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Ask An Expert: How Is The HIV Epidemic Disproportionately Affecting Communities Of Color?

"I want to create a sense of hope and possibility around breaking the cycle of disparity." —Marc Meachem, Head of U.S. External Affairs at ViiV Healthcare
Couple smiles at home
Couple smiles at home
Getty Images Stock Photo*

Ahead of National Black HIV/AIDS Awareness Day on Feb. 7, we sat down with Marc Meachem, Head of U.S. External Affairs at ViiV Healthcare, to discuss the future of HIV care, HIV representation in media, and the end of the epidemic once and for all.

What kind of progress was made with the HIV epidemic over the past 40 years after the first case of HIV was reported in the U.S.?

Marc Meachem: In terms of the progress, I would say this is A Tale of Two Cities. It’s really a tale of tremendous progress but also tremendous disparity. With HIV — and I’ve lived through the entire 40 years of the epidemic — we went from the disease being a death sentence to it becoming a manageable scenario wherein many people can expect to live a normal life span. That’s really a testament to the science.

There’s also a humanity component to the progress: Less demanding and less persistent treatment regimens offer many people emotional and practical benefits. We also now know based on the science that if you’re on HIV treatment and you’re undetectable, you cannot transmit to a sexual partner. That knowledge is a huge relief in terms of the humanitarian progress of HIV.

However, not everyone has benefited from the scientific and humanitarian progress equally. Certain communities remain disproportionately impacted by HIV and so, even after 40 years of progress, there’s more work to be done.

Couple walks down metropolitan street
Couple walks down metropolitan street
Getty Images Stock Photo*

As we approach National Black HIV/AIDS Awareness Day on Feb. 7, I’d like to ask about the significance of this anniversary. From the perspective of ViiV Healthcare, can you speak to the importance of this day of observance and why it’s imperative that it remains distinct from commemorative days such as World AIDS Day?

MM: National Black HIV/AIDS Awareness Day, or NBHAAD, highlights the fact that the standards of care for HIV prevention and treatment do not reach everyone equally. For Black men who have sex with men, the statistic is that one out of every two men will acquire HIV; for Latino men, it’s one out of four. The standard of care for HIV doesn’t affect everyone the same way. So that glaring disparity is the key issue.

There is also a misperception that HIV is a gay man’s disease, and of course that’s not true. Black women, for example, are 12 times more likely to acquire HIV than white women. The false notion that this disease doesn’t affect women — that it only affects gay men — is harmful and provides a tangible disservice to all people, particularly women of color.

Representation is important. Empathy is important. Understanding who this disease affects and how is a must.

What is your response to the Biden administration’s recent press release regarding its National HIV/AIDS strategy?

MM: ViiV Healthcare 100% supports the Biden administration’s strategy. The goals are crystal clear: The administration is working to prevent new infections, ensure people living with HIV have good health outcomes, and reduce the disparities we’ve been talking about here.

The goal is to end HIV by 2030. In order to meet that goal, the heavy lifting has to happen between now and 2025. My hope is that people will understand that if you keep doing the same thing, you’ll get the same results. We have to ask ourselves, What can we do differently? We have the reality of these horrible imbalances that exist between communities. We’ve got to do something different.

Girl on the beach using phone
Girl on the beach using phone
Getty Images Stock Photo*

Can you describe the impact COVID-19 has had on the Ending the Epidemic HHS initiative, as well as on the community of those living with HIV?

MM: This is the understatement of the century, but it’s created a divergence. The healthcare workforce has shifted focus to COVID, so resources that may have otherwise been allocated toward HIV/AIDS have of course been scarce. The COVID pandemic also highlighted the inequalities. I don’t think the racial disparities of COVID surprised anyone. It makes clear the work that still needs to be done in this country. I think that if we keep up the status quo, we can’t expect different results.

Of course, there’s also been a lot more public health presence. So on the positive side: Can we build on that beyond COVID and take that momentum into the treatment and care of people living with HIV?

What are your thoughts on media representation and communications initiatives being culturally relevant and representative of POC communities?

MM: Things have changed so much, but there’s still room to grow. There was a time when there were just a handful of media representations of people of color. And those stories were directed, told, and written by white folks. It wasn’t from our perspective and they weren’t our stories.

Now we have Black creatives, Latinx creatives, Asian creatives telling their own stories. That was a big breakthrough and we need to continue in that direction. We don’t want to see a caricature, but rather the breadth of our humanity.

When we’re exposed to the breadth of different experiences and humanities, doors open. Culture allows people to address serious issues and to have breakthroughs and to take action.

Group of friends together at night
Group of friends together at night
Getty Images Stock Photo*

Where do we go next to end the HIV epidemic once and for all?

MM: The resources that we have for HIV don’t always trickle down. When you look at the communities that are supposed to be receiving these resources, that money is just not having the impact it’s meant to. And so the question is, what is it that needs to be done from a systemic point of view? What kind of change can we demand for the investment that’s being made?

It takes money to generate these advances in society. For community-based organizations, we tend to expect them to solve some of our biggest problems with the leanest budgets. That’s a deep and ugly falsehood.

We need to find ways for these resources to get into the communities that are consistently underserved. You can see the lack of resources in these communities and so we’ve got to find a way to get more of these essential tools into those communities.

Friends help each other fasten earrings
Friends help each other fasten earrings
Getty Images Stock Photo

Any final thoughts?

MM: It’s easy to feel as though it’s always been like this, that it’s always going to be like this. The reality is, we can end the HIV epidemic. I want communities to have hope and to understand that things have changed. I want to let people know that we can do this, that we have a set of tools to accomplish this on the biomedical side.

Because of the lack of visibility and representation in media, the stories and realities of the impact of HIV on communities of color were never really told. But within the communities, those stories live. The reality of the disparities lives. I want to create a sense of hope and possibility around disrupting disparities.

National Black HIV/AIDS Awareness Day is Monday, Feb 7.

*Stock photos are not meant to imply that the models depicted have HIV.

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