On World AIDS Day 2015, there is some risk in resting on the considerable successes in treatment AND prevention of HIV. The capacity to treat HIV using one or two tablets per day changed a disease that many called a “death sentence” to being a chronic illness that can be controlled with daily medication, similar to Type II diabetes. Strong scientific evidence shows that the risks for transmitting HIV to ones’ sexual partners are low for those living with HIV/AIDS who successfully use their medications to sustain elimination of virus in circulating blood. This finding shows that treatment IS prevention and led to policy changes in most countries to start treatment early in HIV infection, no matter the t-helper cell count. More, HIV-negative men who have sex with men (MSM) can greatly reduce their risks for HIV infection even when their sexual practices are at high risk by taking daily oral antiretroviral medication, especially when using condoms consistently. Using antiretroviral medications by HIV-negative MSM is effective biomedical HIV prevention.
While these events should be (and are being) celebrated, the impact of this success is uneven – with the impact seen most in individuals who have healthcare and economic privileges. At the same time, those who need these effects most are among the last to access the treatments. In the United States, Black MSM account for a disproportionate percentage of those who become infected with HIV, while keeping all other variables constant. More, in Los Angeles, the rate of HIV infection among Black MSM who have condomless anal sex is between 5-7%, a rate that has yet to budge even in light of all of the successes in the HIV treatment and prevention fields. (This rate of infection, by the way, is comparable to the highest rates of infection found in any group on the planet.) What is deafening is the silence about this situation at all levels — from policy and decision makers to our communities and informs some aspects of the answer to the question of whether black lives matter in the United States. Let this situation become unacceptable for even one day more. On this AIDS Day, it’s time to rally to ensure initiatives are enacted to reduce this important healthcare disparity, to reduce the number of new infections in communities of Black MSM and to provide evidence that black lives, indeed, do matter.
— Dr. Steve Shoptaw
