Blog Sexual Health

HIV prevention: past and present role in global health

By Raveena Mata, MA candidate in medical anthropology at Wayne State University;
Colonel Carroll A. Ockert Award Scholar
in the 2020 Institute for Public Health Summer Research Program – Public and Global Health Abbreviated Track

As COVID-19 and racial tensions continue to bring health disparities to the forefront in America, it is crucial to take a deeper look at other prevalent infectious diseases, their sociopolitical context, and their past and present role in global health.

As of 2019, there were about 38 million people living with HIV/AIDS around the world. In the United States, the burden of this disease is disproportionately borne by men who have sex with men (MSM), racial and ethnic minorities, and increasingly, youth. Recently, we had the pleasure of hearing Ericka Hayes, MD, Medical Director of the Pediatric and Adolescent HIV Program, speak on “HIV Prevention: Advances and Disparities”. We discussed important background and context on the disease as well as the challenges that remain to optimize treatment and prevention locally and globally.

Key Concepts and Background

HIV stands for “human immunodeficiency virus” and attacks T cells, which eventually weakens the immune system and leads to AIDS (acquired immunodeficiency syndrome) if left untreated. HIV/AIDS was first recognized in the US when young MSM began presenting with illnesses usually associated with immuno-compromised individuals. However, despite its rapid spread, the path to research and treatment was initially a slow process. It was the efforts of activist organizations like ACT UP who demanded a prompt solution, and demonstrated the role of public engagement in advancing scientific research and access to care.

HIV/AIDS can be transmitted through all forms of sex, from mother to child, and through infected blood. To combat persisting stigma, it is equally important to note the ways in which HIV is not transmitted (shaking hands, using public toilets, and sharing food). Furthermore, since undetectable HIV (based on viral load) is untransmittable, prevention and treatment are not two separate concepts, but rather go hand-in-hand.

Looking Forward: The Work That Remains

  • Combating stigma: It is crucial to educate communities on how HIV is and is not transmitted, as well as protecting patient privacy. One strategy Dr. Hayes shared is labelling facilities discreetly and using them for multiple purposes so that patients are not stigmatized.
  • Increasing access to prevention, testing, treatment, and care, especially for marginalized populations like MSM living in areas (like the rural south) where access to prevention and treatment is often riddled with geographic, cultural, ad socioeconomic barriers. This includes strategically using available resources to fund PrEP for those at risk who otherwise wouldn’t have access.
  • Leveraging support from stakeholders, such as HIV+ community members who can educate, encourage, and empower young people at risk through their networks
  • Ending Criminalization of HIV: In many states, for example, not disclosing one’s HIV status to a sexual partner can result in jail time, even if the disease is not transmitted.

To learn more about important work being done on HIV/AIDS here at Washington University in St. Louis, check out Project Ark.