It is hard to imagine that it was only 34 years ago when the first case of HIV was first documented in the United States. Shortly after, the virus seemed to spread like wildfire, burning a path of hysteria, frustration and sadness across the U.S. and throughout the world. In a short period of time, and thanks to a series of political blunders from the Reagan administration and many other political figures across the nation, HIV went from hundreds to millions and became the closest we have ever come to a modern plague.
Although there is still no cure for the virus, this plague is now classified as a chronic illness with those who are HIV positive living long and healthy lives. So the obscene terror that lived in the hearts of every gay man in the world merely three decades ago has all but been erased in the minfs of the millennial age. In its place now lives a vague but often-impenetrable fear of those who carry HIV and a diluted sense of safety based on the idea that the transmission of HIV is related to a character flaw of promiscuity. This blind faith that the virus is relinquished to "other" types of people has allowed for this disease to continue affecting the millennial generation at staggering rates.
According to the Center for Disease Control's National Progress Report of 2013, an estimated 1.1 million people are living with HIV in the United States with 50,000 more becoming infected each year. One out of every six people living with the virus are unaware that they are infected, thus continuing the cycle of transmission. And worse, one out of every five gay men are living with HIV, yet the millennial generation often treats the disease as if it is only reserved for the history books.
But beyond the numbers, just what exactly does it mean to live HIV in today's world? For starters, HIV is now officially classified as a chronic disease. Although most people assume that treatment involves a series of toxic cocktails that HIV positive men and women take throughout the day, a person diagnosed today will most likely be on one daily pill to manage the virus. And reports suggest that, given a person is compliant with their medication; they can expect the same estimated lifespan as they did when they were HIV negative.
"A person who is 20-years-old and diagnosed today can expect to live into their 70s, roughly the same lifespan they would expect prior to being diagnosed," says Dr. Gary Blick, HIV Specialist and Founder of World Health Clinicians, an international HIV treatment organization.
However, it isn't all good news. The span of your life may be the same, but your worries certainly are not. People living with the virus run an increased risk of developing other life-threatening diseases such as cancer, heart attack and stroke. Combined with other STI's, these risks are even bigger, making it even more important for a person living with HIV to manage all aspects of their health, not just their pillboxes. However, an HIV positive diagnosis is merely a charge to be drastically more responsible with a person's health instead of an order to make arrangements for a pending funeral.
To many of the people living with the disease, it is also a scarlet branding that induces emotional and psychological symptoms that far outweigh the side effects listed on the side of their medication bottles.
The organizations charged with delivering the message of HIV awareness and prevention have grappled with advancing their messaging with the advancements of modern medicine. Managing HIV is a drastically different animal than it was merely a decade ago, but many still view the virus with the same gravity that they did in the 1990s. The few organizations who have tried to modernize the approach to HIV education have been lambasted for "making light" of the disease, trying to "make HIV cool," or downplaying the severity of living with the virus.
This struggle over messaging has never been more contentious then in the present as institutional juggernauts like the AIDS Healthcare Foundation (AHF) battles with more progressive activists and organizations over the promotion of PrEP, or pre-exposure prophylaxis. This new drug, nicknamed the birth control pill for HIV, now personifies the crux in HIV treatment debate.
PrEP is an Antiretroviral Therapy drug that, if taken correctly by an HIV negative individual, has a 99 percent efficacy rate in preventing the transmission of HIV from someone who is HIV positive. This drug has been on the market since 2012, but several prominent organizations such as AHF, the largest HIV treatment provider in the U.S., have taken an active stance against the HIV prevention pill.
Michael Weinstein, the Executive Director of AHF, has publicly referred to PrEP as a party drug and suggested that the "people who would be taking the drug" could not be trusted to be compliant with their dosage. This stigmatizing rhetoric, combined with the pharmaceutical company, Gilead's, unwillingness to advertise the drug to at-risk populations, has led to a virtual standstill in people seeking a prescription for the prevention pill.
People like J Nick Shirley, a 24-year-old gay man from Dallas, represent the most at risk demographics for HIV transmission, and yet has never heard of PrEP. When asked about the new form of prevention, he was shocked that this was the first time he was hearing about it.
"I just can't believe that we have such a ground-breaking tool at our disposal and so many people don't know about [PrEP]," Shirley said. "I am pretty sure none of my friends know about it. We have never talked about it before."
Long term HIV survivor, activist and former reality T.V star, Jack Mackenroth, is mortified that organizations like AHF have taken on such a damaging approach to PrEP.
"If this were the '90s, people would be lining up down the streets to take PrEP," says Mackenroth. "It is so sad that the fear that we went through has given way to the judgment and stigma from gay men onto other gay men. HIV isn't going anywhere if we don't wake up and realize that condom-only messages don't work."
Which leads us to the use of the problem; organizations using worn out methods of education and prevention, further stigmatizing others looking for prevention methods beyond condoms and leaving the vast majority of millennial, at-risk individuals to believe that HIV is a virus that "other" people get.
Movies like The Normal Heart serve as history lessons, leading young gay men to cry, "Never forget," while failing to realize the dangers they face. LGBT youth are left grappling for connection, because most of the visible reminders of the risk of HIV are only ashes, while the living, more relevant examples prefer to remain in silence for fear of public ridicule and castigation. Sadly, the community that was once unified under the call to fight the virus is now complacent in a pseudo-class system of HIV status that only serves to perpetuate transmission.
But change is on the horizon. Grassroots campaigns such as HIV Equal, The Stigma Project, The Needle Prick and several others have worked to change the climate of HIV stigma for those living with the virus and educate the public on the real vs. perceived danger of HIV transmission. A new wave of young, HIV positive faces, such as Josh Robbins, Cory Lee Frederick and Jake Forth, are making their presence known in the public eye, humanizing the virus for the millennial generation while serving as living examples that HIV is still an issue for their age group. And this year, as the Obama Administration unveiled the HIV Care Continuum at the third annual HIV/AIDS Strategy, President Obama's HIV prevention policy recognized Antiretroviral treatment as a valid form of prevention, giving authority to the fact that HIV positive men who achieve undetectable viral load levels are actively preventing the spread of HIV.
While the level of danger has waned over the past three decades, the threat of HIV still remains. Unlike the generations first affected by the virus, the millennial age is now armed a wealth of information and a variety of prevention tools to change the course of HIV for good. And this young generation should take note that these tools came at a very heavy cost.
If you have had sex even once since your last HIV test without a condom, it is worth it educate yourself on PrEP and determine if it is right for you. It only takes one time to transmit the virus, and it only takes one pill a day to stop it. The millennial generation no longer has to face a multitude of limitations when concerning HIV, so there is no excuse to get tested, know your status and pick up the slack in the fight against HIV. After all, most of the heavy lifting has already been done.