Talk That Talk

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Frontdesk by David Waggoner

Talk That Talk

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Since the beginning of the epidemic—as it was first reported by The New York Times on July 3, 1981—the amount of ink (as well as electronic ink) about HIV and AIDS has wildly fluctuated. When Rock Hudson disclosed his HIV status, condoms were discussed for the first time around the dinner table of millions of Americans; when Magic Johnson came out as HIV-positive, testing skyrocketed, and AIDS awareness was driven home to both the suburbs and the sports arenas. And then there was a deafening silence.

It was as if AIDS had all but disappeared, or it became a “problem” only in Africa and Asia, according to the media. But guess what? The number of people now living with an end-stage form of AIDS in the developing world has gone down for the first time. Why? Nearly one out of three persons living with the virus in Africa is taking at least one form of antiretroviral therapy. And those that were near death are now thriving. In South Asia the figure is one in four. Hardly 100 percent, or universal access, but certainly a vast improvement over the situation just three years ago. For all the good news abroad there are some sobering statistics right here at home. Less than fifty percent of Americans living with HIV see their docs on a regular basis. Ironically, the percentage of people in HIV care in the United States is lower than in some so-called emerging countries like Brazil. America has the most expensive healthcare system in the world; but also one of the least efficient. Partly it’s due to the fact that not everyone who is HIV-positive in this country knows their status. The fact is that living with HIV isn’t easy; even with the newer drugs—which require less complicated dosing—disparities in healthcare delivery still occur.

But let’s not complain too much. Let’s go back a decade or two. One particularly bad year was 1994, just a few short years before the advent of protease inhibitors. I remember reading more AIDS-related obituaries that year than any year before—many friends in their forties and fifties, the first generation of AIDS, were finally succumbing to AIDS-related opportunistic infections. These days, those who are long-term survivors over fifty are those who benefited from the first round of protease inhibitors, and they are still alive today due to even newer classes of AIDS drugs. In this issue, Larry Buhl investigates the latest on HIV and aging; first he uncovers services and support available (or not) to those over fifty and positive, and then he delves into the specific health challenges for those facing their golden years. And they can be golden. As he suggests, it’s never too late to thrive.

Also, in this issue, the cover story with actor and author Hill Harper proves it’s never too late to thrive for anyone, in any circumstance. Whether he is writing about AIDS advocacy or fighting for social justice, Harper believes in the power of positive thinking as an essential part of activism.

Speaking of the power of the written word, America’s leading activist of AIDS journalism, Patricia Nell Warren, contributes her final Left Field piece for the magazine after a tenure of fourteen years. Over the years “Patch,” as she is known to the A&U staff, has explored government corruption, drug pricing, and religious ideology, to name a few issues. We will sorely miss her unfettered voice in an age of media constraint. PNW is never afraid to swim against the currents of mainstream AIDS media. She will continue to write, and surely she will be one of the journalists to report on the end of AIDS, when that time comes.

From villages in Botswana to Greenwich Village in New York, we are working toward that end. HIV is no longer out of control. Breakthrough medicines are keeping the virus undetectable. Poor countries and rich countries alike are sharing in the wealth of knowledge, treatment options, and continuing care that is required to reverse the devastation caused by AIDS. First there were doctors without borders; now, increasingly, there are patients without serious disease.

As Hill Harper tells us, “Awareness is very important in this epidemic. We need to talk about it…because it saves lives.”