Zero new HIV infections, zero discrimination and zero AIDS-related deaths. This is the “Getting to Zero” challenge. Currently there are 35million people worldwide living with HIV/AIDS. With HIV-related stigma still persistent today, it is commonly said that individuals die because of stigma, not HIV/AIDS. The World Health Organization cites fear of stigma and discrimination as the main reason why people are reluctant to get tested, disclose their HIV status and take antiretroviral drugs.
Many communities, states and nations struggle over whether to fund HIV treatment, HIV prevention, or both. As a public health major and Grassroots coach, I strongly believe in allocating resources for HIV prevention. However, we know that behavior change is a difficult expectation that requires more than just funding to accomplish. It requires manpower, long term commitment and often a shift in cultural values. In the “getting to zero” fight, preventive services along with eliminating the stigma can make all the difference. However, in some parts of the world, existing social conditions can make this feat nearly impossible.
Key affected populations are increasingly marginalized from society and from receiving prevention or treatment they need. This is a trend around the world that still persists in the United States despite the availability of life saving treatment. Even worse, HIV infection rates amongst young women and girls remain high worldwide because young women and girls still have little social power. Little social power means that the decision to use contraception or to get tested for HIV simply do not exist. This issue speaks to the fundamental circumstance of unequal gender relations that transcend any issues regarding HIV prevention or treatment.
Since fundamental issues such as poor access and gender inequality persist in many countries with stubbornly high HIV/AIDS rates, prevention and treatment are exceedingly difficult goals. Stigma will continue to be a massive barrier in the “Getting to Zero” challenge. A vast amount of commitment, funding, and a shift in values is absolutely essential to reduce the stigma, improve access and equalize gender norms. Until these deeply rooted deficiencies are improved, any large prevention or treatment efforts will be arguably unsuccessful.
