Ending the HIV Epidemic Requires Supporting Those Already Living With HIV

While the challenges continue to be daunting, there are numerous signs of progress in the fight to eradicate HIV by 2030.

Between 2012 and 2016, new infections in New York City decreased by 26 percent. In 2017, new infections in San Francisco fell to a record low of 221 in the city that was once known as ground zero for the AIDS epidemic. While we still have a long way to go, each of these headlines would have been unthinkable 24 years ago.

This year, as we mark the 50th anniversary of the Stonewall uprising, it’s a time to reflect on the extraordinary progress we have made toward ending the epidemic. But it’s also the time to redouble our efforts to care for the 1.1 million people already living with HIV in the United States.

Today, women account for nearly 20 percent of new infections. Transgender people and people of color are disproportionately affected. The South, where progress on HIV is lagging, now represents the epicenter of the epidemic.

Thirty years ago, few had the opportunity to grow old with HIV, but thanks to scientific advancements, people with HIV can now live longer, healthier lives. And one of the most crucial demographics is the population aging with HIV: Half of the people in the United States living with HIV are over the age of 50. By 2030, that number may be up to 70 percent.

Those aging with HIV face a particularly difficult set of hurdles, and our public health infrastructure is largely unprepared to help address these new challenges. In the next 10 years, more than 80 percent of people living with HIV will face at least one age-related medical condition, compared to just 29 percent in 2010.

Despite their increased risk of age-related health problems such as cardiovascular disease or kidney impairment, people aging with HIV often struggle to receive coordinated care from their medical providers. These problems are exacerbated by the challenge of medical providers who may not be familiar with treating people living with HIV over 50. To truly end the HIV epidemic, we must address these challenges.

In addition, those aging with HIV often struggle with stigma, loneliness and isolation. A 2018 survey conducted in San Francisco showed that 62 percent of people living with HIV reported that they had been depressed in the past year. This is significantly higher than the general population, which reports depression rates below 10 percent. These HIV-related struggles are compounded by the fact that many Americans living with HIV are people of color and/or those from the LGBT community — groups that are still facing discrimination and unfair treatment.

While these challenges may seem daunting, they are solvable if advocates, allies and government alike can come together and tackle them head-on, as we’ve done so many times over the past 30 years.

There are 30 organizations across the country — including ours — that are working together to ensure those aging with HIV can live comfortable, long lives. Through a program called Age Positively, we are improving care coordination, increasing resources for better well-being and educating policymakers and advancing policies that create systematic change and increase care for people aging with HIV.

Recently, this community joined forces with LGBT elder advocates in Washington, D.C., to make sure Congress and the White House understand that ending the HIV/AIDS epidemic requires public policies that protect survivors. In the last 50 years since the Stonewall uprising, the LGBT community gradually found new allies and support in its struggle for equality and fair treatment. The history of the Stonewall generation — those pioneers for progress and a more inclusive society — reminds us time and again that we can come together and tackle obstacles that once felt insurmountable.

Now is the time to become an ally to any survivors disproportionately impacted by HIV and AIDS, including people from the LGBT community and people of color. These survivors — these fighters — deserve to be supported and offered the best standards of care as they age so they can live long and healthy lives. Turning our backs on them would mean ignoring the sacrifices and hard work of trailblazers and pioneers, especially those of the Stonewall generation.

Thanks to them, we have made great progress. Standing with them and supporting their call for public policies that address their challenges is the next step in ending the HIV epidemic. We must take that step together.


Michael Adams is the chief executive officer of SAGE, and Amy Flood is senior vice president of public affairs at Gilead Sciences.

Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.

Morning Consult