Monumental HIV treatment and prevention research advances over the past several years have reached a tipping point. At last July’s International AIDS Conference in Washington, DC, numerous government and non-government leaders declared that we now have the tools to achieve an “AIDS-free generation.” This aspiration was buttressed by former Secretary of State Hillary Clinton ’s pre-World AIDS Day release of the Obama administrations’ ambitious PEPFAR Blueprint: Creating an AIDS-Free Generation .
Treatment Action Group (TAG) applauded the Blueprint for reinforcing the United States’ global commitment remains strong, comprehensive and driven by science, we recognized that the plan far surpassed those in place to achieve clear and measurable domestic targets, as specified in the 2010 White House release of the National HIV/AIDS Strategy(NHAS). In turn, TAG has fortified its efforts to end the inertia in a country where more than 15,000 people continue to die with an HIV diagnosis annually and the infection rate remains around 50,000 per year.
In December and June, TAG convened meetings of HIV activists, service providers, researchers, and government agency directors to address glaring disparities in the U.S. treatment cascade, which begins with only 80% of those with HIV being aware of their status and ends with only one in four being effectively treated with antiretroviral therapy. A key advocacy priority borne out of the meetings was the development of a research agenda to ensure that policy and care programs reconfigured to address these gaps are based on sound data, particularly within the context of implementing the Affordable Care Act, Medicaid expansion and the uncertain future of Ryan White CARE Act funding.
Short of highly effective and affordable cures or vaccines, the push to get more people living with HIV into care and on treatment—and people at risk for HIV into services that can reduce the risk of infection, such as counseling, mental health services, recovery programs, pre- and post-exposure prophylaxis and clinical trials of novel biomedical prevention technologies—is, in many respects, a final frontier of HIV activism.
TAG and its dwindling band of HIV advocacy partners can’t do this alone. Working against the economic downturn and legislators on both sides of the aisle who have become increasingly hostile to disease-specific research and program funding, we require all the political capital we can muster. Where are the coalitions of women’s and minority health organizations? Most distressing is the absence of LGBT leadership from any of the conversations taking place; marriage equality will do precious little to remedy the burgeoning incidence, morbidity and mortality rates among gay and bisexual, particularly same gender-loving young men of color.
As the saying goes: AIDS is not over. We may have the tools needed to achieve an AIDS-free generation, but we’ve barely begun to figure out how to get them to the people who need them most. We’ve fought long and hard for these tools. We now need to ensure that this wasn’t in vein.