A few weeks ago, UHS, PRH, DIHG and the Nathan Smith Society sponsored “Living HIV Positive: Managing the medical and social realities of HIV infection” at Dartmouth Medical School. Panelists included Tim Lahey, MD, a specialist on the treatment of AIDS; Victoria Brooks, the Executive Director of ACORN, a local non-profit that is involved with community outreach and services to people infected with HIV; and *Bill, an HIV-positive patient who has lived with the disease for over twenty years. The panel provided audience members with a variety of ways to approach HIV/AIDS in our community and abroad.

Dr. Lahey opened with familiar, but nonetheless staggering statistics: 35 million people are currently living with AIDS, with approximately three million new infections appearing each year. This year, that number has decreased for the first time in history to 2.7 million. Over twenty million people have already died, and we have lost two million lives across the globe to AIDS in the last 365 days.

It is well known that some of the hardest hit areas are in Africa, and while HIV is still rampant, Dr. Lahey explains there is hope. In the last five years, there have been great advances in providing antiviral medications to HIV-positive individuals across the continent, and the growth of public infrastructure designed to provide both education and treatment is impressive. Furthermore, antiviral therapy has improved substantially in the past decade, with 59 different strands of drugs available, providing patients who suffer from adverse affects or who have grown resistant to many of older treatments with more alternatives. The drugs have also gotten better: the debilitating side effects, such as nausea and fatigue, that Bill discussed in his powerful narrative, are milder in the new drugs.

There has also been reason for great optimism within the science community, as the potential exists for a vaccine and a sexual lubricant with HIV-fighting mechanisms, which are both currently being tested. One recent vaccine tested in Thailand showed a 26% decrease in HIV/AIDS contraction. Researchers hope that a sexual lubricant will be especially empowering for women, who may be coerced into a sexual relationship, or forced to have intercourse without a condom. Additionally, there is evidence that circumcised males are less likely to contract the disease during intercourse.

Despite these encouraging breakthroughs, Dr. Lahey and the other panelists indicated that HIV/AIDS in the United States is a very different disease. In the Global South, the governments lack the public services and federal funds to contain the disease; in the United States and Western Europe, HIV/AIDS often finds people living in the “nooks and crannies.” The Disease highlights the inadequacies of our public healthcare system: less than half of all adults in the United States have been tested for HIV/AIDS, and African Americans disproportionately overrepresented. Even more worrisome are the local numbers. While all statistics draw from voluntary reports, all panelists agreed that the rate of infection has increased in Vermont and New Hampshire in the last few years. Ms. Brooks confirmed the most recent statistics, which show 500 people are currently being treated for HIV in Vermont, and roughly 2,000 in New Hampshire. While Bill is fortunate enough to have health insurance that largely covers his medical bills (though he does pay a hefty premium of over $1,200), many other HIV-positive individuals cannot afford treatment. Ms. Brooks discussed working with patients who couldn’t afford the transportation from nearby neighborhoods, like Woodstock and Hartford, to DHMC.

So, in light of World AIDS Day, I ask readers to consider people living with HIV/AIDS both abroad and at home. AIDS is not something that afflicts only those far from our communities: it’s a disease that deserves our scrutiny within our very communities.