How do you make people positive about HIV?
For years the popular perception was that HIV infection amounted to a death sentence. At last week’s International Aids Conference a new, more positive picture emerged – but public perception has yet to catch up.
The International AIDS Conference is the largest conference on any global health or development issue in the world. This year’s event in Amsterdam incorporated a unique blend of science, the arts, celebrity, humour and activism. For a condition that has for decades been associated with stigma and fatalities, the positivity that frames discussions within the global HIV community is quite remarkable.
There is a strong sense, within research, clinical and patient communities alike, that elimination of the disease is no longer just a fantasy, but something we should realistically aim to achieve within a generation.
While there are still significant barriers to extending testing and treatment to low and middle-income countries globally, the HIV and AIDS environment in the UK has shifted. This is thanks, not least, to vocal and well coordinated patient activism. The discourse within the HIV community is no longer framed around life or death, but rather quality of life.
An HIV diagnosis is not, as it used to be seen, a death sentence and those with the condition can expect to live as long as those without it. Antiretroviral treatments, PEP and PrEP, if used effectively, mean that the risk of transmitting the virus to a partner is negligible.
Stigma remains a huge barrier to those living with the condition, whether in relation to their treatment, employment, housing or relationships.
But these significant breakthroughs in prevention and treatment do not yet seem to have significantly influenced the public’s view of HIV. The most recent IPSOS Mori research revealed that 1 in 3 members of the public disagreed with the statement ‘I would feel comfortable working with a colleague who had HIV’. Stigma remains a huge barrier to those living with the condition, whether in relation to their treatment, employment, housing or relationships.
Reports in recent years, from organisations such as the National AIDS Trust and the APPG on HIV and AIDS, have highlighted how and why stigma surrounding HIV manifests itself across public services, as well as among the friends and family of people living with the condition. For many, especially those who lived through the epidemic in the 1980s, HIV is still associated with accusations of immorality, promiscuity and/or drug use. This climate continues to have profound implications for the mental health and wellbeing of those living with the condition.
How, then, can we look to foster a new public understanding of HIV? One that views HIV in the same way as other long-term health conditions such as cardiovascular disease or diabetes.
A new initiative, U=U, will perhaps help. Standing for ‘Undetectable=Untransmittable’, the campaign seeks to raise public awareness of the fact that people living with HIV who are on antiretroviral therapy and have been undetectable (less than 40 copies in a millilitre of blood) for at least six months cannot infect others through sexual transmission. It is this key message, printed on signs, T-shirts and posters at the IAC in Amsterdam, that the HIV community is united behind. Those living with the condition are campaigning not just for access to treatment, but also against social and economic marginalisation.
As employers and public service providers become more interested in health and wellbeing, campaigners want to see U=U embraced not just within clinical settings but across civil society. Universities, faith organisations and community pharmacies, for example, may prove crucial in raising awareness of the modern realities of living with HIV.
HIV and AIDS prompted a global moral panic and for many of those at IAC who have lived with HIV since the 1980s or 90s, the fact that humankind can start looking towards elimination is hard to believe. Recent scientific breakthroughs have allowed HIV to become both manageable and preventable; it is now time to shout about it.
William Pett is a Senior Account Manager for MHP Health.