HIV/AIDS: More than Just a Virus by: Perry N Halkitis, PhD, MS, MPH
On July 3rd, 1981, The New York Times reported on the first cases of a disease afflicting young gay men—a disease we would soon come to know as AIDS.
Some 33 years later much has changed in our ability to combat the HIV virus and prevent the multitude of deaths that we witnessed for nearly two decades. Nowadays, a normal life expectancy is estimated for a young person who is newly infected with HIV and detected to be HIV-positive, who accesses healthcare, who begins and adheres to a daily antiviral therapy (ART), and who lives a generally healthy lifestyle. But as is clear, a normal life expectancy is predicated on many demanding conditions. Perhaps this is why for every 100 Americans living with HIV, only 28 succeed in achieving full suppression of the virus in their bodies, the prerequisite for living a normal life expectancy.
In fact, if we fully examine what is known as the “treatment cascade, “ what we know is that of every 100 American infected with HIV, 80 know they are living with the virus, 66 are linked to care, 37 are retained in care, 33 are prescribed ART, and ultimately only 28 are virally suppressed, meaning it is also very unlikely they can transit the virus to others. Moreover, in 1996, when ART first become available, we witnessed a dramatic decrease in AIDS related deaths, and for a short period it appeared that we would be able to effectively control HIV/AIDS. But in fact, annually there are 50,000 newly diagnosed with HIV/AIDS, with gay men and African Americans continuing to bear the brunt of this despicable disease. Black gay men in are particularly susceptible.
This is all to say that HIV/AIDS is more than a biomedical condition. If this disease was simply about the virus, then our medical advances should have effectively controlled the epidemic. Rather, HIV/AIDS is a disease shaped by biological, psychological, and social conditions. The long term survivors I interviewed for my book, The AIDS Generation: Stories of Survival and Resilience all understood their survival in relation to physical, emotional, and social care.
Vulnerable populations with limited access to healthcare, which experience discrimination and marginalization, which confront economic and housing struggles, which daily experience stigma are much more likely to acquire the disease. This is why the epidemic continues to burden gay men and African Americans.
To this end, if we are effectively to fight this epidemic we must acknowledge that HIV/AIDS is a disease involves more than a viral pathogen, and healthcare providers, especially those in the medical profession, must espouse a much more holistic approach to prevention and care. We have the biomedical tools to fights HIV/AIDS. If coupled with effective psychosocial services, then the effectiveness of these treatments are likely to have a much larger impact. We must acknowledge that those vulnerable to HIV also experience a multitude of life burden , and thus we must embed HIV prevention and care in programming that acknowledges the total life experiences of people and delivers holistic care that attends to the whole person.
Perry N. Halkitis, Ph.D., M.S., MPH is a Professor of Applied Psychology, Global Public Health and Medicine at New York University. He also directs the Center for Health, Identity, and Behavior & Prevention Studies. Dr. Halkitis is a highly funded funded scientist with expertise in biobeheavioral, psychological, and public health research. Dr. Halkitis also has presented extensively throughout the world to large academic and non-academic audiences, including on television and radio, and is available for interviews, lectures and speaking series on all subjects relating to the health issues affecting gay men of all ages including HIV/AIDS, substance use, and mental health. His latest book The AIDS Generation: Stories of revival and resilience, published in Fall, 2013, was nominated for Lambda Literary award and received The Distinguished Book Award the field of LGBT psychology from the American Psychological Association. www.perrynhalkitis.com @DrPNHalkitis
Associate Dean for Academic Affairs, Global Institute of Public Health
Professor of Applied Psychology, Global Public Heath, and MedicineDirector, Center for Health, Identity, Behavior & Prevention Studies (CHIBPS)
Associate Director, Health & Human Devt, Institute for Human Devt & Social Change (IHDSC)