It's more than 30 years into the HIV/AIDS epidemic, and around 35 million people are living with HIV/AIDS, according to the Joint United Nations Program on HIV/AIDS (UNAIDS). About 50,000 new infections per year happen in the U.S. -- and black and Latino Americans are disproportionately affected. Men who have sex with men -- especially those of color -- have among the highest infection rates across the globe.
The elusive search for a "cure" and a preventive vaccine may succeed one day -- but unfortunately it may not be soon enough to help the millions of people living with HIV/AIDS today. But despite significant obstacles, there are some reasons for celebration this World AIDS Day. Here is our look at "10 Moments in HIV Empowerment in 2014."
Removal of Nick Rhoades' GPS Monitoring Ankle Bracelet
Nick Rhoades became the symbol of the anti-criminalization movement when Iowa Sen. Matt McCoy removed his ankle bracelet at the close of the HIV Is Not a Crime conference at Grinnell College in June. McCoy led the effort to amend Iowa's archaic criminal transmission laws, spurred in part by Rhoades' story. Although he used a condom during sex and had an undetectable viral load, Rhoades was sentenced to 25 years and forced to register as a sex offender for not disclosing his status. The work continues: At least 32 states and two territories continue to criminalize HIV exposure and transmission.
Obama Appoints Douglas Brooks as Director of ONAP
President Obama announced the appointment of Douglas M. Brooks, M.S.W., as the director of the Office of National AIDS Policy (ONAP) in March. Brooks is a leading HIV/AIDS policy expert and the first African American, openly gay, HIV-positive man to lead ONAP.
For many advocates, this was an appointment long overdue. African-Americans and other black communities represent only 14 percent of the nation's population but account for almost half of all new infections. Black gay and bisexual men have the highest HIV infection rates in the country. Rates among youth of color are even higher, and they are also least likely to be aware of their status, which could put their own health and others' at risk. Brooks, no stranger to this data, wrote in 2011 that "we need an HIV portfolio for black gay men that's rooted in social justice."
CDC Issues New Guidelines for Using Truvada as PrEP
The Food and Drug Administration (FDA) approved Truvada for pre-exposure prophylaxis (PrEP) in July 2012. But the use of an antiretroviral for protection against possible HIV exposure had been overlooked, or perceived as a "boutique" intervention by some public health experts, until the Centers for Disease Control and Prevention (CDC) recommended PrEP for "hundreds of thousands" of "at-risk" Americans -- gay and bisexual men, injection drug users and their sexual partners, negative partners in sero-discordant couples and others.
The guidance "could transform AIDS prevention in the United States from reliance on condoms" to a biomedical intervention, noted The New York Times. Many challenges remain around cost -- up to $13,000 per year -- and access, especially since some of those most at risk may also be most likely to be uninsured. In October, Washington became the first state to offer a PrEP assistance program; there's also a national assistance plan sponsored by Gilead, the company that produces Truvada.
#TruvadaWhore
Clinical trials demonstrated that taking Truvada daily as PrEP had an efficacy of more than 90 percent for those with high adherence to the regimen. But not everyone was a convert -- even after the CDC's historic recommendation.
The most vocal critic has been Michael Weinstein, president of the Los Angeles-based AIDS Healthcare Foundation. Weinstein slammed Truvada for PrEP as a "party drug" in an Associated Press interview that went viral last spring.
The pushback has been intense. PrEP advocates turned to social media. #TruvadaWhore quickly became a trending hashtag on Twitter, Facebook and Tumblr, as well as a popular T-shirt. PrEP uptake remains relatively modest, but the criticism has sparked a major discussion on prevention options.
"No Shame About Being HIV Positive"
Stigma stubbornly remains a major obstacle to treatment and is considered a driver of many new infections. Social media has become the go-to platform for a number of creative and high-impact online anti-stigma campaigns, such as The Stigma Project and HIV Equal.
One grassroots Facebook campaign that has created a huge buzz is "No Shame About Being HIV Positive" in the "Rise Up to HIV" group.
The campaign has received 120,000+ likes and more than 16,000 comments. Virginia-based activist Byanca Parker's photo went viral, reaching over 500,000 users and receiving 20,000+ likes. Parker was born HIV positive and is now featured in HIV awareness campaigns by POZ magazine. "Being HIV positive [no] longer bothers me," the 22-year-old told BlackAIDS.org. "I get to educate people and change their views."
Chris Beyrer's Speech at AIDS 2014 in Melbourne
The incoming International AIDS Society President Chris Beyrer received a standing ovation at AIDS 2014 in Melbourne when he announced that he was the first openly gay leader of the distinguished organization.
"As a man who buried too many friends and lovers before we had effective treatment," said the physician and Johns Hopkins University professor of epidemiology to conference-goers, "let me pledge that inclusion for all who need and want HIV services will be a fundamental focus of my leadership."
Of the estimated 35 million people living with HIV/AIDS worldwide, men who have sex with men (MSM) "are 19 times more likely to be living with HIV/AIDS than the general population." MSM are often harassed, threatened or discriminated against when seeking services in the developing and developed world.
The Lancet's Special Issue on Sex Workers
"Sex workers, their clients and regular partners are key populations at risk for HIV infection," reports the World Health Organization (WHO). "Contextual factors such as stigma and poverty may further exacerbate sex workers' vulnerability to HIV."
Harsh laws punishing sex work, harassment from law enforcement and punitive legislation that restricts prevention targeting sex workers also fuel the epidemic.
AIDS 2014 Melbourne opened with a special issue of The Lancet on HIV and sex workers. This was the first time the distinguished publication included a community representative as a guest editor. Every paper in the issue included a sex worker as a co-author.
Sex workers from more than 30 countries gathered for two days right before the conference, and brought a comprehensive consensus statement to AIDS 2014. Unfortunately, a number of sex workers traveling to the conference were reportedly prevented from obtaining Australian visas.
Sean Strub's Body Counts
Sean Strub isn't necessarily a household name -- but he is well known across the LGBT and HIV/AIDS movements.
Strub is the founder of POZ magazine, was deeply involved in ACT UP and made history as the first openly gay and HIV-positive person to run for Congress.
Strub's memoir Body Counts: A Memoir of Politics, Sex, AIDS and Survival was published in January.
The book is a "page turner," said Andrew Holleran in the Washington Post. "It's both the chronicle of a young man's experience of the disease and the memoir of an activist who witnessed a great deal of history."
Recognition of the Transgender HIV Crisis
"Of all populations affected by HIV worldwide, evidence suggests that trans[gender] populations may be the most heavily burdened," reports amfAR, the Foundation for AIDS Research. "Globally, limited available evidence suggests that trans women are 49 times more likely to be living with HIV than the general population."
HIV/AIDS resources, services and interventions targeting the trans community are severely lacking. And most public and private tracking systems "do not record data on trans people. "Meanwhile, trans communities -- especially women of color -- continue to experience extreme levels of stigma, discrimination, harassment and violence.
The Elton John AIDS Foundation announced funding for a one-year project to the San Francisco-based Transgender Law Center for an initiative to "reduce structural inequities that drive high rates of HIV" in transgender communities. TLC senior strategist Cecilia Chung -- who chairs the San Francisco Human Rights Commission -- will lead the initiative.
Maria Mejia: A Warrior's Passion for Social Media Activism
Miami-based Maria Mejia should be a familiar name to many readers. The 41-year-old activist and international motivational speaker -- positive for about 25 years -- has shared her story in a popular series of blogs here at TheBody.com. Mejia is maximizing social media to spread awareness and connect with others: She founded an online support group that boasts more than 25,000 members. She also hosts a popular bilingual YouTube channel that has more than 500,000 views. Maria's story has now also been chronicled in a book, called From a Warrior's Passion and Pain. She recently married Lisa Laing.
Mejia is also using her platforms to call attention to Latinos and HIV/AIDS. Latinos are about one-fifth of all new infections despite being about 16 percent of the population, reports the CDC. The rate of new infections among Latinas is more than four times that of white women.