AIDS Awareness Month: We Still Have A Long Way To Go
It’s December, HIV/AIDS Awareness Month. We’re on the cusp of 2020. New York, along with many other major cities in the US set goals that, by 2020:
-90 percent of people living with HIV will know their status
-90 percent of people diagnosed as positive will access antiretroviral therapies (ART)
-90 percent of people living with HIV who are on treatment will be virally suppressed (undetectable).
New York City major Bill De Blasio recently announced that NYC is more than on-target for their 90-90-90 goals.
According to the 2018 HIV surveillance report, New York City met its goal for treatment for HIV-positive people in general, and the data suggests that in 2018, 93 percent of people living with HIV have been diagnosed and 92 percent had been virally suppressed.
While many viewed this announcement as a “win,” activists note the lack of mention of HIV-positive trans women, who have not benefitted from these efforts as much as the general population. According to a report released by the NYC Department of Health and Mental Hygiene, 84 percent of trans women had been prescribed ART and only 70 percent were virally suppressed.
It’s important to recognize that people who have been marginalized still need help accessing the care and services required to get treatment and become virally suppressed. Trans women, who face issues including substance abuse, homelessness, incarceration, systemic violence, and discrimination from the medical community, have barriers to care that need to be addressed.
There is still a long way to go. And not just in NYC, which is an outlier in terms of progressive attitudes and access to HIV treatment and preventative care. In the rural south, the situation is much more bleak. The region accounts for more than half of new HIV diagnoses, but is home to only around 25% of the nation’s PrEP-prescribing clinics, making diagnosing and treating HIV difficult.
What’s more: there is still a ton of misinformation out there, which impacts the lives of everyone.
Merck recently published results of a study it did in partnership with the Prevention Access Campaign (U=U), which surveyed over 1,500 Gen-Zers and millennials all over the country. As young people account or the majority of new HIV diagnoses, the study aimed to see how informed young people (both living with and without HIV) are about the virus.
The study found that young people are not being properly informed about HIV and its transmission. This trend worsened among Gen Z—which happens to be the population furthest removed from the HIV crisis of the 1980s and 1990s. Forty-one percent of HIV-negative Gen Z respondents said they were either not at all informed or only somewhat informed about HIV, compared to twenty-three percent of HIV-negative millennials.
Stigma remains a problem. 28% of HIV-negative millennials said they have avoided hugging, talking to or being friends with someone with HIV, which is just heartbreaking.
It should be no surprise that 90% of people surveyed who are living with HIV agreed that someone may avoid sharing their status because of the fear of losing friends or family, or experiencing mental, physical or emotional abuse.
And while HIV-negative respondents expressed concerns about contracting HIV (above other STIs), over half reported that they did not use condoms or PrEP when having sexual encounters.
When it comes to U=U, the survey showed that there is still a knowledge gap among young people.
….Even among young people who are living with HIV today. Among diagnosed survey participants who were asked about the term “undetectable,” only 31% reported that it meant that a person living with HIV cannot transmit the virus sexually.
When HIV-negative participants were asked, nearly 50% reported a belief that HIV could be transmitted when someone is undetectable. What’s more: over a third of the surveyed millennials and Gen-Zers living with HIV incorrectly believe a person with HIV can stop treatment if they are feeling better.
What these results tell us is that our work is cut out for us. There needs to be more access to treatment for marginalized populations, but there needs to be systemic change when it comes to dispensing sexual health information. In a country that has no mandated, uniform sex ed curriculum — where there are still many, many schools who teach “abstinence-only” — it is no wonder people are still so ill-informed, that there is still so much stigma and confusion surrounding HIV and AIDS.
We are in a bizarre point in time. It is more than possible for folks diagnosed with HIV to get on treatment, to get their viral load down to zero, and therefore, be unable to spread the virus to sexual partners — even without protection.
Today, it’s possible to go on PrEP, which prevents people from contracting the HIV virus — even when having contact with a partner who is not undetectable. The challenges are barriers to care and misinformation: these culprits are deadlier than the HIV virus itself. Until there is increased access of care extended to the most vulnerable, and until we dispense accurate, practical, and science-based sexual health information to all of our young people, HIV and other STIs will remain public health issues.
Stay sex positive!