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2010: The Year the Tide Turned Against AIDS?

A number of new medical breakthroughs, a slightly softened stance from the Vatican and a vigorous new generation of activists offer new hope--but huge challenges remain.
 
 
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Earlier this winter German doctors announced that a man who had been given a bone-marrow transplant had been HIV-free for three years. Last month, a drug used to contain HIV was shown to also prevent its spread from person to person. Meanwhile there may be a blueprint for a vaccine, more people are getting tested than ever, the Pope has loosened his stance on condom use just slightly enough to give experts a sliver of hope that contraception distribution will be easier, and a new breed of anti-AIDS activists puts increasing pressure on the government to act with urgency.

There’s a long way to go, and the stigma of HIV lingers, but it looks as though the tide may have finally turned against this persistent disease.

 Medical Breakthroughs

The most recent breakthrough came from Germany, when doctors announced that thanks to stem cells (ahem, right-wingers), they had successfully reduced a man’s HIV levels to undetectable, even going so far as to use the word “,” as MSNBC reported:

In 2007, the man received a bone marrow transplant to treat his leukemia. The transplant — which treats leukemia by essentially rebooting the body'simmune systemand creating new white blood cells —also had the benefit of wiping out the HIV infection. Now, three and a half years later, the patient remains HIV-free, which suggests he is cured of the disease, the researchers said.

While many scientists suggested caution at the word “cure,” as the disease might remain undetectably, there was no question throughout the community that the findings were heartening. Furthermore, finding a donor with the right kind of rare irregularities that helped rid this test subject of the disease is no easy thing--it’s a 1% occurrence in Northern Europe. But there’s hope that gene therapy--an experimental, cutting-edge technique which would potentially work by“inserting a gene into a patient’s cells instead of using drugs or surgery”--can replicate the results of the marrow donation.

This case study, which was initially published last year in the New England Journal of Medecine and then confirmed in the journal Blood, comes on the heels of another promising study. The second study posits that Truvadia, an antiretroviral currently used to contain HIV in infected patients, can actually help prevent the spread of the disease when taken daily by healthy gay men. This second study, also published in the New England Journal, showed that the men who took the pill daily--without skipping or forgetting--were 73% less likely to contract the disease than those who didn’t.

The drug needs to go through further rounds of testing to see if it has similar beneficial effects for women and heterosexual men, and even then, would only be considered one aspect of a wide of methods for protection (e.g along with condom use and frequent testing). But it’s still heartening, Dr. Anthony Fauci, The director of the National Institute of Allergy and Infectious Diseases of the National Institutes of Health, which sponsored the Truvadia study explained the upshot to NPR in November, saying, “we now have a potentially new tool in our armamentarium of preventive measures, which must be always considered as a multifaceted, comprehensive approach to prevention. But this is a very important weapon now we have in that approach...”

These cutting-edge medical breakthroughs won’t have a major impact on society for months or even years, but at least they’re finally being made.  Two other major breakthroughs this year were outlined by TheBody.com's editor-in-chief Kellee Terrell in the Huffington Post:

...the discovery of two rare human antibodies that kill 90 percent of all HIV strains, which could provide the basisfor a vaccine. The first-ever successful clinical trial of a microbicide, which could bring us one step closer to women being able to have more control over their sexual health.


A Change in Attitude

Meanwhile, the primary means of preventing the spread of HIV/AIDS has always been the barrier method, or the use of condoms. As common sense as it is, religious forces from the Vatican to American evangelicals have been squeamish about aid money going to condom distribution, a stance which arguably more than any other has contributed to the public finding these groups irrelevant and even immoral. But condoms got a rather an unexpected boost recently from notorious condom-scorner (and policy-influencer) the Pope himself, when he went on the record saying that although condom usage was still a sin, there were certain instances (an HIV positive prostitute, for instance) when it became the lesser of several evils. This was a tiny, incremental step forward, ad several Catholic aid groups immediately stepped up to say would have no effect on their AIDS policies, but as Frances Kissling wisely noted, it would give a crucial boost to workers in the field who want to give out condoms anyway. Hopefully, she wrote, it will at least begin a conversation.

Finally, in another sign that AIDS activism has gone mainstream, the NY Times ran a feature about a “new breed of AIDS activist” young, wonky, and not particularly rebellious students who are moved to urgency on their issue, even to the point of pubicly heckling their hero, president Obama. Writes the TimesSheryl Gay Stolberg:

Roughly a quarter-century after gay men rose up to demand better access to H.I.V. medicines, a new breed of AIDS advocate is growing up on college campuses. Unlike the first generation of patient-activists, this latest crop is composed of budding public health scholars. They are mostly heterosexual. Rare is the one who has lost friends or family members to the disease. Rather, studying under some of the world’s most prominent health intellectuals, they have witnessed the epidemic’s toll during summers or semesters abroad, in AIDS-ravaged nations like Rwanda, Tanzania and Uganda.


While the activism of these often-privileged kids is no more important  or influential than any other kind of activism, their position in the world indicates the steady erosion of the AIDS taboo, and shows how accepted it is to tackle the problem of AIDS head on, with righteous anger. They have interruptedObama repeatedly, confronted his advisors at campus events, and picketed vigorously, all in the service of demanding more funding for AIDS. And they're even studying the tactics of 1980s-era Act UP AIDS activists.

Challenges remain

Of course, the battle is far from over. While more people than ever are getting HIV tests, and easier tests are being developed--more than half of Americans still do not get tested. As with many health issues, under-served populations continue to get shafted. African-American women in 2006 were getting infected at a much higher rate than white or Latina women. And with the budget crunch, many states are cutting off access to free drugs. And the lingering persistence of homophobia is and always will be a hurdle to overcoming stigma.

It’s also true that medical breakthroughs that initially look exciting can linger in limbo for years, end up being disappointing. And if AIDS is still stigmatized by right-wingers or homophobes here, it’s got an even further way to go in many developing nations where the work of activists and advocates to change perceptions has begun more recently than it did in the United States, ground zero for AIDS activism.

Still, with all the dismal news progressives faced this year, we can definitely take a moment to savor the progress the medical and activists communities have made against AIDS, and hope 2010 will be remembered as the year the tide turned.

Sarah Seltzer is an Associate Editor at Alternet, a staff writer at RH Reality Check and a freelance writer based in New York City. Her work has been published in Jezebel.com and on the websites of The Nation, the Christian Science Monitor, and the Wall Street Journal. She can be found at sarahmseltzer.com.
 
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