Written By Colin Quinn
One reason that this year’s World AIDs Day feels especially significant to me as a gay man, and to many, is that the ongoing COVID-19 pandemic has provided so much cultural context through which to understand the HIV/AIDs epidemic. Reflecting on the history of how this disease has affected the LGBTQ+ community especially, and the ways that slander and stigma have been used to harm queer and trans people, I feel most grateful to have been able to build a company and put together a team of people that are passionate about creating better healthcare experiences and increasing access to affirming healthcare for our LGBTQ+ community. But there are many other things to reflect on when it comes to tackling the COVID-19 pandemic through the lens of how society and systems mobilized (and should have mobilized) around the HIV/AIDS epidemic. I am honored to have had the opportunity to sit down with Dr. Demetre Daskalakis, the Center for Disease Control’s (CDC) Director of the Division of HIV/AIDS Prevention, for a conversation to talk about how far we’ve come, what we’ve learned, and why there’s so much hope for the future.
Dr. Daskalakis is recognized nationally and internationally as an expert in HIV prevention and has focused much of his career on the treatment and prevention of HIV and other STIs as an activist physician with a focus on LGBTQ+ communities. “Forty years into the HIV epidemic, we need to re-energize a whole-of-society mobilization effort in order to end the HIV/AIDS epidemic,” says Dr. Daskalakis. “This requires reinvigorating and diversifying the HIV response to ensure equitable access to prevention, care, and treatment services, especially for those disproportionately affected by the HIV epidemic. This effort is only possible by engaging people with lived experience and elevating their efforts to energize the community. We have made remarkable progress in preventing and treating HIV in the U.S. and around the world and our work is not finished. Stigma remains a significant barrier and the COVID-19 pandemic has slowed and threatened hard-won gains.”
In general, this day is always a time to reflect on our response to the HIV/AIDs epidemic and the more than 32 million lives that we’ve lost to AIDS-related illnesses globally. This year’s theme, Ending the HIV Epidemic: Equitable Access, Everyone’s Voice, is meant to highlight our collective commitment to ending the HIV epidemic by addressing health inequities and ensuring the voices of people with HIV are centered in everything we do, Dr. Daskalakis emphasized to me.
The CDC data finally shows hopeful signs of progress in preventing HIV. It’s nothing short of a miracle that we’ve reached this point, considering that there were over 130,000 new HIV infections each year during the height of the epidemic in the 1980’s. The investments in HIV prevention and new treatments have severely reduced new infections, and after four decades, the data from the CDC shows how far we’ve come.
“Progress is likely due to increased uptake of key HIV prevention and treatment strategies such as pre-exposure prophylaxis (PrEP) and treating people with HIV rapidly and effectively to help them maintain a suppressed viral load – a measure of the amount of HIV in a person’s blood,” says Dr. Daskalakis. “We have witnessed major breakthroughs in HIV treatment and prevention during the history of this epidemic. As a young doctor in New York City in the 1990s, I personally witnessed the miraculous transformation of HIV from a possible death sentence into a manageable, chronic disease, thanks to improved medications. To help ensure these strategies reach those in need, particularly during the COVID-19 pandemic, the HIV community is advancing innovative solutions designed to reach people where they are. These innovations include expanded self-testing, increasing the number of mobile options for service delivery, and creative community outreach to those disproportionately affected by HIV.”
Dr. Daskalakis emphasizes that we need to “accelerate efforts to provide equitable access to HIV prevention and care for everyone.” To do that, he says we need to “address the root causes and social determinants that contribute to disparities among people with HIV, such as poverty, unequal access to healthcare, lack of education, stigma, systematic racism, and work circumstances.” Although it would be stigmatizing to classify HIV/AIDS as a “gay disease” or as something that specifically harms the LGBTQ+ community the way that it used to be characterized at its height, the reality is that it continues to disproportionately harm the health and well-being of the most marginalized people. HIV/AIDS most disproportionately affects gay and bisexual men, Black and African American people, Hispanic and Latiné people, and transgender women.
“Growing up as a first-generation gay Latin man, I never really learned about HIV/AIDS because I wasn’t out, and I was afraid to ask about it in school or with my family,” Jon Marquez, an Engagement Marketing Manager for the LGBTQ+ community at Included Health, tells me. “As I got older and interested in working in LGBTQ+ health, I dedicated time to learning about HIV/AIDS to help dispel some of its stigmas. World AIDS day gives us, as a society, a chance to reflect on how far we have come and the work we still need to accomplish.”
To end this epidemic, we need to address the systemic factors that turn health differences into public health injustice, Dr. Daskalakis explains. “That starts with recognizing that HIV disparities are not inevitable,” he says. “We know what we need to do. We believe ten years from now, with the infusion of new resources, community innovation, and collective commitment, we will celebrate new triumphs as we reach ever closer to health equity and ending this epidemic once and for all.”
Thankfully, there are more prevention options than ever before. They range from incredibly effective HIV treatments, to biomedical HIV prevention options like PrEP and PEP. Within the last year, the FDA approved the injectable ART treatment. And the injectable PrEP method is set to be FDA approved by early 2022.
As we continue to transform the way care is delivered and how we treat HIV, it is important that we keep these learnings in mind to end the harmful effects that HIV/AIDS has taken on the world and hopefully prevent other pandemics from taking hold. Equally as important on this World AIDS Day, I hope we can all commit to doing our part to shift the conversations in healthcare settings and even our social groups to be more inclusive, supportive, and less stigmatizing. Due to medical advancements, we have medications like PrEP that can prevent a person from contracting HIV. Additionally, people living with HIV on effective therapy can be “U” or Undetectable, which means their viral load is so small that it cannot be detected in blood samples and as a result the virus cannot be transmitted. As Dr. Daskalakis says, “I’m thrilled that we are going to approach addressing HIV like a new outbreak all over again so we can end it once and for all.” Together we can make this happen to support our community and deliver the healing we all deserve.
For more information on HIV and AIDS, find resources here:
- State HIV Laws
- Positive Women’s Network
- HIV-Specific Criminal Laws, State Guidelines for Health Care Workers with HIV, Youth Access to STI and HIV Testing and Treatment, HIV Testing and more
- HIV Policy Resource Bank
- Transgender Law Center Research on Trans and Non-binary People’s HIV/AIDS Experiences
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Included Health Co-Founder | Health Equity Advocate | Healthcare Investor |