President Obama has announced a new $100 million commitment to HIV research. As figures out this week show HIV rates are still rising among men who have sex with men, this commitment is sorely needed.
To commemorate the 25th World AIDS Day this past week President Obama announced that the National Institute of Health would be shifting existing funds to the tune of $100 million and channeling them into new HIV/AIDS research. This, the President said, was about ensuring that the United States remains at the forefront of the battle to beat the virus.
“The United States should be at the forefront of new discoveries into how to put people into long-term remission without requiring lifelong therapies — or better yet, eliminate it completely,” Obama is quoted as saying.
Over the next three fiscal years, money will be channeled from existing sources and from expiring AIDS research grants into cutting edge research for an HIV cure.
This initiative aims to capitalize on recent scientific findings where HIV has been put into remission or even functionally cured (not the same as being completely eradicated from the body) via procedures like bone marrow transplants and aggressive treatment regimens. These have so far been minority cases that, because of their extremes, do not translate into wider-reaching treatment programs. What they do suggest, however, is that an HIV cure really might be possible and indicate key research areas to explore.
Other research options being touted as promising include the identification of antibodies that may be able to neutralize several HIV strains, and hoping to replicate the biological mechanisms that mean some people simply do not contract HIV.
At the same time, the Obama administration announced the United States would pledge $5 billion to the Global Fund to Fight AIDS, TB and Malaria if other countries also contribute their share. This week the President also signed into law the PEPFAR Stewardship and Oversight Act of 2013, legislation reaffirming the United States’ commitment to ending the global HIV/AIDS crisis.
This comes as startling new figures reveal that several at risk populations, in particular men who have sex with men (MSM) in the United States, are continuing with their ambivalent attitude toward HIV and are not using condoms even if they are unsure of their HIV status.
The findings, in a new report by the Centers for Disease Control and Prevention (CDC), say that while HIV positive men are not having significantly more unprotected sex than in previous years, the numbers of MSM who are not aware of their status and who are having unprotected sex has risen.
The breakdown says that, relative to 2005′s figures, the proportion of men reporting having sex without a condom increased by 21% among HIV-negative or untested men. It went up 12.5% among HIV-positive men.
Perhaps the more interesting figure is that the increase among HIV positive men doesn’t appear to be among our youngest sexually mature generation. The CDC found that 55% of 18- to 24-year-olds reported having sex without a condom while 72% of 30 to 39-year-olds reported the same. These figures did not adjust for those who are having sex with other HIV positive people, or those using a pill which can prevent the spread of HIV. It does not necessarily undercut data showing that globally most new HIV infections are occurring among 13-24 year-olds either, but it does serve to suggest that focusing on youth awareness strategies alone could miss key at risk populations.
With the rise of effective anti-retrovirals, the fear of HIV no longer seems to be a motivator for using protection. Indeed, HIV is no longer the death sentence it was during the height of the HIV/AIDS crisis in the 1980s — and that is undeniably a good thing. Still, it should go without saying that HIV is serious and for many can be debilitating if not in terms of the health impact as the psychological effects of being tied to cumbersome treatment regimens for the rest of your life.
There is a pressing need, then, to find new ways to reach the MSM community that do not hark back to scaremongering and that focus instead on the evidenced drawbacks of being HIV positive and the reasons why it should be avoided both in terms of personal interest but also social responsibility. There are programs that are getting this right, including the HIV Equal program that promotes an end to stigma but at the same time responsible practices like continued HIV testing.
So while the Obama administration is certainly right to funnel money into an HIV/AIDS cure, it is worth considering that new barrier methods – like revolutionizing condoms — and awareness programs must also be given their share of funds. It’s true that there is no one way to beat HIV/AIDS, but certainly the United States reaffirming its commitment to trying for a cure and to dealing with the situation as it currently stands is what’s needed.
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