Target Zero: Review

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Target Zero
Directed by Mary Potsako
MedCine

Reviewed by Mel Baker

Target Zero: Preventing HIV Transmission looks at how the array of HIV meds are preventing new infections between HIV-positive mothers and their infants as well as the use of PrEP to prevent infection between sex partners.

The documentary uses award-winning animations to show how HIV infects T cells and how various HAART medicines block different stages of its deadly life-cycle.

Target Zero is broken into three parts; two focusing on HIV-positive pregnant women and the third on the mostly young men getting prescriptions and follow-up care for PrEP.

Carmen’s Second HIV Pregnancy
Carmen’s first pregnancy a few years earlier, reminds us that it wasn’t that long ago that many healthcare providers remained ignorant of the options for HIV-positive pregnant women. “I had gone to a clinic and I asked the nurse, since I’m HIV-positive does that mean the baby’s going to come positive, she said ‘well yeah, you share blood, of course he’s going to come HIV-positive’ and at that moment I remember breaking down.” Luckily Carmen went on to get competent medical care at another clinic where the doctor reassured her that they could prevent transmission to her son.

We follow the team at the MCA Clinic in L.A. as they help her and her fiance’ maintain the drug regime and testing needed to prevent their infant daughter’s infection.

Ella: A Hard Road
The second segment looks at Ella, who recently became HIV-positive while living on the streets. We see her more complicated story as she works to overcome addiction, find housing and make sure she maintains a complicated HIV regime to keep her baby HIV-free.

Remember the Dark Ages
Target Zero is its most compelling when some of the Los Angeles-area medical providers speak of how helpless they felt in the early days of the pandemic. “For the first fifteen years of the epidemic it was kind of like being a first responder at a train wreck,” Dr. Michael Gottlieb, Associate Professor at the David Geffen School of Medicine at UCLA, says, adding that he felt helpless. “I can’t tell you about the countless young men, who were my patients who died of AIDS before effective therapy was developed.”

The first HIV drug, AZT, did little to help those infected as the virus quickly mutated away from the single-drug regime, but in 1994 it was approved for use in pregnant women, which Dr. Alice Stek, Director of Perinatal Services, MCA HIV Program at LAC-USC Medical Center, says was a game changer. “This regimen of AZT during pregnancy and during delivery and to the baby for six weeks, we were able to reduce transmission by two-thirds. That was really remarkable, the people that are in training right now, they have no idea what things were like then.” Since then multiple drug HAART has reduced that to a one-percent infection rate among women who adhere to the program.

Carmen at her doctor’s. Photo courtesy MedCine

PrEP
Using HAART to prevent mother-to-child transmission also led to the relatively new use of mainline HIV drugs to prevent sexual transmission in the uninfected.
Physician Assistant Rochelle R. Rawls is helping a new generation of young gay men and others avoid infection by using PrEP. It’s a process that goes beyond simply dispensing the medicine. “We’re here not to cure it, because there is no cure, but to start healing. A process that not only starts on the cellular level, but starts in the heart, starts in emotions and wounds that have been open in your life for years.”

Dr. Gottelieb sums up the feelings of many of the healthcare providers in the documentary, who have watched a fatal, mysterious disease be contained by science and the brave work of activists and health providers. “I’ve been fortunate enough to see things get better, from the dark ages when people died daily and I remember people back then who so very much wanted to survive. I used to say that my wish was to go gray with my patients and amazingly that wish came true.”

Target Zero: Preventing HIV Transmission is primarily intended as a teaching tool for medical students and providers. It can be streamed on Vimeo (check out targetzerofilm.org, as well) and will have some limited showings including a March 13th screening and Q&A at Rutgers Women’s Health Institute in Piscataway, New Jersey.


Mel Baker is a broadcast journalist and former LGBT and anti-nuclear weapons activist. He is married to artist Leslie Aguilar and lives in San Francisco, California.