What Ever Happened to AIDS?

AIDS test

n 1984, when HIV (the virus that causes AIDS) was discovered, much was unknown.  Because it was a new pathogen, experts did not fully understand how it was contracted, or the prognosis after infection. Predictions were that millions of adults would be infected by HIV/AIDS and hundreds of thousands of children orphaned as a result in the United States alone.

As more became known, first about the U.S. epidemic and then the global pandemic, it became clear HIV/AIDS was the biggest health crisis the world had faced in generations.

Resources and research were mobilized. Within a decade, initial treatments were identified, providing subsequent discoveries in diagnosis and treatment.

Although HIV is still not curable, today it is no longer an automatic death sentence. For young adults with HIV in the U.S. and Europe who began treatment in 2008 or later, and have a low viral load because of medications, life expectancy is near normal (The Lancet, May 10, 2017).

As a result of scientific progress, we have made several discoveries:

– How to eliminate mother-to-child transmission (no babies born HIV-infected in the U.S. in 2015)

– The combination of therapies that help suppress the virus to a point where those infected are much less infectious

– Improved treatment regimens with fewer and less severe side effects, which greatly improve quality of life for those diagnosed with HIV

In 2003, President George W. Bush initiated an unprecedented program to respond globally to HIV/AIDS called the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). As of 2017, through PEPFAR, 11.5 million individuals are on HIV treatment; 2 million at-risk babies worldwide have been born HIV-free; 1 million youth ages 15-24 have received risk avoidance messages; 11.7 million men had received voluntary male circumcision treatment (shown to reduce transmission); and 6.2 million orphans and adolescent children have received comprehensive treatment and care.

These unprecedented gains in the face of seemingly insurmountable odds has led many to believe the problem is solved—that HIV/AIDS is history. However, that is not reality. Despite the amazing results achieved over the last three decades, HIV/AIDS is still with us.

The U.S. Epidemic

According to the Centers for Disease Control and Prevention (CDC), there are an estimated 1.2 million HIV-positive people in the U.S., and 1 in 8 do not know they are infected. While the CDC reports the annual number of new infections declined 19 percent between 2005 and 2014, the number of new diagnoses in 2015 was 39,513.

The burden of HIV is not evenly distributed either ethnically or geographically. In 2015, African Americans represented 12 percent of the population but accounted for 45 percent of HIV diagnoses; Hispanics/Latinos represented about 18 percent of the U.S. population but accounted for 24 percent of HIV diagnoses. In 2015, HIV infection rates were highest in the South (16.8%), followed by the Northeast (11.6%), the West (9.8%), and the Midwest (7.6%).

By age of persons diagnosed in 2015, 4 percent were 13 to 19 years old; 37 percent were 20 to 29; 24 percent were 30 to 39; 17 percent were 40 to 49; 12 percent were 50 to 59; and 5 percent were 60 and older. Most affected populations include gay men and bisexual men, heterosexual women, and injecting drug users.

At the end of 2013 (the most recent available data), young people were the most likely to be unaware of their infection. Among people ages 13 to 24, an estimated 51 percent of those living with HIV did not know their status.

We in the U.S. often think of HIV/AIDS as primarily a sub-Saharan Africa issue. However, in 2015, both the District of Columbia and Baltimore (Maryland) reported infection rates of 2 percent, which exceeds the World Health Organization’s definition of 1 percent as a generalized epidemic. Comparing that percentage with the following African nations is eye-opening: Senegal (0.5%), Burkina Faso (0.8%), Democratic Republic of Congo (0.8%), Burundi (1.0%), Sierra Leone (1.3%), Ghana (1.6%), Chad (2.0%), Nigeria (3.1%), and Ivory Coast (3.2%).

The Global Pandemic

In 2015, 36.7 million people globally were living with HIV; 2.1 million became newly infected; 1.1 million died from AIDS-related illnesses. As of June 2016, 18.2 million people living with HIV were accessing antiretroviral therapy.

Because of treatment availability, AIDS-related deaths have fallen by 45 percent since the peak in 2005. But the difference between the number of people living with HIV globally and those accessing treatment approximately 18.5 million continues to drive the pandemic until global diagnosis and treatment are more accessible.

According to UNAIDS, if the world is to end the AIDS pandemic by 2030, rapid progress must be made by 2020. Quickening the pace of essential HIV prevention and treatment approaches will limit the epidemic to more manageable levels and enable countries to move toward elimination. If the response is too slow, the pandemic will continue to grow, with a heavy human and financial toll of increasing demand for treatment and expanding costs for prevention and treatment. UNAIDS modeling predicts that if the world reaches 2020 targets by 2030, that delayed response will lead to 3 million more new HIV infections and 3 million additional AIDS-related deaths between 2020 and 2030.

What Churches Can Do

There are many ways the church can engender a redemptive, compassionate response to those impacted by HIV/AIDS, as well as to help end the pandemic. It’s important to remember that families and loved ones of HIV-positive individuals are also HIV-impacted.

1. Recognize the reality of the challenge. Talk about it not just once, but regularly over time. This can be done through presenting special messages on World AIDS Day (Dec. 1); offering on-site HIV testing on National Testing Day, with church leaders being tested to encourage participation; providing youth programs focused on prevention education and service opportunities; making it a topic of regular prayer. Because the biggest predictor of HIV infection and STDs is number of lifetime partners, telling young people to wait until marriage and then be faithful in marriage will protect them from HIV for life.

2. Identify organizations in your denomination, city, or state serving HIV-impacted individuals, and explore opportunities for outreach and partnership.

3.  If you are not in a region with many HIV-related programs, partner with a sister church located in an area with higher infection rates to provide volunteer and outreach opportunities for your congregation.

4.  Review and employ Saddleback Church HIV & AIDS Initiative resources on how to start an HIV/AIDS ministry at hivaidsinitiative.com.

5. Ask your church-supported missionaries (especially in sub-Saharan Africa) about their ministry related to HIV/AIDS and how you can support their goals.

6.  Work with groups like the National Association of Evangelicals which continually advocate in Washington for U.S. government resources to fund and support programs focused on HIV/AIDS, poverty, nutrition, clean water and hygiene, human trafficking, refugees, maternal and child health. Discover the critical role the faith community has historically played, and continues to play, in mitigating all of these.

If we daily follow Christ’s example of compassionate redemptive actions to serve those in need, there will be no end to the opportunities. As stated in a USAID article authored by Saddleback Church’s Kay Warren, Elizabeth Styffe, and Gil Odendaal: “The only organizations with large enough volunteer labor forces and distribution networks to tackle the global giants [HIV/AIDS and poverty-focused development assistance issues] are the Christian church and other faith communities—the grassroots fellowships found in every community and village around the world. . . . This network of congregations is a sleeping giant waiting to be mobilized.”



Anita Moreland Smith is president of Children’s AIDS Fund International in Washington, DC. 703-433-1560; www.childrensaidsfund.org