fbpx The Real Future of HIV
A hand holds a smart phone with a glowing strand of DNA floating above.
A hand holds a smart phone with a glowing strand of DNA floating above.

The Real Future of HIV

Continuing to improve care and awareness of the virus requires a mix of optimism and realism.
Aleck Woogmaster
Written by

Aleck Woogmaster

Whenever we talk about diseases, it's easy to focus on the goal of discovering a cure. However, when talking about human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), hoping for a cure won't answer immediate questions.

Modern treatment and prevention methods are extremely effective at preventing transmission and minimizing the physical symptoms of HIV. People who are HIV positive can live exceptional and outstanding lives, enjoying longevity without much risk of passing the virus on.

Maria Mejia is an outspoken, long-term survivor of HIV in Fort Lauderdale, Florida. Since her diagnosis 35 years ago, she has made a tremendous impact on both HIV-positive and -negative communities, and she works as a politically, scientifically and socially aware advocate on social media and in real-world meeting rooms. While Mejia is unabashed about how she talks about the current realities of living with HIV, she also does not take the subject lightly.

"This is not a death sentence anymore, but it is a life sentence," Mejia said. "You cannot take HIV lightly. Just because we have good access to medications and everything, people still die, people are still dying from complications of AIDS all the time."

The realities of living with HIV

Mejia stressed that a pressing concern for HIV awareness in the United States is to continue emphasizing testing and prevention.

"Those who are not positive should get tested if they're sexually active and not using protection," she said. "Always get tested at least every six months. It's free and it's available, especially in the United States, right? So if you find that you do have HIV, you can get on treatment immediately, which is something that's helped."

Many people want to know if and when a cure for HIV, including a possible vaccine to prevent the virus, will be available. This conversation brings up challenging medical questions but also creates room for oversight of addressable issues on the table for HIV-positive people today.

For example, recent historical events have had consequences on the HIV-positive community and its supporters. The impact of broader social health problems can be felt emotionally and spiritually by people who understand the devastating impact HIV can still have on survivors.

"Mental health is a huge issue right now," Mejia explained. "We all have a collective trauma because of COVID and the things that COVID brought, which is that it isolated many of us. A lot of my friends, last year alone, like 30 of my friends died; half suicide and the other half was, again, cancer diagnostics. For some, it's been a huge loss."

Despite successes and breakthroughs in the search for an HIV vaccine and cure, those options are not ready for the public.

Yet the horizon doesn't necessarily have to look bleak when you squint at the future of HIV. There are many victories to celebrate and an abundance of knowledge to soak up and use so HIV can be a fully suppressed condition with almost no chance of transmission.

Resources may be difficult for some people to access but they are available. The more people undergo testing and use resources like PrEP—pre-exposure prophylaxis can reduce your chance of getting HIV from sex or injection drug use—the brighter the future will become in regard to HIV transmission and diagnosis rates.

Solid science is only half the battle, however, as it's well known that public awareness of HIV and AIDS is still steeped in stigmatizing language and false impressions.

What do we do to combat that aspect of the problems associated with HIV? How do we normalize awareness and education the same way we have normalized living with HIV by creating a world where U=U?

When taken as prescribed, HIV medications can decrease the amount of HIV present in a person's blood—also known as their "HIV viral load"—to the point where it's too low to measure or detect. Being undetectable prevents HIV disease from progressing and allows people to live long and healthy lives.

It also protects the health of their sex partners. People cannot pass HIV through sex when they have undetectable levels of HIV. This is known as Undetectable = Untransmittable (U=U).

Real talk and real laughter

Speaking candidly about HIV is a start, but the conversations don't need to feel bleak. People can live well with HIV. Shouldn't we be able to laugh as well?

Andy Feds is a comedian based in Las Vegas. Born Brandon Cox Sanford, Feds was also born HIV positive due to contracting the virus from his mother. Despite living with the condition since birth, Feds didn't start incorporating HIV into his comedy routine until he received a suggestion from his partner. He said he simply didn't think to connect the two things at first, but there have been a wealth of experiences supporting and encouraging him to help normalize HIV by incorporating his perspective into his act.

People diagnosed with HIV come from all walks of life, and performers and nonperformers alike can use some of the advice the comedian provides.

"You have HIV, HIV don't have you," Feds said. "People are living and thriving with HIV. And so this one little diagnosis should not stop whatever it is that you had going on before. It's just going to slow you down a little bit, maybe. And, you know, you have to take your medicine, you have to go to the doctor, you know, basically, keep up with yourself, but it doesn't stop anything."

In simplest terms, HIV is difficult to cure and vaccinate against because of its unique ability to replicate and mutate. Scientists have yet to identify a way to eliminate HIV from the deep reservoirs it plants itself in within the human body. Permanently removing it from a person's system is like trying to wrestle an eel out of a jello pool if the eel had shape-shifting powers.

There have been a few cases of HIV being seemingly eradicated from select patients, but because those cases are considered extreme rarities, there are more practical places for people to direct their attention.

"I always tell people that, to me, in my opinion, the real cure to HIV is to educate, communicate and prevent," Feds said. "Once you educate yourself on what it is, once you talk to your partner about how you can protect both of you, and then once you actually act on that prevention, we can lower the amount of HIV to a point where there's no more transmission."

The fact remains that HIV today poses much greater problems metaphysically than in terms of symptom manifestation or disease progression. Many of the physical problems related to HIV are problems of a flawed health system in general. And like a cure for HIV, those flaws are not problems that can be solved overnight.

Mejia explained that people within and outside the HIV-positive community need to look to each other to overcome boundaries in communication and culture. She said the empathy gap between generations of people needs to dissolve and be replaced by mindfulness, respect and intentionality.

"There's a lot of loss," she said. "I have lost a lot of people. There are a lot of people, still, with no access to medication; like in Venezuela, for example. I urge young people to respect their elders and listen. Obviously, the elders need to respect them as well."

Respect may not be a cure for HIV or AIDS, but communication and actually listening can help reduce the impact of stigma and ignorance surrounding people living with these conditions.

How to move forward

There's a tremendous amount of serious conversation to be had surrounding HIV, AIDS and healthcare in general throughout the world.

Mejia drove home that point by emphasizing how today's solutions are not able to erase the impact of yesterday's failures. "Listen, HIV and AIDS are not conditions that are quite like anything else; that you take one pill and, 'I'm fine, OK,'" Mejia said.

As important as it is to celebrate successes—which in turn allow us to better manage the crisis of HIV in the immediate future—we should continue to recognize that successes don't come without tragedies to mourn. The big takeaway, though, is that those tragedies don't have to be seen as inevitable anymore.

"We have treatment options. We have prevention. We have testing," Mejia explained. "The next big step on the journey is for us to see those services utilized more effectively."

For a reminder of how important those services are, people should look to others who have experience living with HIV, such as Mejia and Feds.

"I tell [my followers] to get tested, to respect this condition, to respect long-term survivors…because we're still here," Mejia said.