Policy Diary: 11/1/11

Friday, November 18, 2011

What's going on with AIDS Activism?

Posted by Brad Ogilvie/The William Penn House/The Mosaic Initiative at 6:56 PM

With all the Occupations taking place around the country, it is disappointing to see that the best the HIV/AIDS activists can come up with is to latch on to a “treatment as prevention” campaign. This is in response to a highly-publicized study showing that getting people with HIV on treatment decreases HIV-transmission in heterosexuals by 96%. This study has been seized on as the opportunity to really envision an “AIDS-free generation” (as promoted by people such as Hilary Clinton, despite the fact that they really mean an “HIV-free generation”, a sign of the need for education).

While this study is good news , the idea that we are going to simply treat our way to the end of the pandemic has serious flaws. First, treatment is not prevention. Treatment – in this case, taking pills – neglects to address the individual and societal transformations necessary if we are to truly have an HIV-free generation. We need education that overcomes stigma and fear. Consider this simple fact: currently, many of the highest-risk people do not get tested for HIV because of stigma, fear, and denial. Merely replacing a test with treatment is not going to get people in the door. In addition, there are these considerations:

While treatments decrease transmission risk, there is a false sense of security that we need to be on alert for.
There is an upward trend in the prosecution of people with HIV not telling their partners of their HIV-status; will this trend continue, or will a person on treatment be less responsible for communicating his/her status.
There are growing waiting lists for treatment already. Merely demanding more money seems to be in denial of what is going on in the fiscal world, especially when the commitment to treatment needs to be open-ended.
Ignored in all of this are studies that indicate self-testing for HIV can reach those higher-risk folks, can be done more cost-effectively, and when done in conjunction with digital education, can be very effective in both educating and encouraging testing, but activists and HIV/AIDS organizations stay silent on this while demanding more funding for treatment.

So what’s going on here? As usual, it seems one need only follow the money trail and its influence. Gilead Sciences is the maker of Truvada, one of the highly-touted treatments. Investment firms are saying that Gilead will be a profitable stock because of, according to this LA Times columnist, its HIV-therapies and “shrewd partnerships”. Gilead is one of the biggest sponsors of HIV/AIDS conferences such as the recently-held US Conference on AIDS. Gilead also has a long reach (both directly and through lobbying arms) of making contributions to politicians such as both Bill and Hilary Clintons, GW Bush, and Rep. Barbara Lee, all of whom are very vocal about supporting “treatment as prevention”.

I am not suggesting any sort of broad conspiracy here, so much as the fact that “AIDS, Inc” (a conglomeration of politicians, pharma, HIV/AIDS organizations and activists) are participating in a sort of “group-think” that only looks at the system in place as the vehicle for ending the pandemic, and promoting campaigns that feed the system. Left out are new ideas and creative brainstorming that integrate such things as social networking and self-testing – both of which research shows are very effective as well.

UPDATE: Just after this was posted, UNAIDS released its annual World AIDS Day Report. In it, on page 21, the case is made for home self-testing for HIV. It will be interesting to see if perhaps an organization like this can help open eyes and minds. See more here.