By B.L. Wilson
In commemoration of World AIDS Day, the George Washington University Graduate School of Education and Human Development (GSEHD) hosted a virtual discussion on the state of the AIDS epidemic that finds, according to the federal Centers for Disease Control and Prevention, more than 37 million people around the world and more than 1 million in the United States living with HIV.
“Many audience members who come to a World AIDS Day event know about it and think this is not getting enough attention,” said Dwayne Wright, GSEHD assistant professor of higher education administration and director of diversity, equity and inclusivity initiatives. “Some don’t know about it at all. The AIDS crisis is becoming as much history as a living experience for many Americans.”
Wright was born in 1988 at the height of the epidemic and has not lost sight of the “devastating” impact it has had on the LGBTQ community and communities of Black and brown people and immigrants.
During the virtual presentation, he introduced H. Jonathon Rendina, an associate professor of epidemiology in the GW Milken Institute School of Public Health and senior director of research at the Whitman Walker Institute. Rendina works in partnership with the D.C. Center for AIDS Research on HIV treatment, prevention, research, advocacy and policy development.
Rendina briefly reviewed the history of the epidemic beginning with reports in 1981 of a cluster of rare disease cases in young gay men in Los Angeles and New York for which the term AIDS was coined in 1982. The AIDS virus was discovered in 1983.
“It took almost 15 years (until the mid-1990s) before we started to see a decrease in deaths due to AIDS, when we finally developed treatments that could be used in combination to prevent the progression of HIV in folks,” Rendina said.
Wright asked Rendina to describe the life of someone living with HIV in 2022.
“The easiest way to answer that question is to say on average, things have gotten better for a person who has the means to access treatment,” he said. “The treatment is highly effective. From a complicated regimen of several medications, the virus can now be suppressed and undetectable with one pill a day.”
Rendina said that people diagnosed with HIV today can have an average life expectancy the same as someone who has not been diagnosed with HIV.
“But that is a privilege,” he said, noting that the United Nations theme for this year’s World AIDS Day is “Dangerous Inequalities,” which describes the disparate gender, sexual orientation and global impact of HIV. It is not the same experience for “folks who do not have access [to healthcare] or trust in a provider whom they feel confident to disclose their HIV status.”
He said that a majority of people are still unaware of PEP or post-exposure prophylaxis, a lifesaving option for those who have been exposed to HIV. In addition, there’s PREP, pre-exposure prophylaxis, which is given before exposure, medications and injections that can prevent or reduce the risk of infection to someone exposed to HIV.
There is no vaccine for AIDS. There is no cure for the disease. Treatment, although it is highly effective, he said, “is referred to as a functional cure… HIV will remit as soon as the treatment is stopped,” so there is a continued need to talk about HIV and for comprehensive sex education.
Inequities in the health care system, discrimination and stigma ultimately undercut progress, he explained. “We will not see an end to the HIV epidemic until we address those systems, and the educational system as an important partner in that process,” Rendina said.
Joining the discussion, Maranda Ward, assistant professor of clinical research and leadership at the GW School of Medicine and Health Sciences, asked if the AIDS epidemic had prepared the United States to better deal with COVID. Rendina said the health care system made similar mistakes in that “both Black and brown folks were significantly less likely to gain access to vaccines for COVID early in the epidemic in much the same way they lagged in getting access to the amazing technologies to prevent and treat HIV…particularly LGBTQ communities, communities of color and those at the intersection of those identifies.”
Some of that can be laid on “a health care system that is not adequately designed to address the needs of a diverse population,” he said.