By Ron Gilmer, Founding Board Member of the Telluride AIDS Benefit
AIDS might seem like a distant memory in the wake of a tumultuous 16 month-long election cycle. The soon-to-be Trump presidency is providing an unnerving picture for the future of AIDS related issues. Under the Affordable Care Act, Medicaid was greatly expanded and many prerequisites were dropped to make access to care easier for almost 45% of HIV positive people. Many of these improvements are likely to be cut or trimmed in the new administration. This will make other funding such as that provided by the Telluride AIDS Benefit more relevant than ever.
AIDS has been a recognized disease for 36 years, many medical advances have been made, and today about 40% of the world’s 38 million people living with HIV are in some type of treatment program, a number unthinkable even 10 years ago. Overall, the rate of new infections is slowing in many parts of the world, however 2015 saw an increase to 2 million new infections overall; up from 1.2 million in 2014. As AIDS is sexually transmitted in most cases, stigma has always been, and remains, the #1 driver of the global HIV/AIDS epidemic.
Ultimately, the health insurance issues may pale in comparison to the larger threat the next four years pose to people living with HIV and the broader demographics to which they belong. The prospect of discrimination unleashed by recent election rhetoric could bring on wide discrimination of minorities, including persons living with HIV/AIDS.
Many common sense measures to prevent HIV, such as syringe exchange programs and widespread PrEP availability are being avoided and potentially face an even harder battle to win approval in certain regions of the country. The recent outbreak of HIV/AIDS in rural Indiana, attributed to injection drug use, could have been avoided. Until the Scott County outbreak, there was just one needle exchange program in the entire state of Indiana; in 17 states, there are none at all. Syringe exchange programs have reduced HIV infections dramatically in many parts of the country where these programs are aggressively pursued. Luckily, Colorado and the Western Slope have numerous programs in place.
The challenge of getting antiretroviral therapy to all who need it is a colossal one. Moreover, treating HIV remains a lifelong proposition. Since current treatment keeps the virus at bay rather than eradicating it, a 25-year-old diagnosed with HIV today faces the prospect of being on antiretroviral therapy for four or five decades. This would amount to well over $1.5 million in health costs that a young, newly infected person would amass by age 60 for HIV treatments alone.
Since no cure or vaccine currently exists, we can take nothing for granted. Nothing about HIV/AIDS has ever been straightforward or easy, and this chapter of the AIDS response—and the uncertain years ahead—will be no different.
As in all years, compassion is everything. The reality is that until we give everybody the same access to treatment and prevention, AIDS will never, ever go away. It's that simple.