The AIDS crisis never ended – and COVID may even have made it worse
Denver’s report earlier this month that an unnamed woman being treated for leukemia may have become the third person to be cured of AIDS, made headlines around the world. More than four decades in a crisis that has killed nearly 80 million people, the news offered real hope that the end of AIDS was on the horizon. It also served as a powerful reminder, two years after another deadly outbreak began, that this one never went away.
The US government believes that 1.2 million Americans are living with HIV, the virus that causes AIDS, and about 13% of them don’t even know they are HIV-positive. That’s more than the number of Americans who have Parkinson’s disease Where multiple sclerosis. Although the HIV death rate has fallen since its peak in the 1990s, there is still among the ten leading causes of death among people aged 25 to 44. (While HIV diagnoses fell for most age groups between 2015 and 2019, they stable in young adults.) And HIV, like COVID-19, is much more prevalent and deadly in the most vulnerable populations.
“As you draw parallels between the HIV and Covid epidemics, I don’t think people were surprised to see the same racial disparities emerging. One of the sad things to think about is the reality that black men and Latino men, black women, and Latino women, and certainly transgender women, are disproportionately affected by HIV,” says Marc Meachemthe head of U.S. external affairs at ViiV Health, a company solely focused on HIV and AIDS treatment and research. “These disparities were there at the beginning of this epidemic. And because in the beginning the face of HIV activism was really a white gay male face, I think that made people think that it’s was a problem that was limited to them. These disparities are enduring, and still there.”
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Shows like “Pose” highlighted the devastation of AIDS for trans women and people of color, but left the story in the past. The numbers tell a different story. While the impact of the COVID-19 pandemic has yet to be calculated, the CDC estimates that in 2019, 34,800 Americans were newly infected. That number is likely to rise as pandemic restrictions have led to a drop in testing and treatment. “At worst, it potentially brought us an increase in cases for at least the next two years,” Emory University researcher Samuel Jenness told Fortune last year.
Dr Sarah Bauerle Bassassociate professor and director of the Risk Communications Lab at Temple University, says: “COVID is everywhere. It’s occupying everyone’s brain and it’s all everyone talks about. This kind of thing repels anything that might be important, especially for young people who are sexually active. They don’t get the information that really makes them feel like it’s a risk that I need to listen to. She just says: “Wear a mask and use a condom.
And these tips are especially important for people in high-risk groups. Almost a quarter of people living with HIV in this country are cisgender women, and heterosexual women are diagnosed at more than twice the rate of heterosexual men. The CDC also notes that “Black/African Americans make up 13% of the US population, but 44% of new HIV diagnoses, [and] Hispanics/Latinx make up 18% of the US population, but 30% of new HIV diagnoses.” As Meachem explains, “When you look at the lifetime chance of contracting HIV, statistics indicate that between one in two and one in three black gay men may contract HIV. Similarly, for Latino gay men, that number is one in four.”
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What is happening and what can be done? The first challenge is to reduce transmission.
“We don’t talk about HIV like we used to,” says Dr. Bass. “People, especially young people, don’t get much of this education in school like they used to. There used to be AIDS-specific health education in most school districts. , or it’s kind of just wrapped up in a general discussion about sexually transmitted diseases. You just don’t have that kind of level of heightened awareness anymore. I think that’s why we’re starting to see this increase in infections in some of these younger populations.
Dr. Gary Blickthe chief physician of International healthcare advocates, accept. “Education in schools is a problem,” he says. “I care for so many transgender kids who don’t get HIV education in school, who haven’t even heard of PReP [pre-exposure prophylaxis]. Can’t you talk about PReP in high school when you get your sex and health education classes? What really troubles me is that we still face HIV-related stigma and discrimination. I think that’s probably our biggest hurdle to overcome.”
Another huge challenge is getting – and keeping – treatment. Dr. Bass says, “You certainly see what we would call the continuum of HIV care. From the time someone is HIV-positive and receives care and is on antiretroviral therapy, you see a decline at every stage. People get tested but don’t. enter care, or maybe people start care but then drop out of care, or people start taking antiretroviral therapy but then stop or don’t adhere to that antiretroviral therapy. these different stages often don’t have health care or have the kind of health care that won’t pay for long-term antiretroviral treatment. in this chronic condition.”
For people who have health insurance and access to effective care, there is good news. Science has come a long way in prevention and treatment, which means more people at risk are living longer, healthier lives. Just this month, the FDA approved a new injectable treatment for HIV-1 which can be distributed every two months. That’s a big deal, given that eleven of the currently FDA-approved treatments are tablets once a day. “Going from 365 to six [treatments a year] is simply an incredible level of innovation,” says Meachem. “This daily pill for some people is a daily reminder of living with HIV. People are able to give up some of that mental space and feel freed from that burden.”
And now, this encouraging news of an individual apparently cured, thanks to a unique umbilical cord blood transplant, opens the door to even greater possibilities. The patient profile makes the breakthrough even more meaningful. “The fact that she is mixed-race, and that she is a womanit’s really important scientifically and really important in terms of community impact,” Dr. Steven Deeks, an AIDS expert at the University of California, San Francisco, told The New York Times this week.
The AIDS crisis remains a crisis. We are still a long way from eradicating the disease, and COVID-19 has presented unique challenges and setbacks to making progress. But the potential for a world without AIDS is there.
“I think people, especially in disproportionately affected populations, need to have a sense of hope,” Meachem says. “We’ve had so many struggles in the country over the past few years. I think people aren’t aware of the full extent of science. I feel like our job is to create hope . It’s telling people, ‘Listen, we can end the epidemic.'”
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