What did we learn from the HIV/AIDS Epidemic?
World AIDS Day 2022
December 1st, 2022 is the 35th annual World AIDS Day. This year's theme is "Equalize" highlighting that global action, including equal access to HIV testing, treatment and care, will be crucial for making progress towards ending the HIV/AIDS epidemic.
Current global challenges:
- People living with HIV continue to experience stigma and discrimination and often excluded from healthcare services
- HIV continues to disproportionately affect folks from low-income countries, especially in Africa, and those in marginalized and/or underserved groups like men who have sex with men & transgender people
- COVID-19 had a severe negative impact on the global HIV/AIDS response by shifting resources and disrupting access to treatment and health services, with the ongoing and long-term impacts still unclear
The crisis can only be solved by working together to remove barriers like unequal distribution of resources and lack of respect for human rights. But to do that, we need to understand where it all began...
1959 to Present Day
HIV (the virus that causes AIDS) was first documented in 1959—but it wasn't fully isolated until the 80s. Within that decade, then saw our first clinical trials for antiretroviral therapies (ARVs) and a global programme for AIDS research by the WHO.
By the 90s, combination ARVs could reduce AIDS-related deaths by 60-80%. The cost to manufacture these treatments went down which made them accessible for low- and middle incomes countries.
Today, the WHO set the "95-95-95" initiative, which is a new global HIV target for 2025 with hopes that 95% of people living with HIV will be 1) diagnosed, 2) receive ARV, and 3) achieve viral suppression.
But this picture of progress doesn't accurately capture the scope of the issue. Let's be clear, more can, should have, and needs to be done, and the failure to do so is a policy decision. So let's talk about it
Deliberate Neglect
Since the beginning of the epidemic, more than
80 million people have acquired HIV and more than 40 million people have died.
But it didn't have to be this way - how the AIDS epidemic unfolded is an example of how Western governments deliberately neglected a very real health crisis because it was initially reported in queer men. Read that twice. Less than 50 years ago, governments like Canada and the US, chose to ignore a health crisis because it wasn't, in their minds, a problem for straight people.
The government originally framed AIDS as only a problem for gay men, causing public discrimination as well as barriers like cutting budgets, lack of education campaigns, and delaying the much-needed research into the virus and treatments. Because of this, many affected by HIV were outted by their diagnosis, evicted, abandoned by their families, and died alone.
“We figured out that this wasn’t just a virus that was killing us. It was that no one was doing fucking anything.
Even medical staff in hospitals worked under a cloud of ignorance and fear. Nurses were wearing space suits, not delivering meals, not cleaning out bedpans because they were afraid to go into patients’ rooms . . .
It was awful.”
Community response
With the lack of government support, it was Queer local leaders that had to fill the gap and fund education, close gathering spaces, and fund research, because the government was silent.
We're still reaping the benefits of this community care that came from such a dark time in history. This past year, during the surge of Monkeypox (now MPX) cases —which was publicized as an infection for men who have sex with men just like HIV was—Queer communities were ready. Decades of locally-led education meant that access and promotion of vaccines happened fast and large waves of infection were avoided because of it. The community was ready. The government wasn't. And the stigma was still very much there.
Communities that were hit hardest by HIV have come a long way despite a lack of government support, but many marginalized groups are still undersupported and disproportionately affected by HIV.
The Canadian Context
By the end of 2020...
About 63 000 people in Canada were living with HIV, and just over 1500 were newly infected (a decrease from previous years)
Although the rate of infection among men who have sex with men decreased, the rate of infection among other vulnerable groups (e.g., people who inject drugs, Indigenous Peoples, women) have increased
Canada achieved 2 out of 3 UN 90-90-90 HIV targets (% diagnosed and % with suppressed viral load)
IN THE NEWS: Canadian Blood Services recently committed to ending its policy restricting men who have sex with men from donating blood. However, the new policy, which uses high-risk behaviours such as anal sex instead of gender/sexuality as a screening question, is still discriminatory and disproportionately affects folks from certain groups such as those in the 2SLGBTQIA+ community
Stigma and Misinformation
On top of all of that, today people with HIV (often self-labeled as Poz) still experience high levels of stigma.
This is despite the fact that STI testing and education around safe sex are much more common in queer communities. So much so, that in recent years, rates of HIV infection are higher in heterosexual people than in homosexual people.
Part of this difference is driven by both stigma and misinformation about HIV, which sets the straights up to practise unsafe sex and further stigmatizes queer people, and those who are HIV-positive. Lack of government support for proper education on sexual health and HIV services also plays a big role in perpetuating stigma.
How can we address it?
Talk about it (helps to normalize the topic)
Learn about it (helps decrease misinformation)
Challenge beliefs (yours and others)
What have we learnt from the HIV/AIDS Epidemic?
Depends on who the we are referring to. The 2SLGBTQQIA+ community learnt a fuck tonne. They learnt that it isn't the government and the systems in place that will protect them but that the Queer community had to take care of themselves. This, by the way, is unacceptable on our government's part.
If you're referring to Canada - we didn't learn enough. This is visible not only in ongoing barriers faced by the queer community today, seen in the mpox spread earlier this year or in the blood ban. So on this International AIDS Day, how can we demand our government to address stigma, barriers and access comprehensively - both here in Canada and worldwide?
Because If our government could willfully neglect a national crisis because they deemed it a 'gay issue;— what issues is Canada willfully neglecting today? What are we, the people, complicit in allowing them to deliberately neglect?
What can I do?
There's a lot we can all do this World AIDS Day!
Buy a Red Ribbon
Go to www.worldaidsday.org and wear a ribbon to show your solidarity for global progress towards ending the HIV/AIDS epidemic.
Get Tested
Testing is one of the most effective measures you can take to end the HIV/AIDS epidemic. Get tested regularly for STIs including HIV (a common rule of thumb is every 3 months or every 3 sexual partners,
if you're sexually active!)
Commit to Unlearning
We still have so far to do in reconciliation between the queer community and government bodies. Educate yourselves and your community about the stigma and stereotypes around HIV.
