How Many Breaths Will It Take to End an Epidemic?

Last week I talked about how we have the tools to end the AIDS epidemic. This week I want to elaborate on what those tools are and why Black folks need to familiarize ourselves with them.


Our toolbox already contains the following:

On the diagnostic front knowing your HIV status has never been easier or more important.  Getting an HIV test is often free. The tests are easy, painless and you can get the results back in less than an hour. There is technology working its way through the FDA to allow home HIV testing, tests that return results in 60 seconds, and tests that you can do at home to learn your viral load and T-cell counts. Undiagnosed infections are a major driver of the U.S. epidemic. Twenty per cent of HIV positive people in the United States don’t know their HIV status.

With regard to surveillance, we can identify what communities are the hardest hit and have the highest community viral load, in some cases down to the zip code or census tract.

When it comes to prevention, we’ve long known about the efficacy of the proper usage of condoms, dental dams, clean needles, abstinence and other behavior-modification strategies.

Recent scientific breakthroughs have shown us how to interrupt acquisition. The data is clear and compelling: Circumcision, vaginal microbicides and oral PrEP can interrupt acquisition of the virus by as much as 95 percent.

We’ve made tremendous improvements in HIV/AIDS treatments. AIDS is no longer the automatic death sentence it once was. New treatments are simpler, less toxic and more effective. I know; I personify what can happen when people living with HIV have the love and support of family and friends and the care and treatment we need and deserve.

But probably most importantly, we now know that treatment is prevention. A study released earlier this year demonstrated that early treatment dramatically reduced HIV transmission. We can interrupt transmission of the disease by getting people into appropriate early treatment.

There are also some policy tools in our tool box as well. The national HIV/AIDS Strategy is in place. Some elements of healthcare reform have been implemented. There is a functional President’s Advisory Council on HIV/AIDS. And, there is a new HIV/AIDS bipartisan caucus in the U.S. congress, to name a few initiatives.

So, we have better diagnostics, surveillance, prevention and treatment. We know how to interrupt acquisition and transmission.  And there is some traction on the policy front.  These are the tent-poles needed to end the AIDS epidemic.

But will our community be prepared this time around to seize this deciding moment?

In 1996 a new class of antiretroviral drugs, protease inhibitors, were approved. When used in a combination cocktail with other antiretroviral classes, these new drugs proved to be powerfully effective in stopping HIV in its tracks. Nationally, AIDS deaths plummeted.

Other communities benefitted by this treatment, known as Highly Active Antiretroviral Treatment, or HAART. But Black communities? Not so much. We weren't ready and as a result we didn't take advantage of the new advances. My worse nightmare is that the AIDS epidemic will end everywhere except in Black America. The challenge for Black people is to make sure that we don’t get left behind this time.

We need to educate ourselves about what's in the new toolbox. We need to make sure we're heavily involved in conversations, research, scale-up and implementation of new tools. We need to retool our organizations to be responsive to the new HIV/AIDS paradigm; the old model of standalone prevention or outreach organizations is no longer sustainable. We need to make sure that Black people have appropriate access to these interventions.

There are moments in time when we have both the power and opportunity to move humanity forward. It is during those times that we must rise to show the best of who we are or we will sink into the depths of the worse of who we can become. We are at such a time and place. United in faith, let us rise to the occasion.

Maya Angelou once said: “Life is not measured by the number of breaths we take, but by the moments that take our breath away.” I promise you ending the AIDS epidemic will take your breath away.

Yours in the struggle,