In 1981, it was pure luck that I was able to succeed the brilliant gay activist Bill Kraus as a legislative aide to Harry Britt, who was serving as our community's representative on the San Francisco Board of Supervisors after succeeding Harvey Milk. Bill always knew which battles needed to be fought to assure justice and improve the lives of LGBT people, and he knew how they could be made to succeed, well before others had a clue. He often saw timidity, or comfort, or self-interest in the failure of community leaders and members to fully embrace critical battles for our rights and for our future. I can still hear Bill passionately, even painfully, ask at Harvey Milk Democratic Club meetings and community gatherings on the burning issues of the day – "Doesn't anyone care?" And invariably he turned inaction into urgent and successful movements for change.
Bill died of AIDS in 1986.
June 5 will mark the 30th year since the first cases of what would become a complete horror for our community would begin. And while we have made huge progress in the struggle to end HIV in our city and nation, we could be much farther along in achieving a vision for gay men in which the ever-present and insidious threat of HIV imbedded in our psyches – a dark cloud over our sexual pleasure, our love for one another, our very futures – is finally and joyfully gone.
Today, it is clear that we have the tools to bring the epidemic to its knees globally – and certainly in San Francisco. Those tools are already helping both to greatly prolong life for people living with HIV and AIDS, and to significantly reduce new infections. Knowledge of HIV status, HIV treatment for those who are positive, disclosure of HIV status to our partners, condoms, and sterile syringes combined together are capable of stopping the epidemic within the next 10 years.
Last Thursday, the National Institutes of Health released the results of HPTN052, a study of the effect of HIV treatment on couples in which one partner is HIV-positive and the other HIV-negative. The results confirmed what we already knew from other research, but they were definitive on the question and electrifying. Transmission of HIV from the positive to negative partner was shown to be 96 percent lower when an HIV-positive partner was on early treatment for HIV, and HIV-positive people who started treatment at 550 T-cells would live longer and prevent infection much more certainly than those who waited to be treated. Proof that current efforts to assure that all adults regularly confirm their HIV status and enter care and treatment early if they are positive would profoundly change the course of the epidemic.
The day after this amazing news was released, I attended a small think tank of global HIV advocates in New York who had already planned a meeting to discuss ways in which the world could advance promising strategies for using HIV treatments to prevent new infections. The group excitedly agreed that, with the news about 052, the world is clearly at a tipping point in the epidemic. There is no doubt that if we demand that governments have the moral compass and political will to provide the resources needed to finance care for all people living with HIV, we can definitely end this pandemic once and for all.
And then I came home. And I guess I sobered up. Because no one was talking about 052 or the end of the epidemic. And I was left wondering – does anyone care? Anyone, at least, in the very communities at risk for HIV and AIDS?
With this news – and clear evidence that efforts by our own Department of Public Health to assure that more people are tested and treated early for HIV are helping more people to live longer and cutting new infections nearly in half so far – will anyone other than those of us who get paid to do it step forward to say: 30 years is enough! Let us end this once and for all!
Because I am not certain that the great community mobilization that could now end HIV – even if it happens only in San Francisco – can succeed if community members themselves don't now take up the flag; our softball leagues, bartenders, shop owners, elected officials, DJs, doctors, porn stars, bloggers, preachers – all joining in a massive effort to encourage one another to ask each other: Do you know your HIV status? If you are positive, are you seeing a doctor and seriously considering treatment? How can I support you to do these things – because I care about you, and because I care about paving the way for a generation of young gay men who do not have to live with HIV hanging over their heads when they arrive in this wonderful city?
Or is HIV now so much a part of our social fabric that we are resigned to it, even comfortable with it?
I am waiting to be proven that it isn't – for Bill Kraus, Dick Pabich, Randy Shilts, Hank Wilson, Martin Delaney, Elizabeth Taylor, and so many of my heroes who did not fight this epidemic simply to have it become something that we merely allowed to become manageable.
Dana Van Gorder is the executive director of Project Inform, an HIV/AIDS advocacy organization and provider of a treatment hotline.