing are valid," she said. "There’s so much overlap."
Charleston is considered an "emerging community" for AIDS cases, said Bradley Childs, the CEO of the HIV-prevention nonprofit Palmetto Community Care.
Palmetto Community Care, which offers free testing for HIV and other sexually transmitted infections at its North Charleston clinic, reported 23 new HIV cases last year to the state health department. In 2017, the group reported 20 new cases.
"I’ve been running (the nonprofit) for 15, 16 years now," Childs said. "I’ve never seen an increase in prevention dollars coming into our service area."
According to the S.C. Department of Health and Environmental Control, new HIV cases in this state are primarily driven by men who have sex with men and disproportionately impacts African Americans.
More than 700 people in South Carolina are diagnosed with HIV each year and nearly 20,000 people are living with a diagnosed HIV infection. Many more, the agency estimates, are infected with the virus and have not been tested.
Childs was likewise surprised to find out that Trump was unveiling a plan to address HIV rates.
He said the Presidential Advisory Council on H.I.V. and AIDS has essentially been defunct for more than a year after the president terminated six committee member appointments in 2017. The committee was established by former President Bill Clinton in 1995.
"That committee, on a federal level, is somewhat dead now," said Childs, adding earlier Tuesday that he was curious about what Trump would discuss.
Trump's AIDS commitment came in a speech that stretched to nearly 90 minutes.