October/November #175 : R.I.P. HIV - by Regan Hofmann

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Table of Contents



From the Editor

Retiring the Ribbon


Letters- October/November 2011


High-Impact Prevention

What You Need to Know

Health Care Should Be a Human Right—for All

Too Few Pharma Companies in the Patent Pool

Legislation Proposed to End Criminal HIV Laws

AIDS Is Not an "Automatic Death Sentence"

Geckos Don’t Cure AIDS

We Hear You

The PrEP Debate

What Matters to You

Getting HIV Care Without Getting Deported

Treatment News

A Peek Into the Pipeline

Savvy Survival Strategy

Going Norvir-Free?

Cure Watch

Listen Up

Oh Baby!

Make Some Bones About It

Comfort Zone

Waiting to Inhale

POZ Heroes

Defying Gravity

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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October / November 2011


by Regan Hofmann


PopeWe need the blessing of the church. The Roman Catholic pope, Benedict XVI, has come closer to sanctioning the use of condoms than any other papal leader. While we recognize it’s unlikely he will ever get all the way there, we need to remind him that if he could, it would create a paradigm shift in how we stop AIDS from spreading. We don’t think God wants people to get HIV or die of AIDS. If the pope is a conduit for God’s word, can’t he tell Catholics it’s OK to save their lives and protect others? Denying that people have sex and telling people the only way to protect themselves sexually is to abstain from sex is killing them. This doesn’t seem very Christian, does it? Helping keep the sick alive, however, does.

We need to leverage the global network of faith-based organizations of all types to spread the good word about HIV. We should work with churches of all denominations to disseminate lifesaving information about HIV/AIDS around the world. Faith-based organizations can play an enormously pivotal role in the end of AIDS. They offer safe spaces, are led by trusted elders and are visited by people from all socio-economic tiers on a weekly, sometimes daily, basis.

Leveraging faith is a great way to reach people who do not intersect with the health care system, and it’s a wonderful vehicle to deliver messages of empowerment, health and tolerance.

There are far more churches in the world than medical centers. There is also a greater chance of people confiding in their pastor, priest, rabbi, iman or guru than coming clean with their medical doctor, nurse or health care provider.

Tolerance—of gay people, sex workers, transgender people, injection drug users and other marginalized populations—especially within houses of worship is key to making it possible for those who need medical help to get it. Can we get an “amen”?


We need to fight stigma, discrimination and the criminalization of people with HIV. Nothing is perhaps harder, or more critical, than removing the very real emotional barriers to testing, linkage to care, retention in care, adherence and disclosure.

It’s difficult enough to face a life-threatening illness. It’s that much harder without the understanding, support and compassion of friends, family, lovers and community. No one who has HIV did anything wrong. There is no shame in having HIV. Those living with HIV who have come to terms with their diagnosis can help newly diagnosed people accept their serostatus and overcome the self- and societally inflicted stigma that beats us down.

Everyone living with the virus needs to be educated and empowered to know that there are many good laws protecting against HIV-related discrimination. And we need to ensure that those laws are upheld, that new ones are created as needed and that unjust laws (such as those criminalizing people with HIV) are stricken off the books. And those of us who suffer injustices need to have the courage to come forward and prosecute those who commit the injustices.

We need to fight the increased incidence and severity of criminalization of people with HIV. The laws currently in place are sufficient to cover the rare cases in which a person with HIV intentionally attempts to infect another person. There is no need for AIDS-specific laws. They backfire and present hurdles to individual and public health. Who would want to get tested for HIV if knowing your status could mean you could be falsely accused of non-disclosure and end up in prison? Criminalization of HIV doesn’t protect anyone, but it does increase the risks for everyone.

We need to fight racism in the context of HIV/AIDS and the health disparities it creates. Because of racism, marginalized populations get disproportionately inadequate health care. No state and no nation should be allowed to offer inequitable health care, or reduced access to people simply because they don’t have as much money or political power as others. The arguments must be clearly made on Capitol Hill that health care is a human right—and everyone deserves equal human rights. Currently, African Americans and Latinos are disproportionately impacted by HIV/AIDS in the United States; they are nine and three times more likely, respectively, to contract the virus than whites.

We need to fight homophobia in the context of HIV. Homophobia is as dangerous as racism and similarly impedes individual health and therefore public health. When we allow large swaths of society to remain sick and when we drive entire populations underground, we give up the opportunity to improve the health of our nation as a whole—and that leaves everyone more vulnerable. Because in the real world, people don’t stay in their corners. People move around and interact. HIV doesn’t know your race, ethnicity, gender, sexual orientation or socioeconomic status. It is a biological agent that can move between any two people who engage in certain activities, and those certain activities have never been the exclusive domain of any one type of person. Sex and drug use seem to be pretty universal.

We will never end AIDS if LGBT people around the world don’t feel safe coming forward to get educated about prevention, get tested for HIV and get care if needed.

We need to stop talking about HIV in terms of “risk factors.” We must reframe the way we describe who may be at risk for HIV. While acknowledging that certain groups are at higher risk than others (for example MSM, African Americans, injection drug users, etc.) we must change the misperception that only people at high risk for HIV can contract the virus. The fact is, anyone who has ever had unprotected sex, received a blood product or an organ or shared injection drug equipment may have been exposed to HIV and should be tested.

Doctors should no longer use risk-sorted behavior to determine whether or not someone may have been exposed to HIV. Most people should be tested at least once. Some people should be tested regularly.

We need to take HIV/AIDS out of its silo and “normalize” the virus/disease. The very thing that helped HIV get emergency funding in the early days is impeding our ability to end the pandemic: AIDS exceptionalism.

We need to mainstream AIDS care. As more people living with HIV globally are tested and diagnosed, we’re going to need a lot more medical care workers. And, most people don’t get diagnosed with HIV in an infectious disease specialist’s office. They discover their status in community health centers, emergency rooms, at the OB/GYN and in other medical settings. We need a better system for linking people to HIV-specific care and retaining them in it. But we also need the general health care system to be better equipped to handle HIV.

Every doctor needs to know how to test for, deliver a diagnosis of and offer basic treatment for HIV. And we need to educate nurses too since in many nations around the world, nurses administer the lion’s share of health care.

We need to make testing guidelines clear, make testing more affordable and consider an over-the-counter HIV test. Guidelines that don’t align are confusing to doctors and present an “out” for them to HIV testing. Currently, the Prevention Task Force and the CDC guidelines don’t align. We need to fix this.


We need to support a research agenda that could fast-track a cure and a vaccine. We must invest heavily in the science that looks so promising at this moment. We are closer than we’ve ever been. According to Kevin Frost, CEO of amfAR, an investment of $100 million in the current cure research could help usher in a cure within five to 10 years. Françoise Barré-Sinoussi, PhD, who co-discovered HIV, is leading a global consortium of people with HIV and scientists to fast-track a cure; amfAR has a new collaborative consortium (ARCHE) hunting for the cure; and the NIH recently made a five-year, $70 million pledge. What we now know about broadly neutralizing antibodies, CCR5 inhibitors, HIV reservoirs and so much more makes this the time in AIDS research when careers are made, Nobel Prizes are won and the course of history is changed.

To sum it all up, AIDS needs a modern elevator speech—a compelling statement any of us could blurt out if we found ourselves, say, face-to-face with the president of the United States or any other world leader. We should all be able to answer the question: Why must the world end AIDS?

Inspired by what Chris Collins, vice president and director of public policy at amfAR, told us he’d say if he found himself in an elevator with the president, we suggest the following: “Mr. President, U.S.-funded science indicates the end of AIDS is now possible in our lifetime. Studies recently revealed that antiretroviral treatment for AIDS doubles as prevention. People with HIV on pills have a 96 percent reduction in odds of transferring the virus. If we significantly expand access to HIV treatment at home and abroad, we will save tens of  millions of lives, slow and eventually stop the spread of the virus, and preserve billions of federal/taypayer dollars. With the right strategic shifts in current resources and an influx of foreign aid from nations who stand to benefit from the end of AIDS, we could see HIV incidence and expenditures decline dramatically in as few as five years. Jump-starting the end of AIDS is a terrific legacy for your administration. Scaling up treatment means scaling up saving lives.”

Or, more simply put, the answer to why the world must end AIDS is, “Because we can.”

Pages: 1 | 2 | 3 | 4

Search: Washington DC, Thomas Frieden, U.S. Centers for Disease Control and Prevention, CDC, HPTN 052, PEP, PrEP, pre-exposure prophylaxis, post-exposure prophylaxis, Bill Gates, Anthony Fauci, National Institutes of Health, National Institute of Allergy and Infectious Diseases, United Nations, Medicaid, Medicare, stigma, discrimination, homophobia, criminalization, deportation, President?s Emergency Plan for AIDS Relief, PEPFAR, Barack Obama, Office of National AIDS Policy, President's Advisory Council on HIV/AIDS, PACHA, Michelle Obama, Global Health Initiative, GHI, UNAIDS, Affordable Care Act, AIDS Drug Assistance Program, ADAP, Ryan White CARE Act

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