June 6, 2011

June 6, 2011
The 4th Decade of HIV

Welcome to another day in my life. Today is Monday and I hope you had a safe and great weekend. It is a very busy week for Dab the AIDS Bear while doing the AIDS Life Cycle from San Francisco to Los Angeles.

Today we begin the fourth decade of America's HIV/AIDS epidemic. It was just thirty years ago, June 5, 1981, that the CDC reported a cluster of PCP pneumonia cases in young men - the first documented cases of what we now call AIDS.

It has been a hard thirty years. People we loved, including two partners of mine, are no longer here. We have had to deal with panic, ignorance, stigma, homophobia, and blame the victim politics.

But it has also been thirty years of remarkable advances. We do not have a vaccine or a cure, yet, but for the first time in years it looks like they might be in reach. We have the cocktail HAART drugs that let people with HIV live reasonably normal, healthy lives with reasonably normal life expectancy. I have colleagues here at NAPWA who became HIV positive in the eighties or even the late seventies, who never dreamed, when they were diagnosed, that they would live to see the epidemic turn thirty.

We have known since 1996 and the first cocktail drugs that living longer with HIV would change everything. Today we are seeing the reality of what we only imagined then: nearly a third of all Americans living with HIV are 50 or older, and soon it will be half. For some of us, that means living with loss and I urge you to read MSNBC's poignant story about a 78 year-old living on alone. But for many of us it means treasuring these years we never expected to have and living well. Now the highly successful Staying Alive conferences have been renamed into the 2011 National Healthy Living Summit, because it is not just about staying alive anymore. It is about living well and responsibly. It is about spreading the get tested, get treated message. It is about prevention, prevention, prevention. It is our job to spread the word.

We have proof now - Julio Montaner's groundbreaking studies in British Columbia, and the recent results of the HPTN 052 trial - that testing more people, and getting those who test positive into immediate treatment with HAART drugs, drastically reduces the number of new infections. It is actually cheaper for federal, state, and municipal health authorities to test and treat everyone they can possibly reach than it is to let people with HIV go undiagnosed, untreated, and more likely to infect others. This should change the terms of budget debates about funding for ADAPs and all other HIV/AIDS programs: we can not afford not to fund them. It is our job to drive the point home, in budget debates and mainstream media.

We know now that the concentration of HIV in marginalized communities - communities of color, poverty, drug use, alternate sexual preference - is the price we pay for having marginalized communities and a health care system that does not serve them well. The health care system needs fixing, and we can look forward to a decade long fight to defend and extend the Affordable Care Act. It is our job to defend health care for all as a human right and to call out prejudice wherever we meet it.

And we know today that the HAART cocktail drugs have long term limitations: cost and side effects. Barely two percent of this country's billion dollar HIV/AIDS budget goes into research and development of preventive vaccines and functional cures. Once again, dollars not spent this year will come back as many more dollars of costs in years to come, as testing becomes more nearly universal and we face the drug cost of immediate HAART treatment for all positives. It is our job to focus the minds of policy makers and elected officials on the need for more basic research towards a vaccine and a functional cure.

It is our job. We are the generation that can make AIDS a memory.

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab