The AIDS community was in an uproar, yet I felt like celebrating.
In late 2006, the Denver metropolitan area had been demoted, and people were angry. The Human Resources and Services Administration had just released new data on areas in the country impacted by AIDS, and Denver had moved down a notch. The metro area no longer had a high enough number — 2,000 new cases of HIV over the previous five years — to keep it above the threshold of the most highly impacted cities.
Having fewer cases is a good thing, right? I thought we should have been ecstatic.
But my Pollyannaish view was not held by many others in the HIV field, who warned that funding would surely go down. Apathy would set in. People living with HIV would no longer have access to health care.
How could I not be outraged? I was asked.
This week, those in the HIV community are yet again in an uproar. The United Nations released a report that states, among other things, that HIV is on the decline worldwide. After several decades of unimpeded growth, it seems to have peaked at around 3 million new cases in 1998 and declined to 2.5 million new cases in 2007.
Some AIDS activists find the release of the report depressing, thinking the data will only lead to less funding and more complacency about the epidemic. Arguments I had heard locally now applied globally.
It is true that the funding for the care of people living with HIV is tied to the number of cases. The fewer the cases, the greater likelihood of funding being cut. But funding is actually tied to living cases, not new cases. And, thanks to advances in therapies, there are more people living with HIV now than in any time in the past.
Colorado has one of the most mature and accurate reporting systems in the country for HIV. Because of this, local funding for HIV care actually increased this year.
Funding aside, HIV has been off the radar screen domestically for years. You would not know HIV remains an issue in the U.S., given the lack of press. Yet there have been enormous increases in the number of cases in women, Latinos and blacks. Yet, during the 2004 vice presidential debates, neither candidate was able to articulate a plan for addressing this concern. In fact, neither seemed to be even aware of the significant shift in the epidemic.
I know well the horrors of HIV: It still strikes without discrimination. Those who are unable to access care or be diligent with their medications continue to die all too early. And a cure or vaccine is nowhere in sight.
My friends continue to be diagnosed with the disease, so I’ve seen the ravages of HIV up close. HIV is not over. Not even close. Two and a half million people infected each year is still incomprehensible.
We must redouble efforts in our community to prevent each new infection. We must continue to research novel treatments and delivery systems for those 33 million people or so who are currently living with HIV. We must remember those 20 million who have already been lost.
The news that HIV may have peaked is not just a glimmer of hope to me, but a shining beacon at the far side of what had previously been an ever-widening abyss. We can conquer this disease. With determination and intellect and money and a sense of self-worth and value, we can turn the tide of one of the worst epidemics to ever hit mankind.
My colleagues have the right to their belief that it is too early to celebrate on World AIDS Day, Dec. 1. But after I have paid my respects to friends who have been taken from me, I am going to let out an unapologetic cheer in their honor.
