By Dr. Latonya Riddle-Jones | The Oakland Press | Published November 29, 2021

As we approach World AIDS Day on Dec. 1, it brings more than the usual commemorations and displays of red ribbons. Those who are leading the fight against HIV, the virus that causes AIDS, are seeing major strides — from declining death rates to more acceptance of individuals living with HIV and improved medications for treatment and prevention — and there is genuine reason to believe that an end to the HIV epidemic can be achieved after decades of heartbreak and lives lost.

Ending HIV stigma

When Corktown Health’s founding organization HELP (Health Emergency Lifeline Programs) was formed more than 30 years ago, HIV seemed an almost-immediate death sentence. At that time, we offered end-of-life services, providing nutritional and emotional support for patients when nobody else would. With so many questions about HIV, people were scared, and many with HIV chose not to inform their family members. We were often the only people with them at the end of their lives.

Over the years, HIV stigma has lessened, in part by cultural revelations (i.e. Magic Johnson’s 1991 HIV diagnosis) that made people realize it can happen to anyone, not limited to gay men. We now see younger people with HIV come to appointments with their family and friends, and we’ve reached the point where there are ads on television for preventative HIV medications. Conversations that once took place in private in hushed tones are now on billboards. This is a huge development and makes people view HIV like the chronic disease that it is.

Medication improves

Key in the HIV fight are advances in medication — both preventative for those wanting to avoid contracting HIV, and antiretrovirals for people working to suppress HIV. These advances help people with HIV live long, healthy lives. Magic Johnson just reached the 30th anniversary of his diagnosis, which many thought to be a miracle, but that type of longevity has become realistic for most people with HIV following proper treatment protocols.

Unlike early medications from the 1990s, which extended life but came with major side effects and often left people unable to work, people living with HIV today can continue working and living full lives. They are managing HIV just like they would manage diabetes or high blood pressure, if not better. Most are also taking just a one pill a day, not multiple. We’ve even seen people born HIV positive grow up to have children who are not HIV positive. By taking their medications, their levels remain so low that it’s not transmittable to their children.

Dr. Latonya Riddle-Jones is medical director at Corktown Health Center in Detroit.

Ending HIV

Between preventative efforts and new treatment options, in 2021 we can confidently say that we are on a strong path to ending the HIV epidemic.

On the prevention side, use of barrier protection (such as condoms) and PrEP (pre-exposure prophylaxis) medication to prevent HIV transmission is key to ending the epidemic. PrEP prevents the person using this medication from being infected by an HIV-positive person and is 99 percent effective. At Corktown Health, we urge all patients at risk of HIV infection to use PrEP, and to regularly screen for sexually transmitted infections.

For those with HIV, the goal is to follow easy treatment protocols that reduce and maintain a low viral load, which is considered virally suppressed or undetectable. An undetectable level of HIV means that person cannot transmit HIV to others.

New technology such as telehealth has emerged as a tool. The fight against COVID-19 showed us how to streamline processes to remove barriers for HIV patients giving them better access to care and better follow-up. There are also continued efforts underway to develop an HIV vaccine, using mRNA technology.

While HIV continues to impact many people in Michigan, the lessened stigma and overall acceptance of people with HIV is a positive development. With the future looking bright in terms of a reduced number of cases and better treatment options, it’s likely the trend of people with HIV being able to live long lives by managing the disease, just like you would manage diabetes or other common diseases, will continue.

If everyone does their part, eventually HIV may be gone, or reduced to numbers so low that it can shed its epidemic status, an achievement that would be the end result of decades of hard work and medical advancements.

Dr. Latonya Riddle-Jones is medical director at Corktown Health Center in Detroit, and an assistant professor of Internal Medicine and Pediatrics at Wayne State University School of Medicine. She is also Vice-Chair, Chief Diversity, Equity & Inclusion Officer for the Department of Internal Medicine at Wayne State. Corktown Health Center is the only health clinic in Michigan focused on the needs of LGBTQ patients. Visit corktownhealth.org to learn more.