World AIDS Day is December 1st, a day when we recognize the impact of HIV/AIDS in this country and around the world. It’s a day to think about all those who have been lost, but also to recognize the medical advances that have been achieved in the last ten years. Today, many people living with HIV are able to take one antiretroviral pill daily and stabilize their health. Newly infected people who are treated promptly can anticipate a normal lifespan. And, by taking a daily pill called PrEP, people vulnerable to HIV can effectively prevent it. Further, the Centers for Disease Control is convinced that People Living with HIV/AIDS who take their medication as prescribed and keep the virus at an undetectable level “have effectively no risk of sexually transmitting the virus to an HIV-negative partner”.
But still HIV infection continues; especially among young men and most often among young men of color. Why? The internalized shame and stigma felt from society regarding their behaviors get in the way. Young people will always push boundaries and experiment with substances and sex. Stigma continues to get in the way of effective harm reduction especially when decision making skills have not been well developed. And shame surrounding their activities will prevent them from asking for the health screenings and treatment from providers. Stigma often gets in the way with providers who may not ask about sexual health or needle sharing behaviors in their offices or exam rooms and thus miss an important opportunity.
But the impact of stigma and shame are the most important within the family. Having an understanding and supportive family is the greatest variable in the prevention equation. This is as true for HIV prevention as it is for suicide prevention or binge drinking. Having a parent or parents who are open to listening and who can accept their child, even if they aren’t comfortable with their actions, will do more to end stigma and to ending this epidemic than any test or pill. Talking and nonjudgmental love is the best prevention strategy we have. By reducing and hopefully ending stigma and shame, we can attain a world without new HIV infections and, in a generation, a world without HIV/AIDS. Only then can we declare World AIDS Day to be a day of remembering, but also a day of true celebration.