Faculty Panel Talks HIV/AIDS

On Thursday, Dec. 3, in an effort to raise awareness of HIV infection and the AIDS pandemic, GlobeMed in partnership with Chellis House held a panel discussion in honor of World AIDS Day. The panel of professors across different disciplines addressed this year’s central theme, “The Time to Act is Now,” when addressing their perspectives on HIV/AIDS around the world. Panelists consisted of Professor of the Practice of Global Health Pam Berenbaum, Professor of Economics Erick Gong and Professor of Psychology Rob Moeller.

World AIDS Day was the first ever global health day that began in 1988. Held annually on Dec. 1, the day is a formal opportunity for people across the world to unite in the fight against HIV, show support for people living with HIV and to commemorate those who have died from the disease.

Berenbaum opened up the panel by saying that people need to challenge the way myths and outdated stereotypes shape notions about HIV. For many, the stigma of testing HIV positive is a deterrent from getting tested. She noted that worldwide trends show that many people who get tested for HIV never pick up their results. “For a lot of people, the benefits of getting tested do not outweigh the costs because in testing HIV positive, some people have a much bigger risk to their lives from the person who is angry about it [than] to the actual AIDS,” Berenbaum said. However, testing remains a vital part of addressing HIV from the start.

“HIV falls into the larger public health problem of individuals needing to change behavior,” Berenbaum said.

She also expressed hope that the issue of HIV infection would be addressed on a global level. “Globally, what I personally would love to see is separating sex from other objectives,” she said. “We need to get rid of rape as a weapon of war. We need to get rid of human trafficking. The vast majority of pornography people enjoy is from sexual slaves. The people who are appearing in this pornography are subjected to HIV risk all the time,” she continued.

Moeller, whose research at New York University focused on HIV infection in black and Latino communities, articulated that the U.S. is in a major health crisis regarding HIV/AIDS. “The people who are most impacted by this are young [14-24] gay and bisexual men of color,” he said. He noted that the common belief that gay or bisexual men wear condoms less than heterosexual men do is false. The issue then lies in the smaller pool of potential partners that is experiencing higher rates of HIV infection.

“For gay men, the idea that sex can lead to death is a reality,” Moeller said. “I have never in my life met a gay man who was not afraid of HIV. The fear certainly exists.”

The panel addressed current medical treatment of HIV. While in the past the common medication for possible HIV infection was curative – to be taken after having unprotected sex with someone who was HIV positive – the current model of medication is preventative. “The problem with this is the issue of access and treatment,” Moeller said. He cited that only one in three doctors knows about pre-exposure prophylaxis, the new HIV prevention strategy that uses antiretrovirals to reduce risk of infection.

Transmission rates of the infection are much lower than common belief dictates. For one sexual encounter between a person with HIV and one without, the rate of transmission is 1/1000. With antiretroviral therapy, this rate is reduced by 70 to 90 percent. Adherence to treatment is thus considered very important. Resistance to the therapies can occur when the full dosage is not observed and the benefit of reduction of transmission rate does not occur.

“When people receive HIV positive tests, some of them will go out and have more unprotected sex because the cost goes down,” Gong said. He emphasized the need for treatment after diagnosis to improve the welfare of the infected person and because it prevents transmission of the infection.

“One of the things that economists have been looking at in terms of changing sexual behaviors is known as conditional cash transfers (CCTs) – you do something and we’ll pay you,” Gong said. With this method, individuals would receive vouchers when they showed up for treatment or extra incentive for fully completing treatment with additional money.

Gong also focused on the presence of HIV and AIDS in Sub-Saharan Africa where he conducted most of his research.

“The puzzle is this: rates of HIV are much higher is Sub-Saharan Africa,” he said. “But if you look at the number of sexual partners between the average person in the United States versus Sub-Saharan Africa, they’re about the same.”

HIV/AIDS affects 33 million people in Sub-Saharan Africa. According to Gong, vaccines are not available because large pharmaceutical companies in the United States are not addressing it. To encourage the production, economists suggest advance market commitment, or the “if you make it, we’ll buy it” approach.

“It’s not really about, ‘Let’s change the message,’ or ‘Let’s figure out the right wording to get people to use condoms,’” Moeller said. “What I think we really need is a vaccine and a cure, both of which we are very far away from attaining simply because we just don’t know enough.”