With Other Public Health Issues, Is HIV Still a Priority?

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As a priority yes, it still should be very high priority. One of the problems we are facing and there are a few and I'll mention a couple of them is the resources for programs like PEPFAR and the Global Fund instead of escalating, they're staying flat or coming down. One can understand in an era of financial and resource constraints why that is happening but that is not a very visionary approach because if you let the pandemic start to do this, you're going to pay twice as much 10 - 15 years from now. So now that it's starting to do this, is the time to really nail it and unfortunately because of constraints on resources we are not giving it the full quad press that it needs, that's globally.

In the United States because we have such good treatments there is the degree of complacency it's not on your front page of the news outlets anymore but there is an insidious thing going on that people are not appreciating we are stuck at 50, 000 new infections which is unacceptable that we went from up to 120, 150000 new infections a year during the really bad years when San Francisco, when Greenwich village in the Castro district in L.A were getting decimated, to turning around and coming down until it got to 50 and then it stayed at 50 and the reason it stayed at 50, there was a shift in the population that was most vulnerable. The face of HIV/AIDS in the very early 1980s was a young to approaching middle age white gay man. Now the face of AIDS is an African-American man or woman.

If it's a man, it's mostly men who have sex with men, you have a 12% of the population in the United States is African-American and almost 50% of the new infections are among African-Americans, so its an example of extraordinary health disparity for a number of complicated societal economic and other reasons.

Stigma, the acceptance over the black gay man, the economic situation in certain regions where the access to healthcare is not as you would hope it would be, all of those things are keeping the epidemic smoldering in the United States when it should be smashed and crushed.