October / November 2011
R.I.P. HIV
by Regan Hofmann
5. THE CHURCH
We 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”?
6. HUMAN
RIGHTS
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.
7. THE CURE
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.”
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bettyforacure, , 2012-03-25 15:37:13
Please keep your negative comments to yourself!! I understand for some of you it has been a long and difficult battle, but there are genuine efforts being made by the scientific communities to find at least a 'functional cure' of some sort for those individuals that can access it. We must not give in to self-pity and defeat!! Instead let us pray and uplift the scientific community for moving forward with a possible resolution to this dreadful disease. I refuse to give up or in to this disease!
David McCombs, Toronto, 2012-01-25 23:52:27
Interesting article, but I was diagnosed in 1985 and have seen lots of hope that never happens. The ARVs are not always the gift we are told they are (I am dealing with liver failure right now because of Darunavir). Friends of mine back in the 80s always believed that if a vaccine ever came out, they would leave us Poz folk to just die off. I'm not sure that is not true. It is a nice dream, but I'm sure that I won't be here to see it. Thanks for the article though
legolas613, Nashville TN, 2011-12-02 03:36:18
It sure is a wonderful ambition. However, the reality is it will never happen with a heavy reliance on ARV's. A preventitive and currative vaccine is the only way to a true victory. The ARVs route is too dependent on behaviors & there are always going to be HIV+ persons who will (a) not know their own status, (b) lie to others about their status, (c) many with a barebacking fetish (like me) (d) will become "lost to follow-up" with their Dr. or (e) choose not take take or adhere to ARVs (like me)
jane, Everywhere, world, 2011-12-01 11:08:37
MM-1 created in 1988... today is 12-01-2011. side effect fever or 102 to 103. Tylenol side effect liver failure and which leads to hospitalization and lots of cases death. truvada issentress, novorir, etc side effects, diarea, vomiting, rashes, severe head achs, some allergic reactions etc, and the lost of control for you own life. As long as there is no cure you are out of control.
Jane, , 2011-12-01 11:01:13
They have been writing promising articals for almost a decade now. We want to see a cure not a change. How long does it take to break through plastic. 20yrs? 30yrs maybe? They can and will always offer only some brief artical about how that "may", be a cure insight. Who's sight is the question. Your not born yet children? Or is it their children? What about MM-1? How long has the government supressed this? I know the answer. They will give you radiation for cancer but no a cure for AIDS. SCINCE
Ce, Orlando, 2011-11-30 10:57:47
I will agree witht he rest. Big Pharma is making too much money which means that the elected officials are making just as much. Lets bring stem cell reasearch into the USA and I am betting we can cure manythigns. Yeah they do not want that cause they all go broke. It is capitalism at its best and worse depends on which end of the money your at. Me it is at it's worse . Folks wake up this is all going to as one person said go away whena new money making drug needs ot be to treat another virus!
michael, san francisco, 2011-11-30 10:10:41
Great article, lots of misguided hope. Sadly, it won't happen. Why? Because Pharma holds key patents required to identify and produce a cure for HIV. Further, Pharma is not interested in killing off their global cash cow. It's too profitable for them. If you really want to eraticate HIV you'll have to find a way to take the profit out of it for Pharma. The obvious solution is to kill off (which Congress, Medicare and ADAP Programs are now doing) those infected with HIV.
Sorry to burst it.
Elizabeth, Marlborough, 2011-11-30 09:19:42
As soon as the pharmaceutical companies find a more profitable disease, they may drop the cost of drug for HIV/AIDS, they will move their business elsewhere. However, it's a disappointment that so many live and research has been done with not a positive outcome for a cure. At least, they have found some cure certain cancer. I wonder if the pharmaceutical companies have put themselves on our shoes I am positive that the cure be available right away.
Cate, Peterborough ,canada, 2011-11-29 06:57:45
As long as pharmaceutical companies make money from HIV + AIDS there will be know cure. AIDS is a big business. I have been positive for 20 years and have taken all HIV drugs but one. I have laid in the hospital near death a few times. There are no silver bullets here. These statements of control and cure are not those of people living with this disease.
David, New York, 2011-11-27 10:20:15
Re Bone marrow transplant as a cure...
Not a realistic option! The procedure kills 1 in 3 patients within the first 100 days, and another 1 in 3 die of long term chronic side effects within 5 years. Would you gamble for a 33 percent chance of total cure vs. 66 percent death?
Rick, West palm beach, 2011-11-10 09:33:58
A great article. Thank You! There are so many institutions which help our cause. I have limited funds, but I want to contribute to finding a cure and a vaccine. To which of these institutions should concentrate my contributions? Does Poz.com have a list of recommended organizations to donate to?
josue, dallas Tx, 2011-11-08 21:08:39
Iam dont like this but until they get tired of make money inventing hundreds of pills maybe wee all get lucky and finale wee ear the CURE is ready because for all those politicians is more important make WAR with every country they decide to keep the business ongoing than make a real effort and end AIDS after 30 years dealing with it
AlexMerida, Merida, 2011-11-02 12:54:39
I totally agree with Rob Careman, but the question is how, wich proyect is closer to a real cure.
We can give money to speed up the research....
AlexMerida, Merida, 2011-11-01 13:08:07
Please, we go to do something
researcher are doing their part,
We have to leave the confort are where many people are (including me) and think that all of us Can meke the cure of HIV possible and soon, please.
In Tunez, Egypt, NY, Spain social networks have made history
Jonathan, New Haven, 2011-10-30 20:35:45
we need to fund ADAP and get the 9000 people in the USA off the ARV waiting list. I agree, the battle will not be easy nor cheap, but it is necessary. I am 30, gay and recently HIV pos. We need policy change-sex education, availability of condoms, and education in general. However, I do not agree about increasing male circumcision. I am VERY against this. I am cut and will always be missing a vital part of my natural body that with proper hygiene, does NOT aid in transmitting HIV
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