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Invest In The Wellbeing of PLWHA To Prevent New Transmissions

This is the second in a series of four Q&A posts capturing founder Bruce Richman’s perspectives on our movement to end HIV stigma with U=U, Prevention Access Campaign, and all of us. Recently he talked with us on DAP LIVE.

Question

We don’t talk enough about how stigma can prevent us from getting HIV testing.

If someone who’s HIV positive can access medication, they can live a very long life. But if they don't know that they have HIV and they don't access medication, there can be all kinds of complications.

Tell me about U=U’s role in ending the epidemic. Because if we don't know our status, and if we don't have access to the medication we need, we're not going to end the HIV epidemic. Also, why is stigma still so prevalent?

Answer

Initially I didn't understand that U=U had a role in ending the epidemic in terms of preventing new transmissions. I always really focused on improving the lives of people with HIV and ending the stigma that we have faced for so long. But in terms of ending the epidemic, U=U is essential. Dr. Fauci says, “U=U is the foundation of being able to end the epidemic,” because the more people who are on treatment and undetectable, the fewer new transmissions there'll be.

So in the United States, when you realize half of the people living with HIV are not on treatment and not in care, and they're not getting the treatment and care or the services, they need to stay healthy.

They're also not getting those services that they need to stay un-transmittable. So if we really want to end the epidemic and save lives, we're going to make sure that we invest in the wellbeing of people living with HIV, so they can stay healthy and prevent new transmissions. We need to link investing in the wellbeing of people living with HIV to ending the epidemic. Because when you invest in the wellbeing of people with HIV, you prevent new transmissions. And that's a big deal.

HIV stigma is intertwined with all kinds of stigma. There's sex negativity, homophobia, transphobia, stigma against people who inject drugs and sex workers. And that deep-seated negativity against all kinds of STIs. HIV stigma is particularly embedded in this country because of the last 35 years of mass fear-based messages. And what we remember since the early days of the 1980s.

It’s something that is really hard to unlearn decades of fear of HIV and people living with HIV. It'll take a long time. That's why we have to keep saying it— “U=U.”

People living with HIV cannot pass it on if you make sure that all of us have the treatment and the care that we need to stay healthy. We're not going to pass on HIV. There's no fear. You can have sex,  babies, love—all with no risk.

Question:

When you started this, did you think it would become a global human rights movement?

Answer:

We launched U=U four years ago. No, I didn't think it was going to be like this. I've always been really behind the scenes with my work in the past. I just knew this had to be done. We had targets, we had the CDC, we had UN AIDS, World Health Organization, public health associations, and research associations.

We were very focused in terms of who we needed to move forward and our advocacy. And we had numbers, I think at the end of the first year, we're going to have 75 in the U.S. and we had already had 200 at that point.

This just goes to show the power, the passion and the brilliance of people living with HIV around the world who are standing up to change the narrative about their bodies. And to reclaim our lives from public health systems that are deeply, inherently flawed, racist and paternalist—all those “isms” that prevented this life changing information from getting to us all those years.

It's almost a thousand organizations in 101 countries. Now it's just, it's phenomenal. And so many different languages.

Preventionaccess.org has a lot of information, including social shares that allies can use. It's got tips about the language that we should all be educating ourselves about. It’s science-based, and values fact over fear.

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