The health-focused targets are referred to as “95-95-95.”

It means 95% of people living with HIV knowing their status;  95% of people with HIV taking anti-viral medicine; and 95%  who are being treated are virally suppressed.

It’s a lofty goal, but for local governments around the globe — and some in Missouri — it’s one they’ve vowed to achieve by 2030. And if they do, the decades-long HIV-AIDS epidemic could be sharply curtailed, if not ended.

St. Louis County and the City of St. Louis are the only local governments in Missouri among more than 500 municipalities worldwide who’ve joined Fast-Track Cities, a non-profit that describes itself as “a global partnership between cities, municipalities and four core partners, the International Association of Providers of AIDS Care, the Joint United Nations Program on HIV/AIDS, the U.N. Human Settlements Program, and the City of Paris.”

Members pledge to shore up programs and local efforts in prevention, diagnosis, treatment and care, as well as regularly monitor and report data, such as new cases and numbers of people linked to HIV care.

Also integral, says Dr. Elvin Geng, who helped found Fast-Track Cities-St. Louis, is the reduction of stigmas and discrimination toward HIV and the people most at-risk.

“Feeling as if they are going to be judged by their healthcare providers may prevent some people from getting tested and seeking treatment,” says Geng, professor of medicine in the Division of Infectious Diseases at Washington University.

Since its beginning in 1981, the HIV epidemic has killed more than 700,000 Americans and 40 million people worldwide, according to the World Health Organization. An estimated 1.2 million people in the United States have HIV, and 13 % of them don’t realize it, say the Centers for Disease Control and Prevention.

More than 13,000 residents of Missouri are living with HIV.

HIV is spread most commonly through unprotected sex or through shared needles and syringes. It attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. Left untreated, HIV can lead to the disease, AIDS, acquired immunodeficiency syndrome.

People with HIV who take their medications as prescribed and get and keep undetectable viral loads will not transmit the virus to their sexual partners, say health experts, who stress that while there is no cure for the virus, thanks to early detection and current medicines, people with HIV can live normal life spans.

Darius Rucker and Cory Bradley, co-chairs of Fast-Track Cities-St, Louis, say help is available for anyone, regardless of whether they’re uninsured or insured. They also share their own personal stories—both are living with HIV—with the hopes of inspiring others to seek assistance and know they can lead long, productive lives.

“It’s not easy hearing the diagnosis, but nobody is going to advocate for you like you can for yourself,” says Rucker, who owns a business infrastructure consulting business in St. Louis.

Bradley, who recently completed post-doctoral training at Washington University, is an assistant professor of medical social sciences at Northwestern University. Discussing his diagnosis and overall health, he says: “I’ve been incredibly privileged to have wonderful medical care, and also have experienced challenges. I am living with diabetes. By sharing my experiences, I believe I can help others.”

Fast-Track Cities originated in Paris in 2014. When signing the Paris declaration of membership and support on World AIDS Day in 2019, St. Louis County Executive Sam Page said the epidemic can only be addressed “if we work together.”

“We look forward to working with the city to move St. Louis toward better public health for all our residents,” he said at the time.

Based on data showing numbers of individuals seeking HIV tests, awareness is growing, says Darne Guest, clinic manager for communicable disease response with the St. Louis County Department of Public Health.

Of the 95-95-95 targets, Guest says such goals assist in organization and articulation of what’s being accomplished and what needs improvement.

A Fast-Track Cities-St. Louis data dashboard says in 2021, roughly 3,400 residents of the city of St. Louis and 2,600 county residents were living with HIV. The local Fast-Track Cities works with the county and city health departments, as well as the Missouri Department of Health and Senior Services.

DHSS says it’s working with health departments throughout Missouri to “reduce new HIV infections by ensuring that everyone living with HIV is aware of their infection, linked to and retained in HIV medical care, and maintains viral suppression.”

Bradley talks about the importance of “breaking down silos” when it comes to improving health equity in the diagnosis and treatment of HIV.

He’s referring to increasing awareness across diverse communities about available services, and easing access for those who lack ready transportation or may have difficulty getting time off from work to seek medical care.

On reaching the 95-95-95 goals, Bradley said: “We’ve made progress. But we can do more to empower people. There’s more work to do.”

This story has been updated to correct the spelling of Dr. Elvin Geng’s name.