Opinion: Stigma a barrier to HIV treatment despite medical advances

By Ben Young and David Cohn

The first seven cases of acquired immune deficiency syndrome (AIDS) diagnosed in Colorado were discovered in 1982. By the end of 2011, almost 17,000 people in Colorado had been diagnosed with human immunodeficiency virus (HIV), the virus that causes AIDS, and more than 5,000 had died from complications of the disease.

These are not just numbers. They represent people our children, mothers and fathers, brothers and sisters, partners, friends, neighbors and colleagues.

Today, we know more about HIV. Many of these advances over the past 30 years can be linked to Colorados role in HIV treatment, prevention and education, earning our state a respected and prestigious reputation within the global HIV community.

The historic 1983 Denver Principles asserted for the first time the fundamental rights of those living with AIDS to participate in the decision-making for their care. The Colorado AIDS Project and other organizations were founded to facilitate and supplement care and education. The Governors AIDS Coordinating Council and Denver HIV Resources Planning Council brought many to the table to collaborate as advisory bodies on advocacy and public policy, and eventually, in decision-making on equitable distribution of much-needed federal funds for care and treatment.

In the 1980s, researchers at Denver Public Health (DPH) and National Jewish Hospital (NJH) studied the epidemiology and immunology of the then-mysterious disease, and both DPH and the University of Colorado participated in early prevention programs in at-risk populations.

In the 1990s, faculty members from CUs Division of Infectious Diseases led the National Institutes of Healths AIDS Clinical Trials Group and Community Programs for Clinical Research on AIDS, providing novel and experimental treatments to many patients, paving the way to the development of successful combination treatment regimens against HIV.

Through collaborations with the Centers for Disease Control and Prevention (CDC) and community clinicians at Rose Medical Center and NJH, in 1998 came the first reports of reduction in the death rate from AIDS. Most recently, critically important work led by doctors at DPH has brought needed attention to important gaps in accessing HIV medical care. All of these discoveries came about because of the Coloradoans who volunteered for clinical studies.

The world is indebted to these many individuals.

Today, with access to medical treatments and care, HIV need not lead to AIDS and death. Indeed, people living with HIV can expect a high quality of life and normal life span.

But decreased death and better medicines have led to false perceptions that HIV isnt a serious health threat or that people are no longer at risk.

We are concerned that these beliefs and other societal barriers have kept our states diagnosis rate, averaging 430 Coloradans per year, from declining over the past decade. Although these represent a rate of new infections that is three times less than 20-25 years ago, we still need to address the plateau.

Stigma, discrimination and prejudice prevent many people from getting tested. Perhaps even more alarming is that among those who do test positive, many never enter medical care or fail to stay successfully engaged with potentially life-saving treatments.

As advocates, activists and concerned citizens who have joined the fight to end HIV/AIDS, we must do more. Today, one new person becomes infected with HIV every 9.5 minutes in the United States, and an estimated 1-in-5 individuals dont know that they are HIV-positive.

The first step anyone can take to help in this fight is to get an HIV test (the CDC recommends regular testing for anyone 13-64). Getting tested is not time-consuming, complicated or painful. Most tests involve a simple finger prick, and results are available in less than 12 minutes. Last week, the Food and Drug Administration approved the first over-the-counter HIV test, allowing people to test themselves at home and get preliminary results in less than 30 minutes.

We can all be HIV/AIDS advocates. So we call on everyone to learn about HIV and start this discussion with family members and friends. By creating a robust public discourse, we can help make discussions about HIV/AIDS less taboo.

After all, HIV awareness shouldnt just take place one month a year, but each and every day.

Dr. Benjamin Young is medical director of Rocky Mountain Cares and chief medical officer of the International Association of Physicians in AIDS Care. Dr. David Cohn is the former associate director of Denver Public Health and founder of the Denver Health Infectious Diseases/AIDS Clinic.