Amid advances and setbacks in care, we must still aim for the end of HIV
by Jeannie Wraight
I recently read a rather angry reader comment on an article that discussed a study looking at a potential strategy as a cure for HIV. The comment-maker was the father of a six-year-old who was struggling with a fatal blood disorder. The man expressed, in no short order, his frustration upon reading of “yet more money being wasted on long-shot research to cure AIDS when there are already plenty of medications to keep people with [HIV] and AIDS alive.” The man continued on to say that he will likely bury his son in the next couple of years as the boy’s disease is rare and mostly unknown and thus research is not a priority. He asked, “Why is my son’s life not as important as the life of someone with AIDS?” My heart broke for this man. He closed his comment by saying, “There’s close to thirty drugs for HIV and not a single drug for my son. Why do they get a cure when my son can’t even get treatment?”
His words remained in my thoughts for days. Living with a rare disease myself, I have to admit, I’ve had similar thoughts. Pulmonary hypertension (PH) has been far more damaging and virulent for me than HIV, which has had little major effect on my quality of life. Like the six-year-old’s blood disorder, comparison of federal funding for PH versus HIV is pennies to billions of dollars. Of course there are many logical reasons for this, the most obvious being that HIV is an infectious disease and epidemic that will continue to spread making it far more costly to ignore. However, I can certainly relate to what this man is feeling.
There are many reasons why curing HIV is vital, however none moreso than the simple fact that no matter how much money is spent on treating and preventing HIV, no matter how hard we work and how many tools we have in our toolbox, despite what President Obama and other “glass is half-full” folks want you to believe, the truth is: We cannot win this war with the weapons we have.
Yes, we have made major advances in fighting HIV. The number of people on treatment grows dramatically every year with 13.6 million of the 35 million people living with HIV worldwide currently receiving antiretrovirals (ARVs). The number of new infections in 2013 was approximately 2.1 million, down thirty-eight percent since 2001. UNAIDS reports a thirty-five percent decrease in AIDS related deaths since 2005 with 1.5 million deaths in 2013.
Despite these advances, the CDC released a sobering report on the current state of HIV in the U.S. that, to me, provides the greatest rationale for continuing the search for an HIV cure with the current or an increased sense of urgency.
A great deal of focus, funding, studies and strategies have been awarded to improving the HIV care continuum. The care continuum is a model used to examine obstacles and best practices in facilitating an HIV-positive person in receiving adequate care resulting in viral suppression. As we know, viral suppression is not only essential to individual health but also to public health due to its ability to prevent HIV transmission. Despite many years of bettering this process, the CDC’s latest statistics demonstrate an overt domestic HIV crisis that is not in-line with the encouraging and hopeful messages we are being fed in the U.S. After reading the report, I’m of the opinion that after thirty years of research, unwavering dedication, targeted advocacy and many scientific advances, and even with relatively easy access to ARVs in the U.S., and with billions of dollars in resources and mother-to-child transmission nearly non-existent, HIV is undoubtedly here to stay without the development of a cure.
The CDC reports that in 2011 (the latest available statistics) of the 1.2 million people living with HIV in the U. S:
• Seventy percent are not virally suppressed
• 840,000 are not consistently taking ARVs
• Sixty-six percent are not in regular care
• Ten percent are unable to maintain an undetectable viral load despite being on ARVs
After digesting these statistics, if I were to ever meet the man with the sick six-year-old, I would tell him that his son’s life is just as important as a person with HIV. I would want to hug him and tell him how sorry I am and how unfair it is that his son has no treatment and how I wish I could change that for him. However I would also know in my heart that despite the fact that there are nearly thirty drugs to treat HIV, if we are to ever see an end to this horrible pandemic, we must continue to push for a cure. I do believe a cure is the only way we will ever see an end to HIV.
Jeannie Wraight is the former editor-in-chief and co-founder of HIV and HCV Haven and a blogger and writer for TheBody.com. She is a member of the Board of Directors of Health People, a community-based organization in the South Bronx and an advisor to TRW (Teach me to Read and Write), a community-based organization in Kampala, Uganda. She lives with her husband in the Bronx, New York.