Overcoming the HIV stigma: Undetectable equals Non-transferable

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By Carl Schmid

Earlier this year, GLAAD – in partnership with the Gilead COMPASS initiative – conducted a study entitled “Study on the state of HIV stigma in 2021”. His job was to measure Americans’ attitudes toward HIV and people like me living with HIV. The results of the study were, to put it mildly, discouraging: Americans, after 40 years, still seem to know very little about the human immunodeficiency virus.

Why so?

Is it because the majority – 51%, according to this survey – just don’t think HIV affects them? Or because most respondents believe that HIV is treatable now? Maybe because among those interviewed they suggested that HIV was only for indiscriminate gay white men and intravenous drug users?

Whatever the cause, HIV continues to spread – and with it the myths and misconceptions born of fear and misunderstanding 40 years ago. Four decades have passed, and yet most people in the United States would feel uncomfortable communicating with a medical professional who has HIV.

We have come a long way in the fight against the disease, but when it comes to combating stigma, there is still a lot to do and it is time to make it a priority, because it is much more dangerous and deadly than the stigma virus itself, which we simply cannot let’s break.

This is one of the main reasons for founding + Life: a leading platform dedicated to removing the stigma of HIV / AIDS.

How is it that as a society we have managed to go beyond the reference to cancer as the word “c”? How is it that the idea of ​​a married couple getting divorced is no longer taboo? Or that a child born out of wedlock no longer means that the mother is ashamed and expelled? But someone with HIV who can be managed and treated with appropriate drugs to the point that the virus is undetectable and sexually transmitted is somehow still stigmatized as “reckless,” “perverted,” dangerous, “” unloved. “And” damaged “goods.”

These words come easily to me because I received them, but even worse, I used them on myself. And I trusted them.

I was just 27 years old when I was diagnosed, living life in London and enjoying everything that came with being an unmarried, young, gay man living in one of the most exciting cities in the world. But the moment I heard the words “You tested positive for HIV,” I felt a pair of handcuffs slapped on my wrists. That was it! It was over. And because of my “reckless,” “perverted,” and “dangerous” behavior, I not only effectively ended my life, but I would embarrass my family and friends who thought better of me.

You see, that’s what most people think when they get the news. Instead of thinking about their health and the realities of living with HIV today, all we think about is how confused we are. Shame, guilt, and self-loathing create the dangerous spiral that many of us descend, because instead of knowing the truth and science, everything we’ve heard is outdated, leaked, and inaccurate.

It wasn’t until 2018, 11 full years of living with HIV, that I even heard the term “U = U” or “Undetectable equals non-transferable”. Even my HIV doctor here in LA, a man I respect very much, who has been treating me for several years so far, had not forgotten to mention this U = U principle. It wasn’t until Bruce Richman of Prevention Access contacted me via Twitter, inviting me to the World AIDS Conference in Amsterdam, where I was introduced to America’s true superhero, Dr. Anthony Fauci, that I learned about this game-changing moment in science. easily expressed. I wanted answers. The answer I got was because it was still in question.

By 2018, there was growing evidence to support this simple message, which would ultimately be the key to those handcuffs that were placed on me and millions of others around the world.

In 1998, a cohort study in San Francisco found that mother-to-baby transmission was reduced to zero. In 2000, there was a cohort from Uganda that showed ZERO transmissions when the viral load on the face was less than 1,500 copies / ml. In 2008, The Swiss Statement concluded that “transmission will not occur” with an undetectable virus load.

Perhaps the two most notable studies were in 2014 and 2018 with Partner and Partner 2 studies, which showed that after 135,000 (yes, you read that right) couples had sex without condoms when the viral load was undetectable, it was there were ZERO shows!

All these pieces of information could give me (and millions of others in the same situation) a very different view of myself and life. Instead of believing in stigma for 11 years and internalizing stigma, I could have hope. And hope is a very strong thing.

And yet my doctor and millions around the world like him continued to keep this information to themselves. It wasn’t until the CDC and the World Health Organization signed that it began to be “accepted.”

The question is why? And now the even bigger question is why is it still being guarded by people? There are many doctors and those in the medical community who are still guilty of saying things like “well, yes, U = U, but that’s not my opinion.” Without taking offense, Doctor, those of us living with HIV do not want opinion, we want science. We want the facts. And we wanted them yesterday.

I am not a doctor and I am certainly not a scientist; however, I am a person living with HIV who bears the real, still fresh marks of the stigma that society continues to inflict on people like me. But I know that messages like U = U are the hope, the sun, and the message that EVERYONE needs to hear to finally get rid of the HIV stigma.

But it exceeds U = U. In my opinion (which I have a feeling that many share), the United States has great uncertainty when it comes to sex. Which is weird, because who doesn’t love sex? Whether it’s ourselves, someone else or a group of people, we human beings, just like any other living thing, love sex. And besides, most of us are here because two people have had sex or at least spent time alone in a booth so that the results can be used in connection with science! SHOCKING! We have this strange ghostly connection with the fact that everything sexual or sex-related is “reckless,” “perverse,” “dangerous.” – Ugh, those words again!

So while we can’t discuss sex casually and comfortably, I’m afraid the stigma surrounding HIV will continue to grow. When we sweep things under the rug, or keep them in whispers, or worse, pretend they don’t exist, then we create that dark underworld where stigma thrives.

IV drug users are equally stigmatized. Dog nonsense on the sidewalk is more acceptable and accessible than the topic of drug addiction in this country. God forbid we have things like legalized clean rooms for injections with help. “No no no! We can’t have that, it will only encourage drug users.” Garbage! Research from the European Monitoring Center for Drugs and Drug Addiction has found that safe use sites reduce drug use in public spaces (and discarded needles) and increase participation in drug treatment programs. They also help limit the spread of HIV, hepatitis C and bacterial infections that are associated with intravenous drug use.

So what do we do then? How to overcome our tightness about sex and drugs? How do we communicate science and facts to people in ways they understand, understand and trust?

We have conversations. We do not fight, we ask questions. We debate and understand that even if we do not agree face to face, we may have planted a seed that will encourage others and ourselves to dig a little deeper. After all, knowledge is power.

This nation is at one of its most difficult crossroads at the moment – the fight against HIV and COVID-19. The misinformation that has caused millions of AIDS-related deaths should never have happened, just like the people who lost their lives to COVID-19. People die for no reason.

It is time to take HIV out of the shadows and darkness of the last 40 years and really just tell the truth. Get rid of all stereotypes, all myths and show the world that as Americans we can lead the way in the fight against the virus and, more importantly, stigma.

HIV is not a death sentence. Stigma is a death sentence – to which I proudly say: “F Stigma!”

Carl Schmid is an Australian-born television presenter and producer. In 2019, he launched Plus Life (@PlusLifeMedia), a digital lifestyle brand aimed at breaking the stigma surrounding HIV. In 2020, Plus Life launched as a half-hour television program on ABC’s digital local network, and in November 2021, Schmid made his Broadway debut as host of a special Broadway night in association with Playbill and Broadway Cares Equity Fights AIDS.

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