Just a decade ago, it seemed an impossible dream: Ending AIDS and HIV.
But science has teamed up with stigma-busting activists, community action groups and bipartisan political support to make the end of HIV a realistic goal. New York state and San Francisco already have plans in place for doing just that, and now Treatment Action Group is mobilizing to take the battle where it’s needed most: the Deep South.
“This initiative seeks to expand the monumental community mobilization that ultimately led to the development and implementation of the blueprint to end HIV as an epidemic in New York State,” said Mike Harrington, TAG’s executive director, in a news release. “Ambitious regional HIV incidence and survival outcomes require significant community coordination and unflinching support from state and other jurisdictional lawmakers. This demands robust community leadership and engagement every step of the way, particularly in regions where resources and political support are currently in short supply.”
And that applies to much of the South, which has been dubbed “Ground Zero” in the fight against HIV. While Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas are home to 28 percent of the U.S. population, the states account for an estimated 40 percent of new HIV diagnoses, 43 percent of AIDS diagnoses, and 43 percent of all U.S. HIV-related deaths, according to the Southern HIV/AIDS Strategy Initiative at Duke University.
TAG Born Out of ACT UP Activism of 1980s
Treatment Action Group was born out of the organization known as ACT UP (the AIDS Coalition to Unleash Power), which effectively thrust the AIDS epidemic into the U.S. consciousness in the 1980s. During those early days of the epidemic, many simply were choosing to look the other way while gay men nationwide were dying en masse. While some considered their tactics extreme, ACT UP did what was necessary to get all of America, regardless of their political persuasion, to take note of the fact that people were dying. ACT UP demanded the unwavering support of the federal government to address and funnel resources toward the epidemic, sometimes disrupting public meetings.
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Today, modern antiretroviral medications not only keep people living with HIV alive, but people with HIV can also expect to live normal lifespans so long as they remain in treatment. The medications also suppress the virus to levels so low that transmission becomes nearly impossible. The HIV prevention pill known as PrEP, when taken daily, wards off infection from people who may have the virus but not know it, and therefore are not in treatment. Modern medicine has made the end of HIV a reality.
Stigma, Lack of Resources Are Big Hurdles in South
But stigma and a lack of resources and political will remain the biggest barriers to ending HIV in the Deep South. TAG has teamed up with AIDS Alabama, National Alliance of State & Territorial AIDS Directors (NASTAD), Southern AIDS Coalition, Southern HIV/AIDS Strategy Initiative and SisterLove, an Atlanta-based advocacy organization for HIV-positive black women, to work to overcome these hurdles.
“How do we translate the robust science and prevention and care toolboxes into strategies that will save lives and support health? How do we mobilize to protect, strengthen, and coordinate programs and services to meet epidemic-ending goals in the fact of uncertainties regarding the future of the Affordable Care Act, Medicare expansion, and other federal health programs?” asked Tim Horn, deputy executive director of HIV and HCV (Hepatitis C) Programs for TAG. “These are just some of the questions we need to be considering, particularly if we want all regions of the United States to meet and exceed the goals of the National HIV/AIDS strategy.”
New York State’s Plan to Get to Zero New Infections
In 2014, New York Governor Andrew M. Cuomo launched a three-point plan to end AIDS in that state. The initial goal? Reduce new HIV infections to just 750 annually from an estimated 3,000 by the end of 2020. The three objectives are identifying people with HIV who remain undiagnosed and get them into treatment; keep those already diagnosed in treatment so that the virus remains suppressed and unable to transmit, and get PrEP into the hands of those at risk for HIV to keep them HIV negative.
Ending HIV, which costs $357,498 (in 2013 dollars) for lifetime treatment, would save hundreds of millions of dollars annually, Cuomo has stressed.
San Francisco Aims to Get People Tested, into Treatment
The San Francisco AIDS Foundation has launched a similar plan, focusing on testing and expanding substance abuse treatment and counseling, among other initiatives.
“The end of AIDS is within our sights,” wrote Neil Giuliano, CEO of SFAF. “Now is the time for all of us to follow the leads of Presidents Obama, Bush and Clinton and seize on a tremendous climate of opportunity.”
HIV, AIDS Still Taboo Around the Dinner Table in Black America
In a Healthline News story headlined “Battling HIV in the American South,” Pastor James Henley of Fresh Start Christian Church in Jackson, Miss. said black churches need to lead the conversations about HIV. “Do we really have a choice if we are to save our next generation? A big part of the problem, and nobody will admit it, is that in the African American home this subject is not discussed as much as it should be, if at all.”
Black men who have sex with men account for 59 percent of all HIV diagnoses among African Americans in the South. Of all black men who had sex with men diagnosed with HIV nationally in 2014, more than 60 percent were living in Southern states, per the CDC. Black women accounted for 69 percent of all HIV diagnoses among women in the South.