In 1996, deaths stopped coming as often. Those who were very sick and weak quickly regained their strength and health. The years of terror appear to be coming to an end.
In fact, 1996 was a milestone year in our fight against AIDS. After years of battling the disease, an approach was found—combining a new class of powerful drugs, known as protease inhibitors, with two other classes of HIV antivirals, and the disease could be overcome. It’s not a drug. It still hasn’t healed. However, the use of this triple combination approach, the “drug cocktail”, initially known as HAART (Highly Active Antiretroviral Therapy) transforms the disease from a fatal disease to a chronic and manageable one.
Many people who survived those trying times lived to tell me their stories, which I share in my book, The AIDS Generation: A Story of Survival and Resilience. I started to understand my generation—those of us who grew up in the 1980’s and early 1990’s as AIDS Generation. Regardless of whether we are infected or not, irrespective of our sexual orientation, race, gender, social and economic class, or hometown — our formative years were shaped by this epidemic. It’s all around us.
Three years ago, we experienced another victory in the fight against AIDS. Researchers demonstrated that Truvada, one of the antivirals used to treat HIV, could stop HIV-negative people from acquiring or being infected with HIV. Taking this pill once a day, in an analogous way to how contraception pills work, can stop a person from becoming infected even if they do have the virus. This approach, known as PREP (Pre exposure Prophylaxis) has great potential and has provided sexually active individuals with tools apart from condoms to keep themselves safe.
In the landscape of biomedical advances to fight HIV, including HARRT and PrEP, a new generation, Millennials, are entering their adult lives and more importantly their sex lives. For them, AIDS is no longer a death sentence for us, and powerful tools are available to stop and fight HIV infection.
Despite our progress, HIV/AIDS is still a health burden in our country. President Obama acknowledged that fact and have become the first president in the history of the disease to propose a national AIDS strategy.
In the United States, about 50,000 new infections occur every year. While this virus can infect anyone in the United States, there are specific populations most affected and burdened by HIV/AIDS—gay men and African Americans. While it’s true HIV doesn’t discriminate and can affect and infect anyone, but to not fully acknowledge the populations in which it’s wreaking its greatest havoc would be disrespectful to the struggles gay and African American men – particularly, gay African American men, face in fight this disease.
My own work over the last 20 years has attempted to untangle the factors driving the HIV epidemic in gay men. In recent years, my attention has focused on HIV in the lives of gay men who are Millennials. I’m guided by a belief that the truth of HIV is very different in the lives of gay men who are Millennials and Generation AIDS. Therefore, in order to continue to fight this disease in the gay population, we must develop tools that are relevant to the new generation of gay men – because the epidemic and the life experiences of gay men have changed, and since the start of AIDS cases were reported in the summer of 1981.
It is in this developing context that HIV must be understood in Millennial life. Generations of me have argued that young gay men aren’t afraid of HIV—that they’re not worried about the disease. It was an unfortunate speculation that did more harm than good.
My own work shows that young gay men are worried about HIV, but it’s not a major worry in their lives. Perhaps because of our biomedical advances they’ve reason to feel this way.
In one of our studies, known locally as P18, we asked young gay men to rate their level of concern about several aspects of their lives including their concern for HIV. Of the around 500 men we have surveyed to date, concerns about HIV are at the center. Greater concern was related to finances, finding a job, and success in one’s career, in addition to future prospects. This should come as no surprise considering these youths are entering their adult lives at a time of great economic downturn and uncertainty. For many of us in the 1980s, the chance of success and wealth seemed within our reach.
This data tells us something very important–HIV is a problem and one that many young gay men face, but it’s a different struggle than my generation. Expecting HIV to become a major problem for Millennials, as it has for gay men in the AIDS Generation, is solely unrealistic. Consequently, in order to combat this epidemic that continues to affect the lives of new generations of young gay men, we must first accept this statement. After that, we must address this ongoing disease in its context and develop messages and programs for Millennials that respect their own realities at 21st century. Innovative community-based organizations embrace this idea and embed their HIV prevention programs within other programs, such as resume building and cooking. The topic of HIV is nested within the context of overall well-being – an approach that may resonate more effectively with Millennials.
As we move forward in fighting the HIV epidemic, we must keep all this in mind. We must develop our thinking and approach in fighting HIV, in addition to other diseases that may affect Millennials. We must act quickly, because the approach we formulate for them may be too outdated as Generation Z emerges in adulthood.
