When I was in middle and high school, I learned about HIV and AIDS the way I learned about the Cold War, or disco. It was a part of recent history – my parents remembered it, I understood that it seeped into today’s world in some way, but it was history nevertheless.
My experience is not isolated. Plenty of young people learn about the AIDS crisis as something with a beginning and an end that predate our birth, rather than as an ongoing epidemic that could potentially affect our own lives. And not only does HIV affect us, we live in a time of great progress in research and policy working to end the spread of the virus. Thanks to the availability of effective medications, it is now possible to live a full and healthy life with the virus and even never to develop AIDS, the condition that someone with HIV develops once the virus has led to a related infection and/or seriously damaged their immune system. The United States has a National HIV/AIDS Strategy, created in 2010 and updated in 2015, which focuses on an intersectional, holistic fight against the epidemic. And prevention research has reached important breakthroughs in recent years – which is why I’m writing this article in the first place!
I first want to acknowledge that my experience around HIV education is not universal. HIV has been tied to various identity markers throughout its nearly-35-year history in the United States, and my lack of HIV awareness is directly related to my being a straight woman who grew up in a predominantly white, predominantly wealthy suburbs.
Overall, the likelihood of having learned about HIV or AIDS in school declined by 7% between 1997 and 2013; awareness rates lag behind the continuing spread of the virus. Some useful facts about HIV in the United States:
- Over 1.2 million people live with HIV in the U.S. today.
- An estimated 50,000 new HIV infections appear each year across the country.
- About 26% of new infections are among youth between the ages of 13 and 24.
- The majority of young people living with HIV in the U.S. do not know their status.
- Men who have sex with men (MSM) remain the population most affected by HIV and AIDS, with black MSM disproportionately impacted.
- Women make up about a fourth of the population living with HIV in the U.S., and 84% of new infections among women are the result of heterosexual contact.
- Although all 50 states and the District of Columbia allow minors to consent to STI testing and treatment, some do not include HIV testing and treatment as part of that package, and some allow physicians to notify parents/guardians without the minor’s consent.
There are many reasons that certain populations are more heavily impacted by HIV and AIDS, which I will not go into in depth but which you can read about in many wonderful places including the CDC, the Positive Women’s Network, and TheBody.Com.
So let’s talk about preventing HIV transmission through sexual contact.
As of May, 2014, a pill called Truvada is available that can be used as “pre-exposure prophylaxis,” or PrEP. PrEP reduces the risk of contracting HIV for those who are considered to be at risk, such as people who do not regularly use condoms, people who use injection drugs, or people with partner(s) who are HIV-positive or at risk. When taken daily, Truvada reduces the risk of contracting HIV from sex by more than 90%, and from drug injection by more than 70%.
Researchers are working to develop PrEP methods aside from a pill, such as injections, a vaginal or anal ring, and microbicide gels and lubricants. It is recommended for use in addition to condoms. PEP, or post-exposure prophylaxis, is a course of anti-retroviral treatment that should be started within 72 hours of being exposed to HIV (and preferably as soon as possible) in order to reduce the risk of becoming HIV-positive. Both PrEP and PEP require a doctor’s prescription and are covered by most private insurance (Medicaid coverage varies by state). There are also programs available to help people without insurance cover the cost.
Condoms: Use them. The Truvada pill only protects against HIV, not other STIs and not pregnancy. It is also not 100% effective, especially if not taken correctly. Condoms are not 100% effective either, but when used correctly and consistently they are the most effective method available to you for preventing against HIV, other STIs, and unwanted pregnancy.
Thanks to the effectiveness of the anti-retroviral medications available for people already living with HIV, you may hear about a beautiful phenomenon called treatment as prevention. Anti-retroviral therapy reduces an individual’s “viral load,” or the amount of virus in their body, in order to keep their immune system functioning. With anti-retroviral treatment, someone living with HIV may be up to 96% less likely to transmit the virus to others through sexual contact. For this reason, and for your general health, it is important that you get tested. Knowing your status means you can keep yourself from developing AIDS, stay healthy, and not transmit to others. And the earlier someone starts treatment for HIV and/or AIDS, the more effective their treatment is likely to be.
Unfortunately, the HIV and AIDS epidemic is still relevant to our lives, our sexual experiences, and our sex education. But treatment and prevention methods are efficient and expanding, and there is an end to the epidemic in sight. Now it’s up to us to make sure we’re talking about, learning about, and using the prevention methods that work best for each of us.
Cover image courtesy of Shutterstock.