In commemoration of Dec. 1, World AIDS Day, here are five things the United States can do to help usher in the administration’s goal of creating an AIDS-free generation:
1. Issue a global challenge to join the United States in creating an AIDS-free generation. At the beginning of 2011, 34 million people around the world were living with HIV. In 2010, 1.8 million people died of AIDS-related causes, and 2.7 million were newly infected with HIV. Currently, more than 6.5 million people have access to effective antiretroviral therapy (ART), but this represents less than 50 percent of the more than 14 million people who need it. The majority of people affected by the AIDS epidemic worldwide are women, poor people, and people of color, and the disease continues to follow other faultlines of social inequality. Both in the U.S. and internationally, marginalized communities such as gay and bisexual men and other men who have sex with men (MSM), as well as transgender women, bear a vastly disproportionate burden of the epidemic.
2. Invest in high-impact AIDS prevention strategies, including treatment as prevention. HIV is a preventable disease. Over the last decade increased access to appropriate HIV prevention mechanisms, including condoms, treatment for pregnant women that prevents mother-to-child transmission of HIV, and voluntary male circumcision, have resulted in a 15 percent reduction in new infections worldwide. New scientific breakthroughs in antiretroviral therapy have also demonstrated that ART not only improves the health and well-being of people with HIV – it also stops further HIV transmission. Simply put, treatment is prevention: we now know that treating a person living with HIV reduces the risk of transmission to a heterosexual partner by 96 percent.
3. Commit to defending, optimizing, and increasing PEPFAR funding to reach a U.S. treatment target of 6 million by 2013. In 2008, the U.S. recommitted to its leadership in ending the global AIDS epidemic by setting aside up to $48 billion over five years to fund the President’s Emergency Fund for HIV/AIDS Relief (PEPFAR). These funds directly support ART for more than 3.2 million people and care and support for 11 million, including 3.8 million vulnerable children, in more than 30 countries. In the current deficit-focused U.S. fiscal climate, we cannot fail in our commitment to finding the resources needed to continue existing treatment, care, and prevention efforts and to expand these services to everyone who needs them.
4. Accelerate access to effective combination prevention services through PEPFAR. Last month, Secretary of State Hillary Clinton announced that PEPFAR will commit $110 million to scaling up combination prevention efforts and research in sub-Saharan Africa. Combination prevention includes:
– biomedical interventions, such as antiretroviral therapy and male circumcision
– behavioral interventions, such as HIV counseling and testing, encouraging consistent and correct condom use, and reducing concurrent sexual partners
– structural interventions, such as changing social norms that contribute to gender-based violence against women and girls, alleviating economic pressures that fuel dependence on sex work, and ending discrimination against gay and transgender communities
5. Remember that the U.S. epidemic is not over. Despite global advances in effective HIV prevention and treatment, the AIDS epidemic continues to rage in communities across the world’s biggest donor of AIDS-related funding. In the last three decades, the epidemic has killed more than half a million Americans, and at least 1.2 million Americans are living with HIV, with more than 50,000 new infections every year. The majority of new infections and deaths are in communities of color and poor communities, leaving thousands of uninsured people without access to HIV treatment and other medical care. Gay and transgender people, particularly young gay men of color, also continue to face discrimination that increases their vulnerability to HIV infection.