By Perry N. Halkitis, Shobha Swaminathan and Travis Love
For the 1.2 million Americans living with HIV or AIDS, the ongoing COVID-19 pandemic continues to undermine their physical, mental, social, and economic wellbeing.
These impacts on health are exacerbated in Black and brown communities particularly Black sexual- and gender-minority men and women and Black cisgender women who are coping with the realities created by COVID-19, ongoing systemic discrimination, and a plethora of other social inequities that create additional vulnerabilities to their overall health.
The COVID-19 pandemic has derailed our efforts to bring an end to the HIV/AIDS epidemic, adding to the stigma, systems of oppression and structural racism that ultimately fuel the HIV/AIDS epidemic in our state and country.
We know all too well that stigma is one of the reasons why patients continue to experience trauma related to their HIV diagnosis. In fact, for many people living with HIV/AIDS, reliving the trauma of isolation while simultaneously fearing for their lives should they become infected with COVID-19 has had a synergistic effect.
As a result of the ongoing stigma surrounding HIV/AIDS, many people who become infected with this virus may not want to know their status, fearing rejection from family, friends, and sexual partners. In fact, for those already diagnosed, the stigma and resulting trauma can prevent many from continuing to seek adequate care, undermining their viral suppression and resulting in the progression of HIV. This can also lead to increased infectivity to sexual partners.
In the early days of HIV/AIDS, victim-blaming was common and those who developed a detectable number of antibodies in their blood were categorized as either innocent victims (i.e. children and hemophiliacs) or immoral beings who through their actions brought the disease upon themselves (i.e. gay men and injection drug users).
We believe that stigma is the driving force behind the health disparities that continue to put people at risk for HIV/AIDS. In order to end the HIV/AIDS epidemic, we must ensure more access to care and cultivate an ecosystem that combats systemic racism, homophobia, and transphobia.
We must call on the federal government to fund and tackle gaps in care and to prioritize care for individuals who are vulnerable to both COVID-19 and HIV/AIDS, who are too often Black and brown people.
It is very possible to envision a world free from HIV, given our current medical advances in the form of preventative medication, PrEP, and effective antiretroviral therapy (ART), which when dosed properly creates a zero probability that an HIV-positive person can infect someone else.
What we need now, is a vaccine. After 30 years of research, a new clinical study, MOSAICO, shows promise and offers hope. The Rutgers New Jersey Medical School Clinical Research Center (NJMS CRC) is currently seeking volunteers who are queer, gender non-conforming, and transgender to screen and enroll in the study. The research team also facilitates workshops to reduce vaccine hesitancy and to raise research literacy.
Yet, medications are not enough. While novel therapeutics remain key, behavioral interventions and social acceptance are essential for their success. By using a status neutral approach, we will stop the forced differentiation of HIV positive and negative people. This approach is simple: a person is ensured access to care if they are HIV positive. If a person is HIV negative, they are given access to preventative medications such as PrEP.
Practicing a status neutral approach can repair the schism that has existed for far too long between HIV-positive and HIV-negative populations. Our goal is to assure that everyone has a right to good health.
Gov. Phil Murphy has shown how deeply he understands and how passionately he cares about the structural drivers of disease. Now we must act. We cannot let the HIV/AIDS epidemic continue to take a backseat to pressing health care issues of the moment. As we continue to raise awareness, we are calling on New Jerseys Legislative leadership to enact the policies developed by Governor Murphys Statewide Task Force to End the HIV Epidemic.
We all need to raise our voices together to end this epidemic. The public can also make a difference by urging our elected officials to:
To learn more, join Rutgers School of Public Health and Rutgers New Jersey Medical School as we strive to raise awareness of a Neutral Nation with a series of engaging events from February 17 to 20.
Dr. Perry N. Halkitis is dean and director of the Center for Health, Identity Behavior & Prevention Studies (CHIBPS) at the Rutgers School of Public Health. Dr. Halkitis also was a member of both the New Jersey and New York Ending the HIV Epidemic planning groups.
Dr. Shobha Swaminathan is an associate professor of medicine at Rutgers New Jersey Medical School and the Medical Director of the infectious diseases practice at University Hospital in Newark. She was a principal investigator of Modernas COVID-19 vaccine trial in Newark.
Travis Love is a community educator who has served as a public health representative at Rutgers New Jersey Medical School since 2016.
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