Ask an Expert: How Does the HIV Epidemic Disproportionately Affect Communities of Color?

Ahead of National Black HIV/AIDS Awareness Day on February 7, we sat down with Marc Meachem, U.S. External Affairs Manager at ViiV Healthcare, to discuss the future of HIV care, the representation of HIV in media and the end of the epidemic once and for all.

What kind of progress has been made with the HIV epidemic in the past 40 years after the first case of HIV was reported in the United States?

Marc Meachem: In terms of progress, I would say it’s A tale of two cities. It is truly a story of enormous progress, but also of enormous disparities. With HIV — and I lived the full 40 years of the epidemic — we have moved from a death sentence to a manageable scenario in which many people can expect to live normal lives. This is truly a testament to science.

There is also a human component to progress: less demanding and less persistent treatment regimens offer many people emotional and practical benefits. We also know from science that if you are on HIV treatment and you are undetectable, you cannot transmit to a sexual partner. This knowledge is a huge relief in terms of the humanitarian progress of HIV.

However, not everyone has benefited from scientific and humanitarian progress in the same way. Some communities remain disproportionately affected by HIV and so even after 40 years of progress there is still work to be done.

A couple is walking in the metropolitan street

Getty Images Photo*

As we approach National Black HIV/AIDS Awareness Day on February 7, I would like to ask you about the significance of this anniversary. From ViiV Healthcare’s perspective, can you talk about the importance of this day of celebration and why it is imperative that it remains separate from commemorative days such as World AIDS Day?

MM: National Black HIV/AIDS Awareness Day, or NBHAAD, highlights the fact that standards of care for HIV prevention and treatment do not affect everyone in the same way. For black men who have sex with men, the statistic is that one in two men will get HIV; for Latino men, it’s one in four. The standard of care for HIV does not affect everyone in the same way. This glaring disparity is therefore the key issue.

There’s also a misperception that HIV is a gay man’s disease, and of course that’s not true. Black women, for example, are 12 times more likely to contract HIV than white women. The misconception that this disease does not affect women – that it only affects gay men – is harmful and does a tangible disservice to everyone, especially women of color..

Representation is important. Empathy is important. Understanding who this disease affects and how is a must.

What is your response to the Biden administration’s recent press release regarding its national HIV/AIDS strategy?

MM: ViiV Healthcare is 100% behind the Biden administration’s strategy. The goals are clear: the administration is working to prevent new infections, ensure people living with HIV have good health outcomes, and reduce the disparities we’ve discussed here.

The goal is to end HIV by 2030. To achieve this goal, the heavy lifting needs to be done by 2025. I hope people will understand that if you keep doing the same thing you will get the same results. We must ask ourselves, What can we do differently? We have the reality of these horrible imbalances that exist between communities. We have to do something different.

Girl on the beach using phone
Girl on the beach using phone

Getty Images Photo*

Can you describe the impact that COVID-19 has had on the Ending the Epidemic HHS initiative, as well as the community of people living with HIV?

MM: This is the understatement of the century, but it created a divergence. Health staff have been focused on COVID, so resources that might otherwise have been allocated to HIV/AIDS have of course been scarce. The COVID pandemic has also highlighted inequalities. I don’t think the racial disparities of COVID surprised anyone. This clearly shows the work that remains to be done in this country. I think if we maintain the status quo, we cannot expect different results.

Of course, there has also been a lot more public health presence. So on the positive side: Can we leverage this beyond COVID and gain momentum in the treatment and care of people living with HIV?

What do you think of media representation and communication initiatives that are culturally relevant and representative of POC communities?

MM: Things have changed so much, but there is still room to grow. There was a time when there were only a handful of media portrayals of people of color. And these stories were made, told and written by white people. It wasn’t from our point of view and it wasn’t our stories.

Now we have black creatives, Latinx creatives, Asian creatives telling their own stories. It was a big breakthrough and we must continue in this direction. We don’t want to see a caricature, but rather the magnitude of our humanity.

When we are exposed to the breadth of different experiences and humanities, doors open. Culture enables people to address serious issues, make breakthroughs and take action.

Group of friends together at night
Group of friends together at night

Getty Images Photo*

Where do we go next to end the HIV epidemic once and for all?

MM: The resources we have for HIV don’t always trickle down. When you look at the communities that are supposed to receive these resources, this money just doesn’t have the intended impact. And so the question is, what should be done from a systemic point of view? What kind of change can we demand for the investment that is made?

It takes money to generate these advances in society. For community organizations, we tend to expect them to solve some of our biggest problems with the meagerest budgets. It’s a deep and ugly lie.

We need to find ways to get these resources to communities that are consistently underserved. You can see the lack of resources in these communities and so we need to find a way to get more of these essential tools into these communities.

Friends help each other to tie the earrings
Friends help each other to tie the earrings

MM: It’s easy to feel like it’s always been like this, it’s always going to be like this. The reality is that we can end the HIV epidemic. I want communities to have hope and understand that things have changed. I want people to know that we can do it, that we have a set of tools to do it from the biomedical side.

Due to the lack of visibility and representation in the media, the stories and realities of the impact of HIV on communities of color have never really been told. But within communities, these stories live. The reality of disparities lives. I want to create a sense of hope and possibility around breaking down disparities.

National Black HIV/AIDS Awareness Day is Monday, February 7.

*File photos do not imply that the models depicted are HIV positive.


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