Three Decades of HIV/AIDS, Part Three

Mainstreaming ... (1995-1998) Through ... Reality (2010-2011)

By Bob Frascino, M.D.

July 27, 2011

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Reality, an Invitation to the Dance? (2010-2011)

According to data from the AIDS Drug Assistance Program (ADAP) Advocacy Association, as of July 2011 the number of HIVers on ADAP waiting lists had risen to 8,689. ADAP is a co-funded program (funded by federal and state governments) to provide anti-HIV drugs to low-income HIVers. Over the past two years 14 states have reduced the number and types of drugs ADAP will pay for in their state. States have also stiffened financial eligibility requirements, capped enrollment and actually removed some HIVers already enrolled. As we observe the 30th anniversary of the AIDS epidemic in America, the news media is again beginning to take note and shine a harsher light on the cruel realities resulting from these unconscionable decisions.

Despite these often sobering and somber recollections of the past 30 years I remain the world's foremost optimist. In 2010 President Obama unveiled the first ever national AIDS strategy. Even more recently there have been significant scientific breakthroughs in HIV prevention, including topical and oral pre-exposure prophylaxis and the extraordinary finding that antiretroviral therapy reduces HIV transmission among magnetic couples by 96 percent. This news alone should prompt an urgent reconsideration for fully funding ADAP.

Not only is it morally reprehensible to restrict or deny lifesaving antiretrovirals to HIVers, it has now been proven it's a monumental error of public health policy. In essence, failure to treat HIVers is fiscally irresponsible because treatment has now been scientifically linked to HIV prevention. China recently reported it slashed AIDS mortality by nearly two-thirds since it began distributing antiretroviral drugs in 2002. Approximately 63 percent of all those needing AIDS drugs are now receiving them in China, up from virtually zero in 2002.

Reviewing how HIV/AIDS has been reflected in the media and entertainment industry over the past three decades reveals how the virus affected our nation's psyche. The media and Hollywood first contributed to the panic, then later helped redefine AIDS as a public health crisis. However, HIV/AIDS seems all but forgotten among today's entertainers. Reality television and pop music seem to glorify the return of sex without consequences. When I hear Lady Gaga wail "I want your ugly, I want your disease, I want your everything, as long as it's free, I want your love," I tend to cringe and shudder a bit, even though I fully realize Gaga's "Bad Romance" was not referencing HIV/AIDS. From the bodacious jiggling bosom on Joanie, the bombshell secretary on Mad Men, to the chiseled abs and rock-hard pecs on the frequently shirtless vampires on HBO's True Blood, sex on television is back big time!

However, HIV awareness campaigns and prevention messages have not been correspondingly rejuvenated. They are either outdated or eclipsed by suggestive ads for Cialis warning only of a four-hour boner.

Yet despite these trends and the post-activism lapse into silence and complacency over recent years, the hopeful signs of renewed interest in addressing the reality of HIV/AIDS in today's society are once again increasing.

Not only did we have a revival of Larry Kramer's The Normal Heart on Broadway, but also a new musical, The Book of Mormon, nominated for 14 Tony awards and set in AIDS-ridden Uganda. Uganda, once praised by international health organizations for its rapid and progressive thinking in response to the staggering pandemic, now faces serious threats to this progress. The collapse of HIV awareness, prevention and treatment in Uganda stems from decreased financial commitment from the U.S. and other wealthy nations. Will the welcomed bubble of media attention surrounding this hit show help educate or remind us about AIDS in Uganda? I dearly hope so. Realistic HIV/AIDS story lines are also being woven into television (Brothers and Sisters) and movies (film versions of Angels in America and Rent).

Yes, the Band Still Plays On. AIDS continues to be a volatile, dynamic and incurable scourge, wreaking havoc on lives like mind and 33,300,000 others worldwide. Yet, I'm increasingly hopeful and confident we are finally listening to the music (recognizing the realities of HIV/AIDS in today's world) and that soon we'll all be moved to dance (to take action to end AIDS). And so dear BBBs, as I conclude this walk down memory lane, I ask you: are you ready to dance? The alternative is clear.

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HIV Guidelines: Some Evolve; Some Don't. What's Up With That? Part One

Three Decades of HIV/AIDS, Part Two

Three Decades of HIV/AIDS: Are You Ready to Dance?

Three Decades of HIV/AIDS, Part Two