The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act created the Ryan White HIV/AIDS Program (RWHAP) in 1990. The RWHAP helps low-income people living with HIV (PLWH) by providing medical care, medications, and support services. More than half of all people diagnosed with HIV receive services through the RWHAP each year. Concurrently, the Ending the HIV Epidemic (EHE) initiative aims to reduce the number of new HIV infections by at least 90% by 2030 through scaling up four key strategies: diagnose HIV as early as possible, treat PLWH rapidly to reach sustained viral suppression, prevent new HIV transmissions by using proven interventions, and respond quickly to potential HIV outbreaks to get prevention and treatment services to people who need them. This is done by focusing resources in the 57 geographic focus areas in 26 states, Washington, DC, and Puerto Rico where they are most needed. Treatment-as-prevention is another strategy for reducing HIV transmission, with pre-exposure prophylaxis (PrEP) reducing the risk of transmission by 99% and at least 74% among people who inject drugs when taken as instructed. This issue brief provides a brief history of the RWHAP and EHE initiative, including their structure, funding history, and opportunities for further improvement and alignment. There are opportunities to focus funding within the RWHAP and EHE initiative to maximize their effectiveness.
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