World AIDS Day: AIDS continues its deadly march

Around the globe, 33.4 million are living with HIV/AIDS and 25 million have died since the disease first cropped up in 1981. Dramatic advancements have been made in the development of new treatments, reducing rates of infection and fighting stereotypes, but we still have a long way to go to eradicate the AIDS crisis. World AIDS Day, held every Dec. 1 since 1988, is a time to recognize this ongoing struggle and fight with one of the best weapons we have: awareness.

HIV has emerged as one of the world’s most pressing health crises. Yet, not only is it treatable, it is mostly preventable. The crux lies in education and awareness, increasing access to health care, getting people tested, and coming together as a global community to fight this horrible pandemic.

Despite the myths and fear, HIV is only transmitted through fluid-to-fluid contact (breast milk, vaginal fluid, semen and blood). It is therefore spread primarily through unprotected sex, mother-to-child transmission and intravenous drug use.

“It is a disease that is really not easy for people to get,” Stephen Bailous, Senior Vice President for Treatment Advocacy and Community Affairs at National Association of People with AIDS, said. “There are only a couple of ways it can be transmitted, and those are (mostly) through sex … You can’t really get it through any kind of casual contact so it is really much harder to get than people think.”

HIV, or human immunodeficiency virus, is a virus that attacks the body’s immune system, decreasing the ability to fight disease by killing helper T-cells. Eventually, the immune system can become so ravaged that the body cannot fight off disease and infections, and HIV turns into AIDS.

Simple tests can reveal whether you are HIV positive. Both oral and blood tests can provide an answer in about 20 minutes. NAPWA recommends that all sexually active people get tested once a year. For more vulnerable populations – men having sex with men, IV drug users and those who have unprotected sex with multiple partners – three or four times a year is appropriate.

“People should know that this is something better to know. Not knowing your status, the status of your friends, family and loved ones, will hurt you,” Bailous said.

Consider the facts: One in five people living with HIV is unaware of his or her status and 50,000 new people each year will contract HIV in the United States. While some organizations advocate abstinence or mutual monogamy, Bailous recommends protected “safe” sex, i.e., with male or female condoms.

AIDS advocates also face another challenge: the emotional and mental side of living with the disease. AIDS, says Bailous, is the “leprosy of our day.”

“Fear, stigma, discrimination – they’re driving this thing because it keeps people from getting tested,” Bailous said. “It keeps people from disclosing and sharing their status. It just makes the person living with the disease a criminal. And we don’t have that issue with any other disease in this country … No one is a bad person if they come up with cancer. They’re wonderful people who have a bad disease. And we have to get to the point that HIV is no different.”

In fact, 34 states currently criminalize HIV.

Fighting AIDS globally is a different ball game than fighting it domestically. Bailous notes that far too many countries lack the resources and infrastructure to effectively battle the disease.

“Domestically, we have more resources and better medical care than almost any other country in the world,” Bailous said. “What we don’t have is access for everybody … This is becoming a disease of poverty, because poor communities, poor people who don’t have care, those are the communities where AIDS appears to be running rampant.”

Disenfranchised populations tend to witness lower rates of treatment and higher rates of infection. This is true internationally, with 97 percent of cases around the globe occurring in low- and middle-income countries. Sub-Sahara Africa is particularly hard hit, with 22.4 million cases (67 percent of all HIV occurrences).

“More people are living with HIV, and people infected are not dying at the astronomical rates we’ve seen before. That’s the good news. The bad news is that the new infections each year, the number living with HIV, continue to go up year after year,” Bailous said.

While there is no cure, treatments are available, including 31 types of pharmaceutical drugs that can make all the difference, lowering the number of HIV cells in the body to allow the immune system to remain healthy. It comes down to funding and increasing AIDS patients’ access to medical care – and catching it early.

Although these meds have side effects just like any type of pills - imagine being on chemotherapy for life – they can keep someone healthy year after year.

For someone untreated, perhaps living in a poor African community, the story is quite different.

“People who go untreated are likely to within 10 years regress to AIDS, and they are going to be very, very sick,” Bailous said. “And ultimately, they are going to have some opportunistic infection that, if left untreated, will kill them. Most people who are untreated show up late in some emergency room with an opportunistic infection and get treatment late. (By this time) unfortunately, their immune system has deteriorated and they’ve got some horrible disease they might have avoided had they been treated earlier.”

If left untreated, late stage HIV is deadly often in a few months, or, at most, a few years. If people know their status and get care, that kind of disease progression is unlikely.

“The problem with any health care issue is if it goes untreated, it’s a problem,” Bailous said. “And it is tragic, because we have all the tools we need. We now know that if people are on treatment and are adherent and become undetectable, it is difficult or almost impossible for them to transmit the virus. So I think you will begin to see people talk about the end of AIDS because we may be able to treat our way out of this.”

World AIDS Day is a time to remember those who have died and those who live in shame and those who suffer without treatment.

“We have a lot of information … so we really want people to commit to ending AIDS,” he said. “People can have normal lives, even normal sexual lives. We just need the will to do it … It is a time for conversation. It is a time for us to not fear talking about it. The silence is killing us.”

More than 1.2 million Americans are living with HIV and that number is growing. “There’s no reason people should not know this basic information,” Bailous said.

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