World AIDS Day 2014 — and Renewed Urgency Surrounding Infection Rates

World AIDS Day ImageBy Leela Ginelle, PQ Monthly

Monday December 1st marks the 26th annual World AIDS Day, which will be commemorated by many events in Portland, including Cascade AIDS Project’s inaugural Heroes of HIV Luncheon. Launched in 1988 by World Health Organization public information officers James W. Bunn and Thomas Nutter, the campaign truly is a global event. For each World AIDS Day, the acting pope has released a greeting message for patients and doctors, and since 1995 each US President has made a commemorative proclamation.

A theme is declared each year by the WHO. Originally these drew criticism, as, fearing the stigma surrounding the disease, early themes focused on children and young people with the disease. As time progressed, more  mature themes, such as “Stigma and Discrimination,” and “Stop AIDS: Keep the Promise” were introduced.

Since 2011, World AIDS Day’s multi-year theme has been “Getting to Zero.” Where once presidents neglected even to say the word “AIDS,” beginning in 2007, the White House has honored World AIDS Day by displaying a 28 foot red AIDS ribbon from its North Portico. From mid-November on, Portlanders will have many chances to observe World AIDS Day in the Rose City. From November 15-December 7, the Cascade AIDS Project’s Archive Display will be exhibited in the Central Library’s Collins Gallery.

On November 21, PSU’s Association of African Students will hold a World AIDS Day event on the campus. CAP’s Miss HIV Awareness Portland Pageant will be held November 30 at 5pm at Darcelle XV Showplace. The Portland-Mutare Sister City Association will hold its “Think Africa” fundraiser from 6-9pm on December 1 at the Eliot Center. Planned Parenthood Columbia Willamette’s free event “Fighting for the Healthiest Generation,” focused on the young population but open to all, takes place

December 1, 4:30-7:30. Also on December 1 is CAP’s “Heroes of HIV Luncheon,” at noon at the Nines Hotel. The event honors OHSU researcher, and recipient of a recent $25 million Gates Foundation grant, Louis Picker, corporate sponsor Nike, and 26 year CAP volunteer and former board member Kevin Cook, aka Poison Waters, who has contributed over 2,260 hours to the organization. Further events include December 3’s “Let’s Kick Ass PDX, HIV Survivors” panel, organized by CAP, from 6-7:30 at the Central Library, the Ecumenical Ministries of Oregon’s HIV Day Center 25th Anniversary Lunch, also on December 3, from 12:30-1:30 at Concordia University, and December 5’s Teen Night Out from 7- 11 at CAP’s Pivot, featuring food, dancing and free HIV testing.

Sadly, this year’s World AIDS Day arrives during a time of renewed urgency regarding the disease within the LGBTQ community. A recent study conducted by the Kaiser Family Foundation, a group described by CAP’s Prevention with Positives Coordinator Benjamin Gerritz as a “widely recognized leader” regarding HIV/AIDS, revealed many disturbing trends. Among the gay and bisexual men surveyed in the study, only 32% knew that HIV infection rates were rising among gay and bi US men, and 22% erroneously believed rates were falling. Kaiser estimates that 13% of gay men are HIV-positive.

The Center for Disease Control suggests that in cities the number could be as high as 20%. Despite this, though, only 30% of gay and bi men studied had been tested within the previous year, and 44% of those under 35 hadn’t ever been tested. These numbers are especially troubling given that, with attentive medical care, transmission of HIV is now preventable. A person diagnosed HIV-positive who employs anti-retroviral drugs can reduce their viral load to “undetectable” levels, according to recent studies. Likewise, those who are HIV-negative who use PrEP, a treatment now endorsed by the World Health Organization, will enjoy almost a complete chance of preventing their infection.

Among gay and bi men studied by Kaiser, however, only one fourth understood treating HIV infection helped prevent future transmission, and only 26% knew about PrEP at all. Such ignorance may be behind the recent upward trends in HIV infection, unfortunately, along with the stigma that still dogs a positive diagnosis. Two thirds of those studied said they’d be  uncomfortable” being in a relationship with someone who was HIV-positive, and 77% expressed discomfort about having casual sex with an HIV-positive man. Such views are counterintuitive, however, as it’s far riskier having sex with someone who doesn’t know their status, like the 44% of young men who’ve never been tested, than with an HIV-positive partner who consistently treats their infection.

Transgender women are another group in the LGBTQ community experiencing alarming trends around HIV infection. A 2013 report from the Center for Disease Control described the transgender community as “among those at highest risk” for infection. Concrete statistics for trans women are scarce as, until recently, incompetent, insensitive practices had lumped their data in with men who have sex with men. Likewise, because of the harassment and discrimination they face there, many trans women avoid the medical establishment, a fact reflected in the CDC’s noting that over half the tests collected involving trans patients occurred at “non-health care facilities.”

That said, the CDC concluded that, “the highest percentage of newly identified HIV-positive test results occurred among transgender people,” and that, “among transgender people, the highest percentages occurred among racial and ethnic minorities.” Within these results, the overwhelming amount of new HIV- positive diagnoses (99%) were trans women, rather than trans men. While the data collected by the CDC, again, was far from comprehensive, a startling statistic jumps out: in a meta analysis of 29 studies of the population, 27.7%, over one in four, trans women tested HIV-positive.

World AIDS Day is a chance to put a spotlight on this pandemic, and focus on what can be done to treat those who have become infected and prevent its transmission once and for all. Over its 26 year history it’s helped bring this condition out of the shadows and drain it of the stigma it should never have carried. Now it’s our chance to join with the Cascade AIDS Project and others to honor those living with, and fighting to end, AIDS, “Getting to Zero” once and for all.