HIV Science Matters
Almost 20 years ago, I began my journey in the field of HIV. Like many of my current colleagues, I had zero intention of ever joining this field. I only thought about working in cardiology or sickle cell anemia. During high school, I studied with researchers who would eventually develop the PET scan. Immediately after undergrad, I volunteered at a sickle cell camp for kids. During college, I did do some work at a local hospital while I was studying abroad in South Africa. It was the late 90's so a public hospital at that point was essentially a HIV Clinic in Sub-Saharan Africa. Still, HIV Research was not my passion.
I was happily unaware that my status as a young Black gay man meant that many of my current and future friends, boyfriends, and colleagues either were infected or would eventually become infected with the virus. But life has its twists and turns and I did eventually enter AIDS Incorporated. My first job was in basic HIV scientific research. I then went onto public health with an unyielding interest in health policy to support people living with HIV. One often hears the saying that pharma drugs go from the bench (drug development) to the streets (public consumption). Well, that goes for me too.
My life vocation has been hell bent on making sure that whatever my colleagues in HIV research did would make it to the best practices of providers and/or into the general knowledge of the community at-large. Occasionally, those scientific updates make it to the common man without much effort or pushback. For instance, part of life is eating, and sometimes certain dietary and physical habits lead to life-threatening health risks. When you have diabetes or are pre-diabetic, your doctor will tell you to take some meds, eat better, and go for brisk walks. You get to choose what works for you. And it is possible that you do not have to do all three, but get to choose from the options suggested and still have the desired results: to live a longer, healthier, and happier life.
In the land of HIV/AIDS, it is more of the same. There are quite a few activities that millions of people are doing as you read this that may lead to infection...having sex, breastfeeding, or even using substances to feel better. And I do not need to tell you that two out of three of those activities bring up a host of other issues that lead to stigma. Who you are having sex with, how you are having it, why you are having it, what kinds of drugs you use, and how you get them are just a few stigma-inducing activities. For Americans who can remember the 80's and 90's, we remember families, friends, and lovers dying far too young and often while being stigmatized and refused empathy and care from other friends and family. For many people around the world, that reality remains.
Thanks to dedicated scientists and public servants, we have begun to see that all change. People who have access to the drugs developed in the past two decades are living longer, healthier, and happier lives. But that word "access" is a huge one. And that's what we struggle with at conferences such as the International AIDS Society's that was held last week. Thousands of physicians, basic scientists, social scientists, public health professionals, stakeholders, and/or people living with HIV converged to share ideas, updates on new pharma breakthroughs, successes, and challenges. All this with one common goal: To End AIDS and reduce HIV in their respective home countries and around the world.
This is an exciting time in our field. Dr. Linda-Gail Bekker, President of the International AIDS Society, confidently declared, "Today, a pill per day will keep the HIV away and we know without a doubt that with treatment, people living with the virus cannot pass it on." Throughout this year's Conference on Science, we learned and confirmed quite a few amazing things that everyone must know:
**First and foremost, people living with HIV who maintain success treatment cannot transmit the virus to another person. That means that people can love openly without being in constant fear of transmitting the virus to their partner. Undetectable equals Untransmittable, or U=U.
**Secondly, we learned that people taking PrEP, the drug that can prevent HIV infections, can sometimes be taken in a variety of ways that better fits your life and will still keep you HIV-Free. And more options are hopefully coming soon if the proven options do not work for your life.
**Also, we are getting closer to being able to control HIV to obtain sustained virological suppression without medication. That is a fancy way of saying we are making focused and realistic steps to a cure within our lifetimes. Future generations will read about HIV in history books as opposed to experiencing it.
**Moreover, the success of engagement with communities at high-risk for infection yields better results than expected. We have seen communities and countries ravaged by HIV become the gold standard in HIV prevention and sustained treatment.
**And most importantly, we saw over and over again how crucial funding is to getting the job done. Governmental and donor support have made this possible. There is a fear that the money will be flatlined or reduced. HIV funding is at a 10-year low and there have been consequences in the States as well as globally.
We have come a long, long way in the world of HIV prevention and care. But all of that is null if the common man and woman on the street are unaware of these advancements or cannot access them. The chief of UNAIDS, Michel Sidibe, announced, "For the first time in history more HIV-positive people in the world have access to medication than need it." There are still nearly 20 million more people globally who need support to make that a reality for them as well.
In the coming days, we will make the decision if our goal to end AIDS is a far-away dream or a goal that is systematically within grasp. And I can safely speak on behalf of nearly all of my colleagues, we pray for the day that our field will be eliminated and we are all out of work. Because that would mean one thing. We competed our lives' vocations and HIV is HISTORY.