“That was stupid.”
I’ll always remember those three words. They’re what a close friend said when I told her that I was HIV positive.
I was so disappointed with her in that moment, and yet a part of me understood her reaction. It is still quite common―three decades into the AIDS epidemic―to assign blame.
Ironically, this is one of the reasons why HIV is still with us, 32 years after the U.S. Centers for Disease Control reported the first cases. I can’t tell you how many men I’ve met who courageously came out as gay in a hostile world, only to build new closets later in life around their HIV status.
They do so because they are scared and embarrassed. This fear keeps people from getting tested. It keeps people from being honest with their sex partners. This silence makes it too easy for the rest of the world to think that HIV is a disease that has gone away, when that is so far from the truth.
The truth is that gay and bisexual men in this country are at least 44 times more likely to become HIV positive than the general population. The truth is that about one in five transgender women are HIV positive. The truth is that nearly 30 percent of those living with HIV in Massachusetts are black, and 25 percent are Hispanic, even though black people make up just six percent of the state’s population, and Hispanics are just eight percent. Racism, homophobia, poverty, and a discomfort in talking about sex continue to fuel this epidemic.
Yet it is also true that we have arrived at a place of hope in fighting AIDS. People with HIV are living longer, healthier lives. It is easier to achieve full suppression of the virus, which makes its transmission that much more difficult. Each month brings an announcement of new and more effective treatment. Just last week, the US Centers for Disease Control issued new guidelines to health care providers recommending that they prescribe pre-exposure prophylaxis (PrEP) to people who are at high risk of becoming HIV positive. PrEP works by keeping antiviral medication in the body so that if there is an exposure to HIV, it can be blocked from establishing an infection. This has the potential of dramatically lowering HIV infection rates in those who are otherwise vulnerable to infection.
But we still have a long way to go in reducing stigma. Despite the rhetoric that HIV is just another chronic condition—like diabetes—it is not. Learning that you have a serious medical condition requiring treatment and medication for the rest of your life is not easy. It is even more so when your particular condition is one for which many people feel perfectly comfortable assigning blame.
In the early days of the epidemic, AIDS activists organized around the slogan, “silence=death.” While much has clearly changed since then, we still need open and honest conversations about HIV. Here in Massachusetts, 12 percent of new HIV diagnoses occur among teens and young adults aged 13-24. And we are seeing more gay men over age 45 becoming newly infected.
In Massachusetts, many of the tools that we need to win the fight against AIDS are in place. But the best medicine in the world is no match for the stigma that keeps people from getting tested and treated.
Carl Sciortino is the Executive Director of AIDS Action Committee of Massachusetts. This year’s AIDS Walk Boston & 5K Run takes place Sunday, June 1. It is New England’s largest HIV awareness event and AIDS Action Committee’s largest fundraiser. Learn more at AIDSWalkBoston.org.