We Are The Generation That Will Win The War On AIDS

Crossposted on Amplify

Currently, 6,000 young people (aged 14-24) contract HIV EVERY DAY, and more then 3.1 million people die from AIDS each year. This disease, while responsible for resurgence in condom use after the rise of the birth control pill, is also the disease that exposed America’s dark underbelly of poverty and homophobia in the 80’s and 90’s. This disease, which defined a generation and revolutionized approaches to sexual health, is stronger then ever both at home and abroad.

It’s important to recognize the success we have achieved.  The United States, under the Bush Administration, saw enormous success and was able to save millions of lives by providing life saving drugs to people in developing nations.  PEPFAR’s ABC approach (Abstinence, Be Faithful, use a Condom) and the millions of dollars we have spent in 15 focus countries have been enormously successful over the last 10 years.  

But, due to short-term thinking and ideological approaches, we are faltering in the war against AIDS.  Through right wing ideological approaches that segment the A from the B and the C (Abstinence, Be faithful, use a Condom), we have created a culture of fear around condoms and sexuality itself that mirrors American society’s dysfunctional approach to sexual health.  

According to research conducted by Advocates For Youth, “despite rapidly growing numbers of HIV infections among youth, the world community has not yet implemented effective prevention. Around the globe, the vast majority of youth have little understanding of HIV transmission or how to protect themselves against HIV infection (link).”  For too long, taxpayer dollars have been wasted on programs that prioritize ideology and right wing abstinence-only programs over science and programs that work. We see this problem in public schools here at home, and in PEPFAR programs abroad.  

Bush’s PEPFAR program made 4 inaccurate assumptions about the abstinence-until-marriage programs they promoted.  

Inaccurate assumption #1: Delivering abstinence-until-marriage programs to youth is a proven HIV prevention strategy. The facts: There is no evidence to show that abstinence-until-marriage programs are effective. 

Inaccurate assumption #2: Providing young people with information about condoms will confuse youth and encourage them to have sex. The facts: A wealth of public health research clearly demonstrates that providing young people with complete, accurate education about condoms does not encourage them to have sex. 

Inaccurate assumption #3: Promoting abstinence-until-marriage will increase abstinence and also increase secondary abstinence for those who have had sex. The facts: After 11 years of federal funding of domestic abstinence-only-until-marriage programs, there is no evidence that abstinence-until-marriage is effective. 

Inaccurate assumption #4: Marriage is a protective factor against HIV. The facts: UNAIDS flatly states:Marriage on its own offers no protection against HIV for young women, especially if their husband is much older.

So there were amazing new funding streams that led to drug treatments that saved lives, but this underlying right wing philosophy made it impossible to set up long term, sustainable, comprehensive programs because PEPFAR largely focused on providing treatment and did not focus enough on prevention.  

The Bush years are over, however, and it is time for a new chapter in the war on AIDS. Unfortunately, this does not mean things are better.  There have been numerous stories recently on the funding shortages that many PEPFAR recipient countries face.  It is estimated that $27 billion will be required this year to fight the disease, and there will be only $14 billion provided. Fewer than 4 million of the 14 million people who need immediate drug treatment are receiving it (NYT).

So, first under Bush there was funding for the epidemic. And largely, it was working.  Now, under Obama, we have a leader who puts science and evidence over ideology, but the administration has focused more money on diseases that are cheaper to treat, such as diarrhea, malaria, and measles.  The original plan was for the United States to sharply increase funding over time, but now the administration is proposing only slight increases.  Since the U.S, is the largest donor country, this leaves hundreds of thousands, if not millions, without the drugs they need for immediate treatment.  It also means that there will not be enough funds to set up new clinics, help distribute condoms for prevention, or invest long term in countries so that they will eventually be able to pay for treatment on their own.  The New York Times recently indicated that

The AIDS pandemic is still spreading. And the goal of universal access to treatment remains a distant dream.

While this dream does remain distant, the dream of universal access to treatment as well as pragmatic solutions for prevention is very much alive. I have seen first hand the optimism and energy that so many amazing health experts, activists, political leaders, and business leaders are putting into this fight.  But one thing above all else gives me optimism that we will win the war on AIDS: the new generation of leaders and thinkers that are just starting to tackle this problem.  I am talking about the teenagers and young adults all over the world that are using new tools like the internet to mobilize and educate each other on the importance of practicing safe sex.  I am talking about a generation that wants to end stigma for HIV-positive people so that no one is afraid to get treatment.  The Pew Foundation has done research on the current generation of young people and found that we are more open, entrepreneurial, service minded, and pragmatic then any other generation in history.  We are the generation that reads Daily Kos while watching Colbert, and goes to college not to become wealthy at a Wall Street firm but start foundations that fight poverty and hunger, AIDS and teen pregnancy.  We will find a solution.  We are the generation that realizes the problems that young people face in east Durham, where I live, are not so different then the problems that young people face in sub-Saharan Africa. We are the generation the world needs to solve this problem, and we are ready for the challenge.