The State of HIV: 5 Stories Currently Shaping the Poz World

We take a look at treatment and prevention breakthroughs, an increased quality of life and the stigma that continues to make up the HIV landscape

By Patrick Rosenquist

January 22, 2016 :: 9:30 AM

The state of HIV in America is changing rapidly. We are finally at a point when, even with no solid cure in sight, the tide of the epidemic could finally reverse. Last year, San Francisco launched its “Getting to Zero” movement. Based on UN initiatives, the program believes the idea of zero new infections—or deaths—is no longer a fantasy but a real possibility. Medical breakthroughs and changes in society have meant those living with the disease are experiencing fuller, longer lives. Here are some of the biggest stories shaping the poz world.

1. PrEP and TAP are stemming the spread of HIV.
Since its approval by the FDA in 2012 as a means of preventing HIV infection, Truvada—generally referred to as PrEP—has become the biggest news in stemming the spread of HIV. “For the first time since the disease’s beginning, we have a new way to stop infections,” says Terry Smith, Associate Director of Prevention at APLA Health and Wellness. PrEP is 99% effective according to Smith, who is excited about the dramatic reduction in infections Truvada has offered the gay community. Furthermore, Smith believes “Treatment as Prevention”—the idea that someone who is virally suppressed has a lesser chance of spreading the virus to those who are HIV-negative—may be a key tool in stemming the spread of HIV. “Those on treatment are 96% less likely to spread the virus,” he says.

2. Treatment of HIV is simpler and comes with fewer side effects.
Treatment has changed dramatically. Long dramatized and experienced as an unusual and complicated cocktail of drugs, HIV treatment has been reconfigured as a ‘one pill a day’ regimen, with a minimal amount of side effects. “The biggest change in treatment is the combo drug,” says Jeff Bailey, Director of Client Services at AIDS Project Los Angeles. “It means more people are able to adhere to treatment, because it’s simpler,” he says.

3. Those with HIV are finally living on par with those without the disease.
On World AIDS Day 2015, Prudential Insurance announced a new plan—citing a dramatic increase in both longevity and quality of life, those with HIV became able to purchase life insurance plans. “The biggest problem with those in treatment is that we are experiencing an aging population, and they experience the same things everyone aging does: diabetes, high blood pressure and more,” says Bailey. Aging with HIV has become similar to aging without the virus, he says, the biggest complication being making sure that medicines prescribed to patients don’t interfere with each other.

4. Stigma persists, though the media’s portrayal is breaking barriers.
Unfortunately, stigma has not decreased among the general population. When Charlie Sheen announced he was HIV-positive late last year, the reaction was a mix of revulsion and worry. He also revealed that he had spent a large sum of money—in the millions—to keep his disease a secret. Within gay-friendly media, portrayal of the disease better reflects the contours of those living with the virus. Both How to Get Away with Murder and Looking have portrayed HIV-positive characters in a realistic light, and have even featured serodiscordant romances (relationships between two people where one is HIV-positive, the other negative) as something safe and routine.

5. Access to treatment is improving.
Since the passage of the Ryan White act, access to treatment in the United States has been strong. Those within 400% of the poverty line were given treatment without thought to their ability to pay. Bailey also mentions that California has been especially proactive when it comes to providing treatment. “It’s never been a problem for those already connected to medical care—whether through Medicaid or another program,” he says. The biggest change in treatment availability has been the shift of patients from programs funded through the White Act to ACA-expanded Medicaid or Covered California schemes. “Unfortunately, you see people transitioning to these programs, and they may experience a small copay that’s new,” says Bailey, adding, “It can complicate treatment for those who can’t afford the increase.”