Today is World AIDS Day. When I first started this work the saying on AIDS activism was Silence = Death. In those pre-treatment days, death was a quick reality for too many. Getting to Zero has been the slogan for the last couple of years. You also hear about an AIDS Free generation. Neither of these things are realities yet, but can we say that we have the end of AIDS in sight?
There is an array of HIV medications to manage and stall progress of the disease. Experts suggest that people diagnosed now with HIV could have near normal lifespans if they have access to treatment. With programs like Treatment as Prevention, touted here in BC for all people with HIV (and increasingly around the world), rates of new infections could decline significantly. When treatments control HIV levels in the body, people are less likely to transmit to their partners. With fewer new infections – and better health for those who are infected – HIV related health issues decrease. With fewer hospitalizations, overall costs for medical care decrease. We can’t forget money in the story, because it is a huge player.
Bringing an end to AIDS could happen in various ways, and all of them need money. Treating people who have the virus is a solid approach, but it takes a lot of investment, and a lot of governmental will behind that investment. It takes money to reach all people needing health services, and money to follow up.
Addressing the social factors of HIV infections is harder, even with money. Global cultural norms that paint homosexuality as morally wrong and evil need to shift. Sexist and misogynist attitudes towards girls and women need to change. Shaming and degrading sexuality needs to turn around too.
In North America there have been changes in public perception and law – homosexuality is normalized in popular culture on TV and other forms of media. Same sex marriage was legalized in Canada in 2005 and is making its way across many American states. It’s a measure of acceptance, but there is still much to do before full equality exists and members of the queer community feel safe in their neighbourhoods.
That same popular culture depicts girls and women as sexual objects to pluck like fruit. (Women always want that, you know.) In the US, regressive politicians are fighting mightily to repeal health policies and laws about reproductive health issues like birth control and abortion.
UNAIDS talks about the goals to strive for by 2015 which include
- Countries with punitive laws and practices around HIV transmission, sex work, drug use or homosexuality that block effective responses reduced by half;
- HIV-specific needs of women and girls are addressed in at least half of all national HIV responses;
- Zero tolerance for gender-based violence.
That’s a heck of a lot of work, friends, and it’s not even the whole list. HIV is not just a physical disease but one of social determinants of health, culture, gender, race and geography. We’re not at the end of AIDS, for sure, but there are plenty of people out there pushing for it.
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