By Greg Lanza

This year, World AIDS Day has a special significance. It was 30 years ago this year that the Centers for Disease Control and Prevention (CDC) announced the first case of a then rare condition that would later be known as HIV/AIDS. At that time, the HIV virus had not been identified as the cause of this illness. Now 30 years later, we have learned a lot about HIV/AIDS. From the virus itself to the social and behavioral factors that put people at greatest risk for infection, we now know both how to treat and how to prevent this infection. HIV testing and treatment work to keep those infected feeling well. Transmission can be prevented by consistently using condoms during sexual activity and avoidance of “dirty” needles and works Due to widespread testing of pregnant women and treatment of those who are HIV infected, mother-to-child transmission of HIV has been virtually eliminated – another prevention success. However, prevention requires consistent, long term changes in behavior, something that is easier said than done.

Since 2000, the Boston Public Health Commission (BPHC) has allocated over $19 million dollars to community based organizations, AIDS service organizations, and other local programs with the goal of providing HIV prevention and education services to Boston residents. While this might sound impressive, the BPHC HIV/AIDS Services Division through federal Ryan White HIV/AIDS Treatment Extension Act funding received and allocated approximately $13.8 million this year alone for services to those who are already infected.

Most recently, the CDC has moved almost entirely away from funding prevention services that target those who are HIV negative, focusing instead on getting those who are positive into treatment. An approximate 50 percent drop in funding to Massachusetts is anticipated by 2015 due to this change. Given this new funding reality, we individually and collectively are tasked with finding new and creative ways of getting the prevention message out to our communities. In a sense, we all need to become peer educators.

Like many of us, I have a core group of very good friends with whom I socialize on a regular basis. We gather over meals, and perhaps a few cocktails, play board games, cards, eat, laugh and carry on. We talk about each other’s jobs and school challenges. The singles amongst us share our dating adventures and misadventures, while the couples talk about domestic bliss and moments that are less than blissful. We talk about the Patriots, tennis, Broadway shows, and whether Kim and Kris will reconnect in time for sweeps. We talk about politics, the weather, and plans for the holidays.

But recently I realized that with all that we talk about, and how well we know each other, what we don’t talk about, what we have never talked about and what we probably should talk about is, our sexual health.

I realize that, with the exception of one friend whom I know was tested recently after a scare, I have no idea if any of my friends have recently been tested for HIV. For that matter, in most cases I don’t know if they have ever been tested. I don’t know if they are aware of their risk factors, or whether they even know they are at risk. This got me wondering, why is that? Why is it that with this group of friends with whom I share any and every other detail of my life, I don’t share this information?

You don’t need flip charts and PowerPoint slides to make sure your friends know some simple key points that may help keep themselves uninfected, or if infected, into care as soon as possible. By having these discussions with our friends and others we care about, we can work to keep those we care about healthy.

Let me give you an example of how you can slip in a comment about HIV testing.

Friend: “Hey, did you get your flu shot?”
Me: “Yup! I got it this past week at my doctor’s. I figured I would get it done altogether. I got my flu shot, my tetanus booster, and an HIV test.”

So what are some key points that we can share with those we care about?

Testing is free and simple – There are still places where testing is free, even rapid testing, if there are concerns around using insurance. You can find a testing site near you for HIV and/or other STIs by entering your zip code here. It’s just that easy!
Know your status – Testing is the only way to know if you’re HIV positive. To ensure that you’re uninfected or if infected, getting care, it is important to get an HIV test. This can protect you and your partner’s health. The life-expectancy of someone with HIV continues to rise, as does the quality of that life, and those with undetectable viral loads significantly reduce their risk of transmitting the disease to others.
Educate yourself – Knowledge can be your first line of protection. Being aware of the disease, how the disease is transmitted, and how to protect yourself is imperative to helping yourself and others. To find out more about HIV, view our fact sheet.
Practice safer sex – Condom use has been proven effective against the transmission of HIV. To find out more about condoms and correct condom use, view our fact sheet.
Don’t share works – If you inject drugs, make sure that you use a clean and sterile needle and works every time, as HIV is transmitted easily through shared products.

Prevention is the best way to protect yourself against HIV, and promoting the message is the best way to protect the ones you love. Be the change that we need to continue to protect your community by preventing the spread of HIV. Talk with your friends, your loved ones, and keep yourself educated so that we can continue our fight against HIV. And remember, it was only 30 years ago that many doctors were completely mystified about the cause of death in so many young people. It was 30 years ago that the epidemic was becoming a pandemic. It was 30 years ago that individuals were being infected without knowing how to protect themselves. While we have yet to eradicate the disease, it is important to remind ourselves after 30 years, how very far we have come.

Greg is a senior program coordinator in the Education & Outreach Office of BPHC’s Infectious Disease Bureau.