The Social and Economic Inequalities of the Continuing HIV Epidemic: Challenges to the NYC DOHMH “End the Epidemic” Program

Historical data from the New York City Department of Health and Mental Hygiene’s (NYC DOHMH) Community Health Survey provides a comparison of multidimensional health disparities for HIV and AIDS healthcare across social and economic groups in New York City. The data cover the period from 2012-2018, the period of PrEP’s implementation in NYC’s ‘End the Epidemic ‘program.’ During the period, persistent health disparities increased for men who have sex with men (MSM), racial minorities, and persons living below the NYC poverty line. The paper focuses on the challenges presented by the political economy of access to preventative treatment for HIV therapy for persons at risk for an HIV infection, as uptake of PrEP by persons at high risk for an HIV infection is the mechanism by which the new rate of HIV infection is expected to decrease. The paper concludes with public policy suggestions for the NYC DOHMH, namely a suggestion of targeted, proportional responses in neighborhoods with a high rate of new HIV infection, community viral load, or HIV and AIDS prevalence