National HIV Prevention Conference: Day One Recap
Eugene McCray, M.D., Director, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
Thousands of attendees from around the country were in Atlanta, Georgia last week to attend the CDC’s 2015 National HIV Prevention Conference. For those who were not able to attend, check out AIDS.gov’s daily conference highlights.
Here’s what happened on Day One of the conference, Sunday, December 6th:
The opening plenary drew over 3,000 scientists, community members, public health workers, clinicians, and people living with HIV to hear the latest policy, scientific, program, and community approaches to addressing the HIV epidemic in the U.S.
Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, opened the session by noting recent major successes in HIV prevention. But he also outlined the significant challenges the nation faces in expanding those successes to all communities by emphasizing that “the growing disparities among communities of color and gay men show that HIV has always been not only just a virus, but an injustice.”
Douglas Brooks, the Director of the Office of National AIDS Policy, framed his comments about the National HIV/AIDS Strategy: Updated to 2020 by noting that the conference opened on the first day of Hanukkah and the 150th anniversary of the ratification of the 13th Amendment to the U.S. Constitution. He drew a connection between the themes of light, freedom, and miracles in those events and the nation’s work to end the HIV epidemic.
Brooks gave an overview of the recent update to the Strategy, and spoke briefly about the release of the new Federal Action Plan and Community Action Framework, which are designed to support efforts to achieve the Strategy’s goals. He expressed hope that the latter would spur conversations and partnerships among community stakeholders and thanked them for their tenacity and leadership in the face of many challenges. He ended his presentation with an exhortation from a famous explorer: “Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it!”
Dr. Eugene McCray, CDC’s Director of the Division of HIV/AIDS Prevention, asked the audience to imagine a scenario in which a man goes to the doctor and is diagnosed with HIV. He is immediately linked to services, and provided with information on treatment and a start-up pack of HIV medications. He is able to download an app that reminds him when to take his meds, helps him track his CD4 levels, and gives him appointment reminders. By beginning treatment so quickly, he achieves viral suppression within 30 days—and his partners can take pre-exposure prophylaxis (PrEP) to protect themselves from infection.
McCray noted that, at one time, we could only dream of these outcomes—but they are all available now. Trends in HIV diagnoses over the past decade show promising signs of progress—though progress has been uneven in certain groups, particularly gay and bisexual men and African Americans, who continue to be the most affected. After reviewing both these positive and concerning trends, McCray said “Change is possible. We have the tools, but we urgently need to improve access so that everyone can protect themselves.”
Dr. Anthony Fauci, NIAID director, spoke about the dramatic scientific breakthroughs that now make it possible for people with HIV to live nearly normal lifespans, if they receive early and continuous treatment. He also extoled the promise of “treatment as prevention” and PrEP for helping to end the HIV pandemic. But he noted CDC’s recent estimates that an estimated one million people who could benefit from PrEP are not getting it; 30% of primary care doctors and nurses in the U.S. have never heard of PrEP; over 60% of people living with HIV are not getting antiretroviral therapy; and many fall out of care after starting treatment. He concluded by saying, “The message is that we can end the epidemic by following the science. The science has spoken—there can now be no excuse for inaction.”
Columbia University’s Dr. Mindy Fullilove discussed the importance of structural change in responding to the epidemic. Her pointed comments on the role that social determinants of health (including issues related to the gentrification of urban areas) play in the transmission of HIV electrified the audience. She ended her presentation with a lyrical call to remember the real lives that are affected by injustice, and closed with a poem, A Small Needful Fact, by professor and poet Ross Gay, that brought people to their feet.