World AIDS Month Highlights Need for Community Activism

With December’s designation as World AIDS Month, a leading expert says the HIV/AIDS stigma remains a tremendous holdback in stemming the epidemic.
“We have exquisite scientific tools in our toolkit of treatment and prevention,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, known for his long-standing contributions to HIV/AIDS research.
“If you identified everyone who was HIV infected and put them on medication, you could save their lives and make it impossible to transmit it to their sexual partner,” he said. “And if [Americans] at-risk took a single pill of [Pre-exposure prophylaxis (PrEP)], it could decrease by more than 99 percent the likelihood they’ll acquire HIV infection.”
Yet fewer than four in 10 of the estimated 1.1 million Americans who need pre-HIV infection treatment have adequate access to proven therapies and healthcare, Fauci said.
Research shows the problem is concentrated in rural areas in seven Southern states, he said: Alabama, Arkansas, Mississippi, Missouri, Oklahoma, South Carolina and Tennessee.
Fauci is one of three healthcare leaders who have compiled a 10-year plan to deal with the issue. It’s called Ending HIV Epidemic (
The initiative seeks to reduce the number of new HIV infections in the United States by 75 percent within five years, and then by at least 90 percent within 10 years, for an estimated 250,000 total HIV infections averted.
The solution isn’t a cookie-cutter one because the at-risk groups are so diverse, Fauci said. “Men who have sex with other men who are African-American (one of the at-risk groups) are not the same as transgender white women, who are not the same as injection drug users, who are not the same as commercial sex workers.”
One key step is to create teams of local community people to help expand HIV prevention and treatment services with an aim to end the stigma.
“Stigma is really the big enemy of public health,” Fauci said.
Globally, 37.9 million people live with HIV, but because of gaps in care, 770,000 people died from HIV-related causes and 1.7 million became infected in 2018, according to the World Health Organization (WHO).
WHO issued new guidelines on Nov. 27 that recommend people do self-testing; endorse using social networks for HIV testing to reach high-risk people with inadequate access to testing services; and encourage countries to adopt a standard HIV testing strategy using three consecutive reactive tests to confirm a diagnosis, rather than two.
Winnie Byanyima, executive director of The Joint United Nations Programme on HIV/AIDS, issued a statement lauding activists and community members who campaign for services and work daily to raise awareness.
Byanyima said in a statement that governments have committed to ensure that at least 30 percent of HIV services be community-led and that 6 percent of all HIV funding go to community mobilization, promoting human rights and changing harmful laws that act as barriers to ending AIDS.
“Let’s be clear,” she said, “defending human rights and challenging discrimination, criminalization and stigma is risky work today.”

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