In November, U.S. Secretary of State Hillary Clinton made an ambitious statement: An AIDS-free generation is possible. Clinton believes the epidemic can be ended in America within our lifetimes.
World AIDS Day is commemorated on December 1. People with HIV/AIDS have many reasons to be hopeful this year. They're living longer lives, have better access to care, and transmission of the disease has slowed dramatically since the disease appeared 30 years ago.
An AIDS-free generation is an idea that would have been seen as unrealistic even a year ago. But now, it's seen as an achievable goal.
dailyRx spoke with Mark Ishaug, president and CEO of the non-profit organization AIDS United. “It's my firm belief and AIDS United's belief that we can end AIDS in America,” he said, echoing Clinton's sentiments.
Over the past 30 years, HIV has infected 60 million people around the world. Half that number have died. Today, 34 million people are living with the virus, and 2.6 million are infected each year. But the number of infections and deaths are falling. In America, an estimated 56,300 people are infected with HIV every year.
The challenge of ending AIDS is large, but Ishaug is optimistic.
“The most important thing is to remember is that AIDS is not over, but that we can end AIDS in America and in the world,” Ishaug told dailyRx. “In 30 years of the epidemic, there has never been a time of greater promise. Ever.”
“We have a prescription for ending AIDS in America, and we have to invest in what works,” he said.
That includes condoms and syringe exchanges, where drug users who might infect other users by injecting drugs with dirty needles can get clean needles. Ishaug also spoke about behavioral intervention programs, which target populations at high risk for HIV infection, such as people of color, men who have sex with men (MSM) and low-income, poor and homeless individuals.
Getting people with HIV/AIDS access to primary care and the services that keep them in treatment helps stop transmission, said Ishaug. “People who have access to primary care and AIDS drugs are less infectious, and much less likely to transmit HIV.”
Maternal transmissions – mothers transmitting the virus to their babies during birth or while nursing – have also dropped. Research has shown that antiviral drugs help prevent these transmissions.
Still, HIV/AIDS is at epidemic levels elsewhere in the world. Two-thirds of all people with HIV live in Sub-Saharan Africa, although the region is home to only 10 percent of the world's population. Ishaug believes the goal to end AIDS applies to these areas as well, not just America. He cited some promising news.
“We have millions more people on treatment. We have continued reduction of maternal-child transmission globally,” Ishaug said. “We have more people accessing care than ever before, we have innovative prevention programs around the globe, we have increased access to condoms, we have more efforts to fight stigma and homophobia than before.”
Ishaug also mentioned medical advances in preventing HIV transmission. The first successful clinical trial for a vaginal microbicide was announced this year. All of these things give him reason to advocate for public and private investments to create an AIDS-free generation.
“I would never have given a speech, even a year ago, saying that we can end AIDS in the world by doing these things. Now we can say it and feel honest and good about that statement. That's what people need to know. We have a choice. We can either end it or let it go on and on and on, past my lifetime, past your lifetime, past my niece and nephew's lifetime,” he told dailyRx. “That's the choice we make. This is the moment we seize the moment or we don't. If we don't seize it, tens of millions of more people will become infected, tens of millions of more people will die needlessly, and that will be on our shoulders.”