Turning the Tide


By Ernest Hopkins, Director of Legislative Affairs

Every two years, the global AIDS community gathers to share ideas on HIV prevention and care, learn about the latest medical advances, and renew our shared commitment to ending the HIV/AIDS epidemic. This year’s International AIDS Conference (AIDS 2012) in Washington, D.C., was the first held in the United States in more than two decades. It provided an important moment in the epidemic for us all to collectively examine where we stand and what we must do to create the AIDS-free generation that President Obama so boldly envisions.

The conference gave domestic advocates a wonderful opportunity to learn more about pre-exposure prophylaxis, or PrEP, and how this HIV prevention method can and should be implemented at the community level. The FDA has approved the drug Truvada for use by HIV-negative individuals at high risk for infection as part of a comprehensive prevention package that includes regular condom use, HIV testing, and risk reduction and adherence counseling. Now gay men, transgender people, and the HIV-negative partners of HIV-positive people, in particular, have another effective tool to prevent HIV infection. San Francisco will soon play a pivotal role in the future of PrEP when it hosts several upcoming demonstration projects and studies to determine the most effective ways to deploy this new tool, including how to get it to people who need it most, how it will be delivered, and how to pay for it.
 
AIDS 2012 also provided incontrovertible evidence that, while new HIV infections are going down in the majority of populations, the number of infections continues to rise in gay men. Moreover, young black gay men are the only group to see a statistically significant increase. This group is becoming infected with HIV at three times the rate of their white counterparts, according to interim results released at the conference from the “BROTHERS” study. That is an unacceptable statistic for our country, and we must do to more to address the reasons these young people continue to experience such high rates of infection—especially when science tells us that they are not engaging in riskier behaviors or having more sex partners than other men. The leadership of the National Institutes of Health must be brought to bear on this problem to understand and address the underlying causes of this troubling disparity.

Two years ago, President Obama introduced the country’s first National HIV/AIDS Strategy. In doing so, he provided us with a long-overdue roadmap for the path to an AIDS-free generation. This roadmap is something we had prayed for since the very beginning of the epidemic, and it clearly states that in order to make ours a country where new infections are rare, we must be strategic in the allocation of resources to address glaring HIV-related health disparities in hardest-hit communities.

Thirty years into the epidemic, sixty percent of new HIV infections occur in gay and bisexual men, and no group in this country is harder hit than black gay men. We can fix this, if we marshal the will and resources to do so. We’ve done it before. We need look no further than our efforts to virtually eliminate the transmission of HIV from mother to child in the U.S. to know that when we put our minds to it, we can reverse lethal trends. It’s time we translate this success into making new HIV infections among gay men extremely rare.

At the conference, Secretary of State Hillary Clinton reaffirmed the Obama administration’s and America's commitment to our leadership in the global pandemic. Using PEPFAR and our bilateral programs at USAID as the foundation, we will continue to partner with other nations to ensure that access to medical care, treatment, and other prevention tools like condoms and adult male circumcision are made available around the world. All this must be done and will be done with resolve and commitment to justice and health care as a human right.

Most importantly, we learned at AIDS 2012 that now is not the time to slow our efforts or let down our guard. We have made tremendous inroads in the past 30 years in the fight against HIV/AIDS, and we have more prevention tools than ever at our disposal. But until we can make those tools available to everyone who needs them, and until we can erase significant health disparities in our nation and across the globe, truly creating an AIDS-free generation will remain a dream. I know we can make it a reality.

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