Op-ed: Look to The Future on World AIDS Day

By Vanessa Cullins

Originally published on Advocate.com December 01 2013 7:00 AM ET

I remember when having HIV was a death sentence — and death was coming soon.  Thankfully, we have made major advances in the prevention and treatment of HIV and AIDS over the past 30 years. The fact remains, however, that we still have work to do — the work of prevention, the work of virus elimination. The epidemic continues to affect millions of people around the world and in the U.S.: HIV infections are still spreading and hundreds of thousands of people living with HIV aren’t getting access to the care and treatment they need.

Unfortunately for LGBTQ people, the epidemic is still impacting different communities in unequal ways. In the United States, gay, bisexual, and other "men who have sex with men" have the highest rates of HIV infection in the nation; within this group, young African-American men are at even higher risk. Also among those highest at risk for HIV infection are transgender people, especially African-American transgender women.

And the impact of HIV and AIDS on members of the LGBTQ community goes beyond infection rates. LGBTQ people have unique health care needs: in addition to high rates of stress due to systematic harassment and discrimination — which has been shown to affect physical and mental health — LGBTQ people are less likely to be insured or adequately insured, and are more likely to face discrimination from medical providers. LGBTQ people of color are at an even higher risk for these disparities — which means they often face greater obstacles, delays, and cost barriers to getting testing and treatment for HIV.

This World AIDS Day, Planned Parenthood applauds President Obama’s ongoing commitment to addressing the epidemic, including his administration’s creation of the HIV Care Continuum Initiative earlier this year. This initiative looks to increase HIV testing and earlier treatment, aligning testing and treatment efforts with new research that supports early treatment of HIV-diagnosed individuals, rather than waiting until they show signs of AIDS. Early treatment helps those with HIV live longer and healthier without symptoms, and early treatment reduces risk of HIV spread to others. So, the HIV Care Continuum Initiative aims to reduce disparities in HIV care.

In addition to the HIV/AIDS Care Continuum, the Affordable Care Act means that millions more people in the U.S. are now eligible for health insurance coverage, including many of the more than 1.1 million people living with HIV who can no longer be denied health insurance coverage because they have a “pre-existing condition.” The ACA also means that new health insurance plans must cover HIV counseling and testing at no cost for adolescents and adults, both men and women, and it puts an end to caps on lifetime expenses for care. In states deciding to expand Medicaid coverage as part of the ACA, more people living with HIV and AIDS will get access to the care they need.

The ACA makes it possible for millions more people in this country to get access to testing and information on preventing the spread of HIV, as well as those living with HIV to get referrals and treatment.

Planned Parenthood believes that when people are truly cared for, they make their lives, their families, and their communities better and healthier. On World AIDS Day, as every day, we are committed to helping create the healthiest generation ever, by working to increase sex education and HIV testing, and by helping patients who need additional care connect with trusted, quality resources. These are effective and essential HIV prevention tools.  
 
In 2011, Planned Parenthood health centers provided 680,000 rapid HIV tests (a 16 percent increase from the previous year); reached more than 1 million people through education programs; and served more men than ever — primarily for STD testing services.

By investing in sex education, fully implementing the Affordable Care Act, and increasing access to sexual health care from diagnosis to ongoing treatment, especially for those communities hardest hit — young, black gay and bisexual men, and black trans women — we can help prevent the spread of HIV and AIDS and reverse the course of this epidemic. We can take action to truly achieve an AIDS-free generation by the time another 30 years goes by.


VANESSA CULLINS, M.D., is vice president for External Medical Affairs at Planned Parenthood Federation of America. She has extensive clinical and administrative experience in sexual and reproductive health.