The State of the Epidemic: World AIDS Day 2012

Wakefield, Pride Foundation Board Member and Community Relations Specialist for the HIV Vaccine Trials Network at the Fred Hutchinson Cancer Research Center, reflects on how far we’ve come and where we have to go to defeat AIDS.

Early in this epidemic we took to the streets. We fought “government” because they were not doing enough or not doing it fast enough or not doing it the right way.

We fought each other in our passion and urgency to make a difference or process grief, anger, or because we were afraid our own time might be short due to a mysterious virus.

Someone took a failed cancer drug AZT and discovered it could impact the virus. We did not know how much we had to learn to move beyond toxic doses of this drug. Today due to working with those “government folks” and “dreaded pharmaceutical companies” we have over thirty drugs that are just as smart and different as our smart phones are from the rotary dial phones of the 1950s and 1960s.

I get to go to work each day at a cancer center where we continue to take what we know about the immune system to search for an HIV vaccine and even a cure. This summer we heard of incredible breakthroughs in HIV science: new tools and declarations that we have everything we need to end AIDS. I need to tell you that this is very true, and yet so false that you might be lulled into a sea of delusion.

Every scientific discovery brings with it the challenge of implementation. In Africa there was great excitement about the fact that circumcision reduced new infections in men by 50%. Yet the other side of that coin was there was no benefit for women, and we cannot currently do the experiments to see if there is a benefit in circumcision for gay men.

Science has proven that if you give someone enough HIV medication to control the virus you dramatically reduce the chances of them infecting their partners. You give them the opportunity to have a normal life expectancy. If you give someone who is uninfected a pill every day they can be protected from getting HIV in their system and worrying about living with AIDS. Both of these strategies work—but we are still doing research to find out the best ways to do this. When do we start people on these drugs? What happens if a healthy person takes drugs for 15 years? If a once a day pill works is there a pill that I can take just before and after sex?

We have the tools, but we are still learning the best ways to use them. Having full access to all of the tools at Sears or Lowes does not make it possible for me to build a house.

When Barack Obama was elected some had the nerve to say we had ended racism. Yet just this week it was noted that Black Gay men in the United States are 72 times more likely than their counterparts in the general population to be HIV+. If we compare young black Gay men to young white gay men they are 7 times more likely to be HIV+.

There are a number of structural factors that contribute to the disparity, but racism is the elephant in the room we seldom acknowledge because we don’t have an instrument to measure prejudice and bias.

We can and will end HIV someday. It’s been a long, tough fight to get here.

What it will take is more of the fighting. We must retool our efforts in a manner that takes these amazing discoveries and couples them with what we know is our biggest human challenge—behavior change. So I am asking you to consider the most radical expression of love for humanity that you can muster.

For some of you it will be offering to talk to the parent of a teenager and then maybe the entire family about sex. For others it will mean posting a red ribbon on your office door today and saying I know how to be stronger—I have hope for the future but it’s not over yet. For some of us it will mean sending a note to someone we have lost touch with and telling them we have made a donation in honor of the memory of a shared love. For many it will mean taking your pills so you can be here one more day, week, or month to give and receive love.

For me it will mean knowing that the end of AIDS will only happen when we can treat 20 million more persons living with HIV, when we have a vaccine that will ensure kids can make a sexual debut and worry more about their capacity to love than fear of getting infected, when you and I have done everything we can.

Just look where we’ve come from. We have come a long way—a mighty long way but we still have a long way to go.

We will continue to fight. We will forge alliances between people with HIV and those with other chronic illnesses and disabilities. We will foster communities of researchers and care-providers, all working to make AIDS a thing of the past.

We have gone from a President who didn’t have a clue about AIDS to one who has a comprehensive strategy for the nation. And just around the corner we have the promise of universal health insurance, making many medical miracles genuinely accessible.

We need to act now more than ever because now we have the possibility of real progress. I don’t predict that it will be easy—nothing about HIV has been or will be easy. But we have important resources that we did not have in the past: Each other.

Wakefield is serves on Pride Foundation’s Board of Directors and is the Community Relations Specialist for the HIV Vaccine Trials Network at the Fred Hutchinson Cancer Research Center. For follow-up questions to this story, please contact Christina Rocks at

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