You Tell Us: On World AIDS Day, no need to look far

Today is the 23rd Annual World AIDS Day–“an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died.”

Normally I would walk through the day obliviously, but this is my first year celebrating the occasion as an HIV positive man. The day has taken on new meaning for me. I am one of the approximate 50,000 Americans who became positive this past year.[1]

In Alameda County, an estimated 3,500 people are living with HIV; the number of new cases per year ranging from a high of 621 in 1992 to a low of 168 in 2006.[2] While the number of new cases has declined, it has remained steady over the past decade. People continue to become HIV positive.

Because of the great medical advances of the past 30 years, which can allow positive people to live full, healthy lives, we tend to believe that HIV is no longer a crisis in the United States. Without the frequent reminder of obituaries and funerals, we forget that Americans live with HIV, a chronic illness requiring constant care. Disparities in global access to new medicines rightly compel us to re-direct attention to crisis in developing nations.

The impulse on World AIDS Day is to think globally, mistakenly downplaying the crisis right here at home. It is easy to forget that HIV affects our community, that we need not look far to find the effects of the virus. As was the case with me prior to diagnosis, perhaps we unintentionally fail to recognize how our own lives our affected. Many of us may believe that we do not know anyone who is HIV positive.

While it is important to recognize that HIV is a global pandemic and that some continents do not have equal access to life-saving medical advances, let us not forget about those in our own community who live and struggle with HIV. Action is needed not just globally, but nationally and locally too.

In the United States today, more than 6,500 people in 12 states are on wait lists to receive life-saving medications.[3] Each state runs an AIDS Drug Assistance Program (ADAP) that provides uninsured and underinsured people with HIV medications, which can cost up to $19,000 a year if paid out-of-pocket.[4] But as we know, we are living in tough times. People have lost jobs and healthcare coverage. Demand for ADAP funds has increased, but funding has not. In Florida alone, 3,213 positive people are on wait lists.[5]

California has not yet had to implement such drastic cost-cutting measures, but other strategies have been considered. Many counties and cities in California struggle to provide services to all who need it. Due to a disproportionately high incidence of HIV, Alameda County officials declared a state of emergency in 1999 and have yet to remove that designation.

It’s not all bad, however. For all its problems, Alameda County does count on a wide network of HIV support and services.

I personally have to thank AIDS Project of the East Bay and AIDS Healthcare Foundation’s Magic Johnson Clinic in Oakland for providing me with compassionate and comprehensive care during this first year of living with HIV (a full list of resources can be found on the website of the Alameda County Office of AIDS). These organizations helped me navigate through the complex emotions of being newly diagnosed and guided me through the complicated process of signing up for ADAP. I was lucky; not everyone has access or knows they have access to a range of resources.

As a person living with HIV, I ask us all to pay attention to how our own friends, family, and community are affected by HIV. On World AIDS Day, no need to look far—we are affected (and infected) right here in Oakland.

As for me, I will observe World AIDS Day by doing what I have feared most—tell my parents that I am HIV positive. I am not certain how they will respond and I am not looking forward to a second “coming out” experience, but I have to believe that talking openly about my status is the first step in fighting the shame and stigma still associated with HIV.

Edward Cervantes is a resident of Oakland and a student of Public Policy at Mills College.

Sources for statistics cited:

[1] Prejean J, Song R, Hernandez A, Ziebell R, Green T, et al.; Estimated HIV Incidence in the United States, 2006-2009. PLoS ONE 6(8); August 3, 2011.

[2] Alameda County Public Health Dept. AIDS Epidemiology Report, Alameda County 1980-2006. Unfortunately, more recent statistics are unavailable at this time.

[3] National Alliance of State and Territorial AIDS Directors (NASTAD); ADAP Watch; November 18, 2011.

[4] HIV Research Network; Contemporary costs of HIV healthcare in the HAART era, AIDS Volume 24, Issue 17; November 2010.

[5] National Alliance of State and Territorial AIDS Directors (NASTAD); ADAP Watch; November 18, 2011.

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