September 27th is annually recognised as National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD). This day brings attention to the disproportionate impact of HIV/AIDS on men who identify as gay, bisexual, or men who have sex with men (gbMSM), and highlights the importance of HIV education in the hopes of ending HIV-related stigma.
In this blog post, we honour the goals of NGMHAAD by briefly covering a range of HIV-related topics, from its history to its treatment.
How It Began
Human immunodeficiency virus – or HIV – is an infection that attacks the body’s white blood cells, weakening the immune system and making it easier to get sick from severe diseases like tuberculosis and cancer. Acquired immunodeficiency syndrome (AIDS) is the last stage of the HIV infection, when an individual’s white blood cell count is below a certain threshold or acquires an opportunistic disease.
The HIV sub-type, HIV-1, first made its jump from chimpanzees to humans in Central Africa at the start of the 20th century. It then made its way to the Americas in the 1960s, likely via Haitian workers returning from the Congo.
The AIDS Crisis that is often referred to today initially began in the US, with the first US case of AIDS occurring in a young gay man from Los Angeles in 1981. The first case of AIDS in Canada was reported in 1982, and the disease spread rapidly to other parts of the world throughout the 1980s. By 2002, HIV had become the leading cause of death worldwide in people between 15 and 59 years old.
Where We Are Now…
Since the beginning of the AIDS epidemic in the 1980s, the WHO estimates that between 65 and 113 million people have been infected with HIV worldwide. 39 million people were living with HIV at the end of 2022. In every geographical region except sub-Saharan Africa, over 70% of the new HIV infections in that year occurred in young men and boys.
Approximately 62,790 Canadians were living with HIV at the end of 2020 – gbMSM individuals accounted for 53.1% of this number. The total for 2020 showed a slight decrease from the estimate in 2018, as well as a decrease in the proportion of new infections among gbMSM individuals. This is undoubtedly a reflection of Canada’s adoption of the “90-90-90 Initiative,” a global initiative put forward in 2014 by the United Nations with 3 goals to accomplish by 2020: to have 90% of people with HIV knowing their diagnosis, 90% of those diagnosed on treatment, and 90% of those on treatment successfully achieving suppression of their HIV. Canada has been doing very well in this regard, as it has currently achieved the 1st and 3rd goals with a sequence of 90-87-95.
HIV/AIDS and Stigma
Before the infection was known as HIV/AIDS, it was known by another name.
At the outset of the AIDS epidemic in the 1980s, the then-unidentified infection first emerged as a series of seemingly unconnected cases of extremely rare and deadly infections in young, healthy gay men across the US. Public health experts soon discovered that the cases were related via an immunodeficiency syndrome which, due to the high number of gay men suffering from it, was erroneously termed “Gay-Related Immune Deficiency (GRID).” This, unfortunately, led the public to believe that the later-termed AIDS was a disease linked directly to homosexuality, causing not only a lack of recognition of the scope of the epidemic, but also increasingly negative attitudes towards homosexuals for being purported spreaders of the disease.
Despite scientific and social advancements in information surrounding HIV, many gbMSM individuals still face stigma associated with HIV today. This is largely because some people still hold beliefs that HIV is a “gay disease,” and that it can be spread through simply touching or being around a person with HIV. As a result, gbMSM individuals may be refused services or care, disparagingly referred to as “HIVers”, or socially isolated by others for fear of contamination. Such blatant acts of homophobic prejudice and discrimination often result in mental health issues, and feelings of shame and embarrassment. Some gbMSM individuals even develop such deeply negative feelings that they avoid getting tested for HIV or seeking treatment, for fear of being shunned. This is especially disheartening, as individuals with HIV can live long and healthy lives with proper antiretroviral treatment.
Treatment, Awareness, and Hope
Living with HIV is not nearly what it was at the start of the AIDS Crisis. Now that we are armed with information about what HIV is and how it’s spread, it is a very preventable virus. Using clean needles for drug injection, condoms during sex, and taking PrEP are just some of the ways to prevent contraction of HIV.
HIV is also treatable and has been for many years through antiretroviral therapy (ART). Taking this medication on a routine basis makes the HIV viral load undetectable, meaning that it can no longer be transmitted through sex and is much less likely to be transmitted via sharing needles, pregnancy, childbirth, and breastfeeding.
With proper treatment, most people with HIV go on to live as long as people without HIV. And with proper education and awareness, we can greatly reduce the stigma associated to the virus, as well as prevent its spread.
Written by: Serena Celeste Romanelli