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What Do We Need to Do to "Get to Zero"?

November 21, 2011

What Do We Need to Do to "Get to Zero"?

In the past year, global leaders have put the HIV community's feet to the fire, and their own, by setting the goal of "getting to zero" worldwide by the year 2020. That means zero new HIV infections, zero discrimination and zero deaths from AIDS complications. "Getting to Zero," the theme for World AIDS Day 2011, reflects this call to action. But how are we as a global community going to reach this lofty goal? We asked advocates and people living with HIV/AIDS to share their thoughts.

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Felipe Hernandez

Felipe Hernandez, HIV Advocate, Tucson, Ariz.

Try to understand sexuality in a greater context. I believe sexuality is more philosophical than just a biological concept. It's not one size fits all. We're just scratching the surface right now. We need to stop prejudice in order to understand sexuality more.

Michael Everett

Michael Everett, Harm Reduction Coalition, New York City

Different populations have been impacted by HIV differently. And I think people have been socialized to understand HIV very differently, too. So I don't think that there's any one way to get to zero.

I will say that I've been learning, over the last couple of years, that there are some groups that need root support around leadership development so that they can be able to advocate for themselves. I also think there are groups that certainly just need education. Because, despite the fact that we think everybody's getting it, they're not.

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Alana Bahe

Alana Bahe, Center for Prevention and Wellness, Salish Kootenai College, Pablo, Montana

Trying to make HIV more relatable individually to people. Everyone's always, like, "Well, that's never going to happen to me," when a lot of the time it can -- does -- happen to them. So I think we need to find a way to break that barrier.

Phill Wilson

Phill Wilson, Black AIDS Institute, Los Angeles; Diagnosed in 1985

I think that there are a number of things that we have to do if we're serious about getting to zero. Number one is, we need to focus on where the epidemic is. You know, not everybody is impacted to the same degree, particularly in this country. So we need to invest in communities that are the hardest hit.

Number two: we need to build an infrastructure and the capacity in those communities. It is shameful that we still have such low HIV science literacy in black and brown communities in America.

And number three: we need to acknowledge that the epidemic isn't over, and we still need to make the investments. And if we make the investments now, we really have a chance of ending the AIDS epidemic.

Mondo Guerra

Mondo Guerra, Project Runway Season 8, Denver, Colo.; Diagnosed in 2001

To keep communication open, you know? And keep the conversation going about HIV/AIDS, and educate.

Ronnie Grace

Ronnie Grace, Community Health Worker, Milwaukee, Wisc.; Diagnosed in 1987

Getting to zero: Eliminate stigma.

Susan Harrison-Hicks

Susan Harrison-Hicks, Registered Nurse, Quad Cities, Ill.

I think we need to educate people. We need to make sure they understand that HIV affects everyone, every race, every nation, every gender. It affects everyone and it doesn't just affect the people who are infected, but the people who are also close to them in their lives as well.

Arick Buckles

Arick Buckles, Illinois Alliance for Sound AIDS Policy, Chicago, Ill.

Address barriers to care -- like HIV stigma. That would be number one. If people aren't talking about HIV, if people are ashamed to talk about it, there's definitely no way that individual is going to be comfortable receiving treatment or care for it.

Bryan Jones

Bryan Jones, Actor, One-Man Show "And I Die Slowly," Cleveland, Ohio; Diagnosed in 1984

I think the ASOs are falling between the cracks. They're not going to the people who really need the prevention -- those people in the 'hood, or the grassroots people who may be doing the trail, so to speak, in parks and that kind of thing.

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Cora Giddens

Cora Giddens, Southwestern Medical Center, Dallas, Texas

I think to get to zero we need to put HIV back out into the public. We need to make sure that people understand that it's still very, very important to make sure that we know how it's transmitted, and we get away from the myths. Because we're 30 years into it and there's still ignorance out there.

Doyin Desalu

Doyin Desalu, AIDS Coalition of Southwestern Pennsylvania

I wish there were. Wouldn't that be a good thing to hold onto? I think if we buy into this test-and-treat buzz, that would help a lot because then it reduces those who do not know their status and are unknowingly infecting others, those who are positive and are not controlling their viral loads and not being treated. If you test and treat them and they're in treatment, you definitely would decrease those numbers.

Ernesto Dominguez

Ernesto Dominguez, Cascade AIDS Project, Portland, Ore.

I think one thing that we're really failing on is using the new media technologies -- social media, online Web sources, specifically tools like Facebook, Twitter, YouTube -- it's the tools that our next generations and our youth are using. And if we're not there, if we're not engaging these new communities, how can we get them the information they need before they are sexually active, before they start to make these decisions? Provide them all that information so that when they do get to the point of wanting to have sex, or wanting to experiment with their bodies or feel someone else's presence, that they know how to do it safely, and how to do it healthily, and how to talk to a doctor?

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Helen Miramontes

Helen Miramontes, Retired Nurse, Las Vegas, N.V.

I don't think there's one single thing we can do. I think there's a combination of them. And it means that we've got to have access for people to treatment, and education, and support. People need to be comfortable with getting tested, having access to treatment, and getting on treatment . . . and then keeping them in treatment. That's the other thing: It's not only getting them into treatment; we've got to be able to keep them in treatment.

Therefore, I think that if we can do that with everyone that is infected, we can certainly decrease the potential of transmission to other people. But we've got to get people comfortable with that. We can't just say we're going to test everybody. We have to get people willing to be tested. And many people aren't, because they don't want to know, because of the stigma.

Jack Mackenroth

Jack Mackenroth, New York City; Diagnosed in 1989

Abolish the stigma, and make sure everyone knows their status. Those are two good steps.

Kimberly Parker

Kimberly Parker, AIDS Behavioral Researcher, Denton, Texas

Be willing to talk about sex and the fact that people are still contracting HIV. I'm a firm believer that to talk about HIV, we have got to talk about one or two things: sex and drugs. And since we don't want to do it, we won't get to zero. Because we still have our head-in-the-sand mentality.

Luke Versher

Luke Versher, AIDS Action in Mississippi, Jackson, Miss.; Diagnosed in 1988

Defeat stigma. I would like to see the day when people think of HIV the way we do diabetes. A person who has diabetes, they don't have to worry about losing their jobs, losing their homes, losing their friends and families.

Marguerite Thorp

Marguerite Thorp, Student Global AIDS Campaign, Boston, Mass.

I'm really excited about treatment as prevention. The HPTN 052 study that came out early this year was, I think, just a landmark, a turning point, saying that, certainly combined with the evidence-based, high-impact prevention tools that we've already had, now we can really look at treatment, not just as saving lives -- which it is and should remain -- but also as a way to drive down new infections and to end the epidemic.

Elena Thomas Faulkner

Elena Thomas Faulkner, Denver, Colo.

You know, it's been interesting: Here at this conference [the United States Conference on AIDS], there's been all this discussion about the tools that we now have to combat HIV and to eliminate it. But I have to say, I'm skeptical that it will happen if we don't address the underlying issues of poverty and disparity in this country that I think really drive people's vulnerability to HIV.

Brian Robert

Brian Robert, AIDS.gov, Fairfax, Va.

I think for us it's about tool and provider awareness. A lot of times, we have lots of resources for test sites and service providers that people look at for the first time and go, "Oh. I never knew this was even available." And that's kind of shocking to us, because there's a lot of stuff out there. We've just got to get it in the hands of people -- especially knowing where they can go to get tested and find providers.

Mary Elizabeth Marr

Mary Elizabeth Marr, AIDS Action Coalition, Huntsville, Ala.

Well, I think the most important thing that we can do is continue to fund treatment and prevention, and I think that's very scary in this day and age -- that the country still needs to realize that there needs to be awareness, and that people need to be treated for HIV and AIDS.

Regnarian Jenkins

Regnarian Jenkins, Housing Works, East New York, Brooklyn, N.Y.

Just make sure that people are aware. I think that our youth, they have a misconception. They feel they know, but they really have no idea.

So I think giving the correct information out is number one; number two, eradicating stigma, as a whole. People are under the impression that HIV looks a certain way. It doesn't. HIV can be me, you, black, white, yellow, brown, young, old. It can be anything. So just give the correct information out there, first of all, and then move from there later.

Dr. Monique Howard

Dr. Monique Howard, New Jersey Women and AIDS Network, Trenton, N.J.

Even though we say that it's not awareness alone that will prevent the disease, it's skill building and it's passing on information, I think that the key is awareness, still. I think that we need to go back to the beginning of the virus, when it was about educating people that the virus does exist. We're three decades into the virus, and there are still people that I come across that think that it's gone, think that it's healed, that it's not a problem. And so one of the things we have to do first is increase our awareness efforts and then, from there, help people asses their level of vulnerability and their level of risk so that we can move on to the other issues that will decrease the rates and incidence of HIV.

Oscar Lopez

Oscar Lopez, Capacity Building Specialist, New York City

I just don't think it's realistic. The government and the bureaucracy are still talking about condoms, condoms, condoms. And it's systematic. We live in a country where, for example, for gay men, for men who have sex with men, fundamentalists are still saying, "No sex, so you can get married. And you're not allowed to get married, so don't ever mess around."

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Vanessa Laurel

Venessa Laurel, Asian and Pacific Islander American Health Forum, San Francisco, Calif.

The most important thing is to educate people. We can't keep talking to the same people. We can't keep doing the same things that we're doing. I think that's what it's going to take. It's not just us, within our own community. We need to band together and make sure we're not necessarily pitted against each other. I'm obviously referring to communities of color. We just need to get together and make sure that everyone is taken care of, and make sure that people are educated appropriately -- whether that's just talking to your friend or talking to a stranger on the bus. It's a little bit difficult, but sometimes you've just got to go out there and do it, and the more times you do it, the easier it gets.

Paul

Paul, NYC Department of Health and Mental Hygiene, Condoms and Materials Unit; Brooklyn, N.Y. / Barbados

We've got to meet people where they're at. It's important to get people open minded -- and not just talking about the disease itself, but talking to their family members, their kids, about protection. Having people be openly aware and self-confident in their sexuality and also in what it is that they're doing -- whether it be promiscuous sex, or whatever. But be upfront and proactive in having safer sex. Make it fun, since we are mostly having sex for fun. Trying our best to help each other. You go to an event; there are condoms there. A lot of people say, "I don't need them because I don't use them." But I'm sure that we all have people in our lives that do use them. So take them for somebody else. Share them.

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Tina R. Sigler

Tina R. Sigler, Mujeres Unidas, Inc., San Antonio, Texas

Definitely finding a way to manipulate those DNA, to find a cure.

Publicist

Publicist, Living Positive by Design, New York City

I think it's about educating people. The new generation, they're kind of . . . maybe too brave? You know, we have medicine and it's great. But they're not thinking about HIV. The only way you can get serious is if everybody's careful, everybody knows what they're doing; and just getting tested and not being afraid.

Social Worker

Social Worker, HIV Clinic, Durham, N.C.

Testing is a big part -- test, test, test. But it's not only that. There's trying to reach all different types of community environments with HIV information -- not just health departments or health settings. It could be churches. That's a big one, especially for certain populations. It would be great if we could get more spiritual leaders involved, and other community agencies, as well. Also, we need even more local pharmacies where people can go in on a daily basis. And then just educating people more and more on safer sexual practices, on the ways that HIV is transmitted versus the myths.

Analyst

Analyst, Washington, D.C.

It's too hard a question, because it's behavioral. I think we need to focus more on reenergizing people to avoid HIV infection. Medication isn't the answer to everything.

Pulic Educator

Public Educator, Washington, D.C.

First of all, we can continue our conversations. We need to up the ante on outreach. We need to make HIV a required test, at every level, to at least get people tested and on medication if they need it. If you make it a requirement I think it's one of the best possibilities to address the issue.




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