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Sheen re-opened the conversation about HIV in a major way Now we need to capitalize on this opportunity to get the story of HIV straight once and for allFor the first time in history there is no debate about whether we have the tools and knowledge we need to achieve epidemiologic control of AIDS worldwide We do One of the most significant barriers to ending the epidemic today (others being inadequate funding and too little political leadership) is the stigma Stigma not only prevents people from getting tested and treated for HIV stigma also impacts resource mobilization and the willingness of politicians globally to pick AIDS as an issue they will support Every time someone publicly discloses his or her HIV status especially when that person is well-known and holds his or her head high in the face of negative blow back it reduces stigma and hopefully catches the attention of some who will choose to help underwrite and champion a more aggressive response to the disease that can be controlledWhen diseases are destigmatized we are able to fight them better Breast cancer is a perfect example First Lady Betty Fords decision in 1974 to invite the press into her hospital room after her radical mastectomy forever changed peoples attitudes about a once unmentionable disease Her courage and refusal to hide in secrecy and shame simply because she was sick started a movement that saved tens of millions of women from breast cancerAnother example is what happened with Ebola—like HIV a deadly virus if left untreated What made the containment of Ebola possible in places such as Sierra Leone and Mali An accurate widespread conversation from political leaders to community health workers to faith-based leaders about what needed to be done to protect oneself from the virus Yes billions of dollars in foreign aid countless health and social workers scientists local leaders community groups and allied support also contributed But the glue that held these various efforts together was the public conversation that helped people understand the disease and how to prevent it The initial hysteria around Ebola mirrored that of AIDS The difference is that in the case of Ebola the dissemination of scientific facts helped quickly curb the hysteria so that people could get down to the business of stopping it Shifting the ConversationUNAIDS recently modeled what will happen if an urgent response is launched immediately focusing on the people and places most affected by HIV so that new bold targets for prevention treatment and the reduction of HIV-related stigma and discrimination can be met by 2020This approach calls for using the latest data to strategically guide the response to ensure that information testing prevention tools and treatment reaches people at highest risk for HIV in the countries regions towns and villages where the disease burden is highestTaking such a "Fast-Track" approach to the global AIDS response so that these targets can be met within next five years puts the world on course to end AIDS as a public health crisis by 2030 The Fast-Track approach can avert 21 million AIDS-related deaths and 28 million new HIV infections by 2030 aloneSpecifically the three Fast-Track targets for 2020 call for: 1) no more than 500000 new infections annually; 2) achieving the "90-90-90" target of having 90 percent of all people living with HIV aware of their status 90 percent of all people who have been diagnosed on antiretroviral treatment and 90 percent of all people on treatment virally suppressed (viral suppression is key as when the virus is reduced to an undetectable level the person living with it is virtually non-infectious); and 3) zero HIV-related stigma and discriminationIt is the achievement of the third target—the reduction of stigma and discrimination—that will accelerate the meeting of the other twoWe must change the way we see and talk about HIV in order to stop itAsk anyone who knows me; I talk about HIV all the time—at work and beyond it What astounds me is that 30-plus years after the discovery of HIV as the cause of AIDS there are still so many people who have not been taught the basics like the fact that AIDS stands for "acquired immunodeficiency syndrome" or that HIV is a retrovirus that uses the bodys T-cells (or immune cells) to replicate itself killing them in the process It works like this: The body replaces its immune cells but not as quickly as HIV uses them up So over time unchecked by medicine HIV kills more and more immune cells and the immune system begins to break down and things that wouldnt normally make a person critically ill or kill them such as pneumonia or some types of cancers do so Antiretroviral medication prevents HIV from killing immune cells when taken as prescribed which keeps the immune system strong the person remains healthy and the HIV virus cannot be passed to others People living with HIV who are on treatment can have normal life expectancy—and as I mentioned they can have babies as the medicine prevents the spread of HIV from mother to childHow is it possible that after three decades of AIDS awareness and education we are still seeing the kinds of media coverage and individual responses we did around Sheens disclosure It all goes back to stigmaI understand that HIV stigma exists in part because HIV can be transmitted through injecting drug use and because it can be sexually transmitted The latter reality raises the issues of sex and sexuality which make some feel uncomfortable When I first contracted HIV I wasnt very comfortable talking about sex Not even with my doctor But in my efforts to de-stigmatize HIV for myself (because I figured that that was a great first place to work on busting stigma: inside my own head) I came to realize that the choice I made that led me to contract HIV—to have unprotected sex with someone I trusted and cared for who did not know he was infected—didnt mean I was unworthy of help and medical care That the virus happened to be there when I made a choice and wasnt there when others made the exact same choice didnt make me a bad person but rather a biologically unlucky one How You Can HelpAbolishing the stigma surrounding HIV so that more people feel more comfortable coming forward to get tested receive prevention counseling and if necessary receive treatment is the next essential barrier to cross in the global response to HIV Its how we continue to support the 158 million people who have been diagnosed and are on treatment Its also how we help the remaining 211 million for whom it might as well be 1981 unless things change and we can connect them to the medicine that will save their livesSo today on World AIDS Day please consider how you think about HIV and those of us living with it Please understand us dont fear us have compassion for us and be on our side If you will stand with us and help remove the agonizing stigma that remains a blockade to our emotional well-being health and survival we will survive HIV will stop spreading and AIDS can soon cease to be a public health crisisI have lived with HIV for 19 years and been open about my status for nine I have journeyed from a place of utter despair and hopelessness to legitimate belief that I may survive to see the end of AIDS and possibly even a vaccine and the cure in my lifetime My dream is to have the chance to return to a morning talk show on a World AIDS Day in the not-too-distant future to celebrate what would unquestionably be one of the greatest humanitarian achievements of the 21st-century: the end of AIDS as a public health threatWhether this can happen depends in part on how we treat the news of Sheens diagnosis and the future disclosures of others In this moment we face an important choice: We either reinforce stigma by receiving his news poorly and discriminating against him because he shared it or we can help-destigmatize HIV and offer him the support deserved by all who fall illI can only hope Sheen receives the same outpouring of love and support I did after revealing my diagnosis—the support and love I have felt in spite of HIV has done as much for my health and well-being as the medicine I take daily From the day I told my sister I am living with HIV when she purposefully dipped her fries in my ketchup at Burger King to show me she understood she could not contract HIV from me through casual contact to peoples willingness today to embrace me— figuratively and literally—despite the fact that I have HIV my wellness has been unquestionably bolstered by those who have not let preconceptions of HIV cloud how they see meThe faster more people are willing to regard HIV and those of us living with it in a fresh and more positive light the faster more people will feel it is safe to come forward to get tested and access prevention tools or treatment And that is how AIDS will eventually endWant to know more about how you can fight the stigma and help people living with HIV Visit unaidsorg for more informationRegan Hofmann is the Policy Officer in UNAIDS Liaison office in Washington DC Her memoir I Have Something to Tell You was published in 2009 by Simon and Schuster She is on Twitter @reganhofmann my heart went out to him. shall we say,
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