AIDS is about to turn 37—it approaches middle age. Still a major killer—more than one million people died of AIDS last year. But tamed in comparison to its youth: 1.8 million new infections this year, down from three million 10 years ago. Nevertheless, since more people are becoming newly infected than are dying, the epidemic is still growing.
In commemoration of its 30th anniversary, AIDS Healthcare Foundation produced a film, ‘Keeping the Promise.’ Watching archival footage reminds us of just how far we have come in the battle against AIDS and how horrifying those early years were. So, when we “celebrate” World AIDS Day on Dec. 1, there is a lot to be thankful for. A disease having its own “holiday” may seem odd, yet it is more important than ever that we remember everyone we have lost as well as the people who need our help today: the 20 million people who remain untreated for HIV, as well as preventing another generation from becoming infected with this still deadly disease.
As a child of a lower middle-class family, I remember how my father would always talk about living through The Great Depression. As a kid who wanted a toy or a treat of some kind, I really didn’t want to hear about the struggles of my father’s childhood. Likewise, talking to millennials about the ravages of AIDS in the 80s and 90s may leave them cold or even sound like a scold. So, forgive me for saying that AIDS remains one of the defining issues of our time and reminding you that those who do not learn from history are doomed to repeat it.
A cure or a vaccine for HIV is not yet on the horizon. Despite tens of billions of dollars and decades of work, there is no tangible progress toward a magic bullet that will stop all new infections and rid HIV from the bodies of those who have it. The best news is that people who receive treatment and whose virus is under control are rendered non-infectious to others.
Treatments for HIV have never been better. One pill, once-a-day is now the norm, with lower side effects and toxicities; however, HIV treatment still means taking medication every day for a lifetime. But these lifesaving treatments are still beyond the reach of most people living with HIV in the world. People living in poor countries in many instances must travel long distances, wait for a long time and cannot access the best drugs. At this moment of maximum hope, AIDS is no longer front-page news and donors are cutting back on their funding.
Prevention of HIV hasn’t changed much from the beginning. Yes, there is Truvada for PrEP. But adherence is spotty and the people taking it are not the ones most at risk—youth and men of color. And once again, it is a pill taken every day and there are side effects. Whether we like them or not, condoms remain the best defense against HIV.
Sometimes we forget that HIV is an STD. It is transmitted the same way that chlamydia or gonorrhea is spread, through the exchange of bodily fluids during sex. The spread of HIV took off in the 80s because we did not heed the warnings about using condoms and reducing the number of sexual partners we had. Today the number of STD cases is exploding. Apps are the digital bathhouses of our time: a closed network of people in a limited geography facilitate the rapid spread of infections. Yet little is being done about STDs at the government or community level. The more STD infections go up, the less funding is available to test and treat them. Community organizations run irresponsible campaigns that urge people to “fuck without fear.”
We are headed over the falls in a barrel. Gonorrhea is becoming resistant to all the current medications to treat it. Syphilis, which was on the verge of elimination in this country, is roaring back. The condom culture that we worked so hard to establish is being destroyed. Just as we did in the 80s, the only way that we can reverse this devastating trend is on a grassroots community basis, which will take courageous leadership.
The LGBTQ community has played a crucial historic role in the war against AIDS. So many of the most important heroes in this battle have come from our community. We understand the devastation of AIDS and also the empowerment that comes from taking action in our own defense. We have many lessons to share with others around the world. Perhaps our most important role is to not allow the world to forget AIDS and to require everyone from our governments, churches, educational institutions, community organizations and society as a whole to keep the promise to not give up the fight against HIV until we have won.
AHF will continue to keep its promise. We are currently treating more than 820,000 patients in 15 states and 39 countries. We will break the one million mark in 50 countries in the foreseeable future. We will continue to partner with anyone, anywhere who shares our commitment to ending AIDS – the scourge of our time.
Michael Weinstein is president of AIDS Healthcare Foundation.