By Kambiz Shekdar, Ph.D.
Whether it is to spare one’s parents, friends or loved ones, the pandemic has changed our daily routines and customs. Some have put an end to family visits. Others subject themselves to two-week bouts of self-quarantine before visiting friends. Blurring the lines between germaphobes and the rest of us, some strip naked upon coming home followed by elaborate disinfection routines. And as always, some don’t care.
COVID-19 and AIDS are diseases as vastly different as are our mechanisms to deal with them. They have different footprints across our populations. HIV/AIDS primarily affects marginalized and underserved populations including gay men, black women, those in our jails, injection drug users, trans women and sex workers, those with the fewest resources and/or the weakest voices. COVID-19 is more equal opportunity. HIV/AIDS is life-long and deadly when left untreated. SARS-CoV-2/COVID-19 is deadly in a small percentage of cases but has as yet unknown long-term consequences. It takes some doing to catch HIV/AIDS. Coronavirus/COVID-19 comes to us as easy as our breath. Despite their differences, both diseases create feelings of fear and guilt.
Like a COVID test, an accurate lab-based HIV test takes days to deliver results. During those days, people’s thoughts often wander. If I tested HIV-positive, would I ever date any HIV-negative person again, fearing I might infect them? For that matter, if I tested positive, would anyone not already infected with HIV ever want to date me? “Serosorting” is a practice that developed among some gay men; HIV-positive and HIV-negative people would tend to have sex with only those in their respective groups. There may not be a relatively straightforward way to fool-proof against the risks and fears of transmitting COVID-19, but in the case of HIV/AIDS, maybe there is.
Truvada/PrEP is an AIDS medication that provides a once-a-day pill to prevent HIV infection in people who do not already have it. By putting an easy HIV prevention tool in everyone’s hands, some argued that HIV/AIDS would no longer be a big deal. Condom use, especially among young white gay men, is pretty much a thing of the past.
“If you do happen to contract HIV while taking PrEP (chances are you won’t), you’ll potentially go from taking one pill a day to taking one pill a day,” or so says Grant Roth, an HIV peer counselor, ending his statement with an emoji shrug. And in response to the news of one of New York City’s first cases of PrEP failure, activist physician Demetre Daskalakis said of Truvada/PrEP, “We should stand unapologetically together in our role to make the serodivide a piece of history and not a part of our future.”
No pill is a wonder-drug. Short of a cure and/or vaccine, single-minded embrace of Truvada/PrEP will only ensure that HIV festers forever among gay men. Did we jump into this new world with eyes completely wide open or were we also prodded by our emotions? Were we guilted into it by HIV/AIDS?
Let’s keep in mind that our feelings about disease factor in our behaviors regarding treatment also. As the world pursues COVID-19 treatments, vaccines, and cures, let’s make sure that eager embrace of possible early half-solutions does not scuttle our stamina for ultimate cures.
Rockefeller University graduate Kambiz Shekdar, Ph.D. is founder and president of Research Foundation to Cure AIDS. Follow RFTCA on Instagram @RFTcureaids.