When Will We Have Universal HIV Care?


by David Waggoner

As we go to press, UNAIDS has announced nearly 20 million people worldwide are receiving life-saving antiretrovirals—that’s about half of the men, women, and children currently living with HIV. But I wonder if that’s the glass half-full. What about the other 20 million living with HIV who don’t have access even to aspirin, let alone HIV drugs? While HIV no longer progresses to an AIDS-related death for the majority of Americans living with the virus, other regions hard-hit by the pandemic cannot say the same. As Annie Lennox pointed out in a recent video for her AIDS-related philanthropies, HIV/AIDS is why there are still countless grocery store aisles only carrying caskets and funeral decorations in southern Africa. While even the most vocal AIDS activists must admit that the stats are not nearly as grim as they were twenty years ago, it is still an important question to ask: Will we have universal, or near universal, access to care, not just for North Americans, but for folks still living in the frontline of the war on AIDS?

Fighting for access to care is clearly working in the U.S. According to the CDC, eighty-five percent of the estimated 1.1 million individuals living with HIV/AIDS know they are positive; forty-nine percent of those engaged in HIV care are virally suppressed. We need to keep up this momentum because, here and abroad, the scales have tipped not only for treatment but for preventing new infections. According to UNAIDS, “the 90-90-90 targets are galvanizing global action and saving lives. Eastern and southern Africa [are] leading the way to reducing new HIV infections by nearly 30% since 2010—Malawi, Mozambique, Uganda and Zimbabwe have reduced new HIV infections by nearly 40% or more since 2010.” UNAIDS also states that AIDS-related deaths have fallen from 2 million in 2005 to 1 million in 2016. Michel Sidibé, Executive Director of UNAIDS, is confident that the world is “on track to reach the global target of 30 million people on treatment by 2020.”

UNAIDS reminds that the work is not done: “Globally, progress has been significant, but there is still more work to do. Around 30% of people living with HIV still do not know their HIV status, 17.1 million people living with HIV do not have access to antiretroviral therapy and more than half of all people living with HIV are not virally suppressed.” That final word is the key one. Without suppression (more attainable than a cure), HIV will continue to keep scientists up late at night and AIDS activists unwilling to dismantle their protest signs.

Most of the news coming out of UNAIDS and other organizations relies on quantitative data. But we can’t forget qualitative data—those thick descriptions and nuanced interviews that tell a more complex story about living with HIV/AIDS than numbers can. And while researchers have done a fine job with qualitative analysis, it is also important to turn to other experts in this field—writers, those who are on board or who might be enlisted to bring greater consciousness to the fact that the AIDS war is not over. Screenwriter Dustin Lance Black leads off our Summer Reading Issue. The Oscar winner for Milk brings insight to his discussion about the generation gap when it comes to AIDS and LGBTQ activism: “When young people start to rail against marriage equality I say, ‘Well, you never survived a plague. You never saw what it meant to have your relationship delegitimized when your partner died. Everything you built and owned together was taken away.’” Other nuanced insights abound in our interviews with the authors of two memoirs, Anne-christine d’Adesky and Mark Olmsted, as well as in the work of the three winners of our fifth annual Christopher Hewitt Awards: Raymond Luczak, John Boucher, and Charles Stephens. While numbers tell some of the story, they do little to destigmatize the disease or show the emotional cost of living with HIV or the breadth of empowerment possible when people fight back.

In this issue, join me in honoring those who heal through words. Writers—they are our true AIDS ambassadors!

David Waggoner is Editor in Chief and Publisher of A&U, the first national HIV/AIDS magazine in the U.S.