In the How to Survive a Plague, David France's new documentary on the history of AIDS activism, we find our activist movement reflected in a mirror that only time can provide.
The images are striking, disturbing and incredibly moving. People with HIV—their depleted bodies with translucent skin stretched over thin bony frames, pocked with vivid lesions of Kaposi's sarcoma—spiral toward AIDS and certain death.
And yet they fought. Organizing under the moniker ACT UP (AIDS Coalition to Unleash Power), they entrenched themselves in the offices of the Food & Drug Administration, demanding treatment for an unstoppable disease ravaging their communities in 1987.
The documentary is both a powerful history lesson and a clarion call to action for the present day. More than 30 years after the first HIV diagnosis, much progress has been made in treatment, prevention and politics.
But look no further than Chicago to understand that HIV/AIDS is still a plague in the poorest communities of color. African-Americans in the city represent nearly 60 percent of the people living with HIV ( www.aidschicago.org/pdf/chicago_factsheet_2010.pdf&. Hispanic Chicagoans represent 26 percent, but make up 16 percent of new infections in the city.
The question is whether we still have the courage and urgency to act up.
The progress of the past 30 years has been vast and won't be fully detailed here. Today, more than 30 different treatments are available. The FDA approved the use of treatment as prevention. Recently, we even witnessed an instance of a person being cured of his HIV, a man known in medical circles as "the Berlin patient." ( www.cbsnews.com/8301-504763_162-57479106-10391704/timothy-ray-brown-man-thought-to-be-first-cured-of-aids-says-hes-still-cured/ )
Such progress is a direct result of men and women affected by HIV/AIDS crying out for public health attention to innovations in treatment and prevention. However, challenges loom large, despite progress in the areas of treatment and prevention.
HIV/AIDS disproportionately burdens communities of color in the United States, with nearly 1.2 million infected nationally, a majority of those are from the African-American and Hispanic communities.
Despite being minority communities, African-Americans continue to account for 44 percent of new infections ( www.cdc.gov/HIV/topics/aa/index.htm&. The rate of infections is especially disturbing among communities of young black gay and bisexual men. Latest data finds that their rate of infection is comparable to countries in sub-Saharan Africa that are hardest hit by the epidemic ( www.hptn.org/web%20documents/IndexDocs/HPTN061ResultsPR23Jul2012.pdf&. About 20 percent of new infections came from the Hispanic community.
Nationally, African-American women are second only to gay men in HIV prevalence. In 2009, three-fourths of women in Illinois infected with HIV were Black ( www.aidschicago.org/pdf/women_factsheet_2010.pdf).
Unstable funding forces storied AIDS service organizations to close ( www.windycitymediagroup.com/lgbt/HIV-AIDS-agency-BEHIV-folds-AFC-responds-to-charges-UPDATE/30181.html ), shrinking health access to communities and placing increasing stress upon an already resource-strapped health system. This year, Illinois was hit with a 42 percent funding cut in HIV funding for community services. HIV services are not unique here, of course. States are putting a disturbing array of health and human services on the chopping block in their efforts to shrink budgets.
Social injustices are driving the epidemic. Issues of economic injustice, such as unstable housing and unemployment, impact the mental, physical health and well being of those struggling with HIV. Loss of harm reduction funding makes it difficult for people to find and exchange clean needles. Struggles in the recognition of the rights of drug users and sex workers continue to impede efforts in turning the tide on the epidemic for communities that are most vulnerable and at highest risk.
Those scenes of 1987 depicted in the documentary warrant an analysis of how government and public health entities progressed, digressed, and now find themselves at a crossroads of truly changing the course of the epidemic at this juncture.
The Affordable Care Act represents a first step of providing unprecedented access to health care for millions who are uninsured, HIV-positive or not. Certain pieces of that legislation have already been implemented; others go into effect in 2014. The outcome of the presidential election will determine the extent to which the ACA is implemented.
Activists in 1987 helped science catch up to the advocacy, the effects of which can still be felt today. In contrast, the HIV/AIDS community today finds itself at the very same crossroads and a new opportunity to help the political will catch up to the voices of the present HIV/AIDS activist movement.
When we look to the DNA of our advocacy, we find the bold men and women featured in How to Survive a Plague were mere ordinary people—just like us. When exposed to the injustices of social exclusion and crippling disease, they fought back for visibility and did extraordinary things, changing the future course of the global epidemic.
Now, we must do the same. Let's act up like it's 1987.
Suraj Madoori is a fellow for the HIV Prevention Justice Alliance, a national AIDS-activism coalition convened by the AIDS Foundation of Chicago.
Find out how you can get involved with ending the AIDS epidemic by visiting the HIV Prevention Justice Alliance website: www.countdownaids2012.org .
