One day there won’t be a virus known as HIV and the last person living with AIDS will have died, not from the disease itself, but from old age. You ask, how can I be so sure of the accuracy of my crystal ball? With early treatment and the community viral load falling, with South Africa fully committed to having every one of its HIV-positive citizens receiving adequate antiretroviral therapy, with UNAIDS stating goals of having every nation on the planet reaching undetectable status by the year 2030, it could become a reality. But a slow-paced reality, as political skirmishes, dire poverty, poorly distributed resources, and even outright war and refugee crises exploding across the Middle East, cloud up the crystal ball.
Forecasting the end of AIDS is ultimately vague in a complex world with so many barriers to access. The HIV-free horizon is going to shift farther away, and then shift again. In the eighties, researchers gave up promising an AIDS vaccine by a certain date, realizing in part that hope was not going to solve the puzzle, and, although we have a vaster amount of scientific knowledge in 2016 than we did then, it may be better to keep the goal of ending AIDS untethered to any fixed deadline and focus on clear-thinking initiatives in the here and now.
We will get where we need to be if we stay on track and if we build on our strengths and overcome our challenges. For example, the UN has dedicated its efforts to provide HIV-related services to women and girls, building on programs to eradicate mother-to-child transmission but also committing to halting key drivers of HV risk—gender inequalities and violence against this population. Women were forgotten in the early days of the epidemic here in the U.S. They were misdiagnosed and excluded from clinical trials, to name two of the most egregious errors in judgment. In this issue, A&U columnist John Francis Leonard interviews Tim Murphy about his new novel, Christodora, which creates a portrait of a woman battling HIV in 1980s’ New York City. It’s a sharp corrective of representations that too often focus on white gay men.
While the federal and state governments here in the U.S. have steadfastly supported the Ryan White CARE Act, which in turn fuels innovation in HIV healthcare delivery, our government is not up to speed on reforming or revoking HIV criminalization laws, and justice is not being distributed equally across serostatus. The unjust laws, based on outdated science and fear and stigma, are being slowly changed thanks to the work of groups like Positive Women’s Network—USA and The Sero Project. This work is much needed—just read A&U Editor at Large Chip Alfred’s interview with Ken Pinkela, whose positive status became the focal point of a military witch hunt, in this issue.
Alongside addressing barriers to access globally and HIV criminalization, initiatives to support HIV cure research have also gained steam. A&U’s Alina Oswald, in this month’s cover story interview with Timothy Ray Brown, the first HIV-positive individual to be cured, examines the advocate’s efforts to support research. With The Cure for AIDS Coalition, Brown hopes to create a hub of knowledge and action: “I’m proof that HIV can be cured. But we have to find out better ways to do it, because nobody wants to go through what I went through….” He is referring to his stem-cell transplants, which were a costly and difficult success that has not yet been reproduced in others, though it is being studied as part of the EPISTEM Project, for example.
If we stay on top of healthcare access and health justice, as well as cure research, we will direct our own destinies. We still do not know the how and when of the end of AIDS, but we will always know the why.
David Waggoner is Editor in Chief and Publisher of A&U, the first national HIV/AIDS magazine in the U.S.