December 11, 2012
Slightly more than 30 years into the HIV/AIDS epidemic, major breakthroughs in biomedical prevention continue to occur -- this year, most notably around pre-exposure prophylaxis (PrEP), which was found effective for both MSM and heterosexual couples and which the FDA approved for men. Significant improvements are also taking place in treatment and access to care, most notably related to the Affordable Care Act (ACA).
Unfortunately, the epicenter of the domestic epidemic remains in Black America. The 1 million-plus Americans living with HIV/AIDS or at risk of infection are disproportionately Black and low-income. There has been an "alarming increase" in new cases among Black gay and bisexual men, and many funding disparities remain for Black women.
We told you to keep your eye on 10 stories in 2012. This week we will review how five stories developed, followed by the last five next week:
1. The Beginning of the "End of AIDS"
What we told you: To make the end of the epidemic more than just jargon, our leaders must invest despite the nation's financial and political crisis.
What really happened: Public officials and public health experts routinely invoke the idea of an "AIDS-free generation." "But it's ironic that at the time with the greatest scientific advancement, we are seeing a decrease in dollars," says Nancy Mahon, global executive director of the MAC AIDS Fund and chair of the Presidential Advisory Council on HIV/AIDS.
What we learned: To end an epidemic, you have to define what that means.
2. AIDS 2012 Goes to Washington
What we told you: Black issues would be center stage at AIDS 2012, the first International AIDS Conference (IAC) to take place in the U.S. in 20 years.
What really happened: More than 25,000 people attended AIDS 2012, many of them Black. Rep. Barbara Lee (D-Calif.) spoke at the opening ceremony; Phill Wilson, president and CEO of the Black AIDS Institute, became the first Black gay man to address the IAC's plenary session; and Linda Scruggs and Debbie McMillan were plenary speakers as well. But many activists were disappointed that President Obama did not appear at the conference.
What we learned: If we want to end the epidemic, we must roll up our sleeves back home.
3. Fiscal and Political Headwinds for the ACA and the National HIV/AIDS Strategy
What we told you: The GOP would continue its attempt to repeal or defang the ACA.
What really happened: House Republican leadership and the Republican presidential candidates vowed to repeal so-called Obamacare, but President Obama's re-election means that the ACA should be fully implemented by 2015. In the meantime, the Department of Health and Human Services is preparing for Medicaid expansion.
What we learned: We will have to fight for Medicaid expansion and adequate essential benefits packages at the state level.
4. Treatment as Prevention
What we told you: Aggressive ARV treatment for the newly diagnosed HIV-positive would be a "game changer."
What really happened: "Treatment as prevention is the biggest scientific revolution [pdf] in HIV/AIDS since the first antiretrovirals became available in 1996," says Elly Katabira, M.D., AIDS 2012 international chair and president of the International AIDS Society. Implementation plans are being made worldwide, and new strategies must be developed to retain people in care and treatment.
What we learned: Biomedical and behavioral strategies are best implemented together.
5. Microbicide Trials and Tribulations
What we told you: There has been mixed progress in microbicide research after breakthrough results were announced at AIDS 2010.
What really happened: No progress has been reported since the National Institutes of Health abruptly canceled its large-scale microbicide trial in late 2011. Scientists hoped that a vaginal-gel version of the ARV tenofovir could be marketed as early as 2013.
What we learned: The road to marketing a microbicide may be rocky.
Rod McCullom has written and produced for ABC News and NBC, and his reporting and analysis have appeared in Ebony, The Advocate, ColorLines, The Body and other media. McCollum blogs on politics, pop culture and Black gay news at rod20.com.