Thirty years ago, the diagnosis of HIV/AIDS was widely seen as a death sentence. In developed countries, thanks to much research and widespread use of anti-viral treatment drugs since 1996, many people with HIV/AIDS can hope for an almost normal lifespan.
In other parts of the world, especially sub-Saharan Africa, HIV/AIDS still decimates populations and creates millions of orphans. According to the international HIV/AIDS charity AVERT, 1.2 million people in sub-Saharan Africa died of AIDS in 2010 and another 1.9 million became infected with HIV.
It is appropriate that the 19th International AIDS Conference convening today in Washington, D.C., chose as its theme "Turning the Tide Together." In a world as inter-related as ours, infectious disease cannot be confined to any village, country or continent. Many approaches must be used to prevent and treat HIV/AIDS, and they must take into consideration vast differences in culture, wealth and education levels.
In the United States, for example, HIV/AIDS was initially noticed as a new and almost universally fatal illness of gay men. Thirty-one years and more than 30 million deaths later, the deadliest infectious disease in the world strikes men both gay and straight, women and children.
But the differences country to country are astounding.
According to the U.S. Centers for Disease Control, three-fourths of the people with an HIV diagnosis in the United States today are men, 74 percent of whom contracted the disease by having sex with other men.
But in sub-Saharan Africa, according to AVERT, 59 percent of the people with an HIV diagnosis are women. Among young people, 70 percent are female. Most were infected through heterosexual transmission.
"In many African countries, sexual relationships are dominated by men, meaning that women cannot always practice safer sex even when they know the risks involved," AVERT states on its website.
There is a belief among some African men that if they have sex with a virgin, it will "cure" their HIV/AIDS. There is often a reluctance to use condoms, or a shortage of them, factors of both cultural practices and poverty. AVERT promotes education as vital to the prevention of HIV/AIDS, something that has been resisted by some African governments until quite recently.
For developed countries, and to some degree the poorer ones, recent announcements will continue to make HIV/AIDS a more preventable, treatable disease. Last week the U.S. Food and Drug Administration approved the first preventive drug for daily use by adults at high risk for sexual acquisition of HIV.
Trade named Truvada, it greatly reduces transmission of HIV between men having sex with other men as well as heterosexual men and women, according to the Centers for Disease Control. The guidelines for using what is called PrEP, short for pre-exposure prophylaxis, will be discussed at the AIDS Conference.
This month, the FDA also approved this month the first rapid home test for HIV diagnosis. The hope is that this will also result in people who test positive beginning treatment sooner.
David Margolis, an HIV researcher at the University of North Carolina at Chapel Hill, spoke about the probability of a cure for HIV/AIDS in an interview with Bloomberg.com earlier this year. "What people want to know is when can someone go to a doctor and be handed a pill and be cured," he said. "That's decades away. I think in 10 years someone with HIV infection could go to a specialist and get a complicated treatment and have some likelihood of a prolonged remission of their HIV."
It's rather like many people with cancer are treated today — no promise of a cure, but a reprieve from a quick death.
Among the many advances in HIV/AIDS since 1981 is the way it is perceived. The World AIDS Conference has not been held in the United States since 1990 because Congress passed a travel ban against HIV-positive people. That ban, a product of the unreasonable fear that characterized much of the first decade of the epidemic, was overturned by Congress in 2008.
In fact, CNN newsman Anderson Cooper, who recently "came out" as a gay man, was featured at a pre-conference party yesterday sponsored by the American Foundation for AIDS Research.
Good for him. Good for our country.
