Global Health Policy Analyst
September 27th was National Gay Men’s HIV/AIDS Awareness Day. It’s the day that approximately 80 gay and bisexual men will become infected with HIV. Thirty (30) of those men will be Black. Twenty-five (25) will be White and twenty-one (21) will be Latino. Some of those men will find out about their status very early, will be engaged in competent healthcare, and will live a full productive life while managing this chronic illness. But to this day, that will be the exception and not the rule.
Like just about all viral illnesses life the flu, treating HIV right away and staying on treatment will not only stop you from getting sicker, but stop you from being able to transmit that virus to others. The same is true for HIV. Last month, Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institutes of Health confirmed what global experts had been saying for years: “Once you begin therapy and you stay on therapy…you are NOT capable of transmitting HIV to a sexual partner.” It is called Treatment as Prevention (TasP). That is excellent news. But that is only true for 30% of Americans. The vast majority of People Living with HIV (PLWH) are not benefitting from the advances in treatment due to not knowing their HIV status, lacking access to care and treatment, lacking social support, or a mix of all the above.
Of those infected each day in the United States, two-thirds are gay and bisexual men. In vast parts of the USA, gay and bisexual men do not receive the type of needed support to access and stay on treatment which puts them at risk for HIV progression and potentially transmitting the virus to another person. Due to homophobia, some men do not have support from their families, have reduced access to jobs and housing, and have had poor experiences in healthcare settings. That creates the perfect storm for the continued epidemic that has gripped this globe for over 35 years.
Today, we live in an age that PLWH can live nearly their entire expected life span IF they receive sustained treatment. We also live in an age that people can take a daily pill (PrEP) that can prevent HIV infection before exposure. And if that is not enough, we also live in an age that people can take a course of treatment that can prevent HIV infection after exposure(PEP).
But what good does TasP, PrEP, and PEP do if people most at-risk for infection are not aware of it. They are really just a jumble of letters. In my circles, it seems that everyone know about these things. But that’s not the norm. For so many, there is nearly no knowledge of these ways to treat and prevent HIV. A couple of weeks ago, I was in southern Georgia visiting my mother and we went on a mini-vacation to Jekyll Island. I was chatting with a young Black gay man who worked at the local hotel. Eventually, we started chatting about what I do and I off-handedly starting rambling on about PrEP and PEP. If you could have seen the look on his face, you would have thought that I had told him that aliens had landed in Times Square. For that young man, we had failed him. He should have known sooner.
The HIV prevention and treatment toolbox is filling faster today than ever before. But not everyone knows what is in it. Awareness, advocacy, and access will be the ultimate tools in the HIV toolbox to ultimately end HIV in mine and others’ communities. We must strive to continue not only raising awareness, but also advocating for access for gay men who have been disproportionately impacted by HIV for far too long.