Fear, Shame and Stigma Cripple Us

Thanks to medicines and medical progress, HIV can be a manageable, chronic disease. Most infected people can live a normal, relatively healthy life as long as they are diagnosed early enough and take their medication as prescribed. Today’s antiretroviral drugs suppress the viral load – (they lower the amount of HIV virus circulating in the bloodstream) – to the extent that someone in appropriate and regular care who is taking medicines as prescribed is healthier and has almost no risk of infecting someone else. That’s a game-changer for all of the folks dating or in relationship with anyone with HIV, and all those who have spent so long afraid. Treatment, is in some important ways, prevention!

But, nationally, only about a third of HIV-positive people reach the point of being and staying virally suppressed. That’s because 18-20% of people with HIV have not tested and do not know they are HIV positive. Additionally, too few people have easy access to appropriate care and medicines – and even amongst those who begin care too many are not able to stay in care, and thus are not able to reach or sustain viral suppression. 

This HIV Cascade or cycle is worst in environments high in poverty, high in stigma/shame, and with significant racial disparities in health education and access. The conversations Center Staff and I are having with too many in the LGBT community are filled with crippling fear, shame and stigma - fear that prevents regular HIV testing, stealing the chance for early detection and treatment.

But San Diego can change all that. People living with HIV/AIDS can receive medicines, care, respect and fair treatment. They have an illness that can be treated and doesn’t need to be transmitted. 
 
We can help those not testing regularly to get tested. Early detection of HIV gives everyone their greatest chance at living a healthy, normal, long life. Silence, fear and stigma limit our chances for that full, healthy life. We can help all those without easy access to care, to get into appropriate HIV care and to be able to stay in care and achieve viral suppression.

San Diego has incredible care available for HIV – but that care cannot be effective if we do not focus on reducing fear and stigma, on regular testing for the untested and on getting/keeping all people in care. Education and information can make a huge difference. Fear, shame and stigma cripple us.

Together we can reduce new cases of HIV in San Diego to zero. Together we can  #bethegeneration

Be the Generation

When AIDS first hit us, it was like a bomb went off in our community, leaving too few survivors. A generation of gay men suffered and died. Some buried partners. We all buried friends - too many friends. In spite of our grief and fear, we fought for compassionate care and medical interventions. We fought for funding and against government silence. We fought to end a plague that decimated our community, and to make the dying stop.

That fight was bold and courageous. More than three decades later, our efforts to end this epidemic must be equally bold. We still mourn our profound losses, but today we have increased knowledge and better tools to fight with.

Unfortunately, the stigma and shame remain. But we are dealing with a virus, not a moral condition. We have to fight through that stigma and shame, and talk openly to get to no new cases - through testing, treatment and new prevention tools.

The San Diego LGBT Community Center, which has been part of the fight since the beginning, remains committed to the battle against HIV/AIDS. Today, The Center and AIDS Walk San Diego call for San Diegans to join us and commit to reducing new cases in San Diego to zero within the next ten years.

We can be the generation that fights to end new cases, that stops the epidemic-level spread of HIV/AIDS. We can make it happen.

To reduce new infections, we must provide HIV/AIDS education without shame or fear, as well as access to condoms and medications for all who choose them. PrEP (pre-exposure prophylaxis - treatments like Truvada) and PEP (post-exposure prophylaxis) are revolutionary tools in this fight, and offer the most promising hope we have seen in prevention. There will be even more next-generation drugs behind these.

We must ensure those who have the virus can access the medical care and medications that will keep their viral loads undetectable so they will stay healthier and much, much less likely to transmit the virus. We need everyone to get tested and encourage others to do the same - frequently. With an intensified focus on prevention, testing and treatment, new infections can and will decrease. Ending new cases will decrease the transmission rate, which will help end this epidemic.

What will it take to end the epidemic in San Diego?

It will take Courage to face the fear and be willing to have the conversations that educate and support. It takes Clarity to create a plan designed for success. We need elected officials in the City and County to come together with the community of HIV activists, educators, healthcare professionals, service providers, business and community members to create a clear and achievable plan to end the epidemic levels of HIV in San Diego. And it will take Commitment to educate, to use the tools that we know will work and execute a plan designed to win. Courage, Clarity, Commitment.

With an intensified focus on education, prevention, testing and treatment, new infections can and will decrease. Ending new cases will decrease the transmission rate, which will help end the epidemic levels of this virus.

California has the second largest number of HIV and AIDS cases in the Unites States. San Diego County has the third largest number of HIV and AIDS cases in California. More than 20,000 San Diegans are living with the virus. Isn’t it time San Diego made a commitment to get to zero new cases by 2024?

Let’s end new cases of HIV/AIDS in San Diego. Let’s do it for those who fought before us, and for ourselves. Let’s do it for those we’ve loved and love. Let’s do it for those that come next and could grow up in a world less afraid of this virus. #bethegeneration