Show Me the 'Get to Zero' Money!

I have been to four International AIDS Conferences, and although they have all been interesting and inspiring, the conference in July was especially wonderful for the mere fact that it was held at home. Having the conference in the U.S. showed that our advocacy had worked. By lifting the HIV travel and immigration ban, we triumphed over stigma, bias and discrimination. We do not often have absolute victories in our social-justice work.

What was also captivating about this conference was the vision of an AIDS-free generation that was often invoked. It has been a long road since I lost my first friend to AIDS back in 1982. Throughout most of my adult life, the losses have continued to add up, so the possibility of ending AIDS is enticing and uplifting. I didn't just hear that message; I believed it. We have the tools to get to "zero new HIV infections," though I am not convinced we have the collective commitment yet. And we definitely don't have the "get to zero" money.

With additional funding, we could increase GMHC's work, expand outreach to women and gay men, provide more testing opportunities and improve treatment adherence. We could make more headway in fighting the structural barriers that place people at higher risk of HIV, and those that block people living with HIV/AIDS from accessing services.

But there is not sufficient funding from the federal government, particularly for prevention programming. Many foundations and private entities do not recognize the complexities of this epidemic. They do not comprehend that structural challenges interfere with achieving good health outcomes. Some of these challenges include the lack of comprehensive sex education for gay youth, insufficient child-care options for mothers who are working or accessing care services, the need for life-skills workshops for elders and the failure of our society to provide support for black men, who are made to feel worthless and emasculated, or women, who are not respected and may experience other stigmas.

While enough is not being done, we absolutely know what works. We know a sustained campaign targeting gay men with a message -- "you are worthy" -- and an increase of affordable housing and culturally relevant resources for HIV prevention would be effective. We have come to recognize that medical treatment is prevention. However, I struggle with the reality of individuals who have doctors but have not successfully suppressed their viral load. Why aren't they achieving that goal? Having a doctor is not enough. Having medications is not enough. Knowing your status is not enough. We need to ensure that people living with HIV are able to achieve this goal, too.

I left the conference conflicted. I have hope and enthusiasm, and now more than ever, it's clear to me that we can win this fight. I am also anxious and agitated about receiving this good news, but I am not sure this good news will be realized. It's like having the keys to the kingdom but being unable to find the door.

As we move forward in the fourth decade of the epidemic, our challenges at GMHC are to continue to do the things we know and to continue to fight for what we know will get us to zero new HIV infections.