A version of this article originally appeared in the Black AIDS Institute’s Black AIDS Weekly e-mail. Colorlines joins other black community media in co-publishing content from the Black AIDS weekly.

Thirty years into the HIV/AIDS epidemic, and after decades of research disappointments, 2010 saw major breakthroughs that put scientific advances such as microbicides, pre-exposure prophylaxis (PrEP) and vaccines within reach and created a favorable environment for other prevention and treatment efforts. In fact, some experts predict that over the next year, some of these discoveries could change the trajectory of the AIDS epidemic.

So what comes next? Colorlines will be covering the HIV epidemic closely throughout this year, in which the epidemic plunges into its fourth decade. Here, we examine 10 major HIV stories of 2010—and how experts expect them to unfold during 2011.

1. Microbicides March Toward the Market

Could applying a gel to the vagina or rectum one day prevent HIV? Scientists hope so. Last year, South African researchers reported breakthroughs in microbicide research. They found that inserting a vaginal-gel version of an antiretroviral medicine called tenofovir (prescribed in pill form as Viread) could reduce HIV incidence in women by 39 percent—and up to 54 percent in the most careful users.

What to watch: Never have scientists been closer to identifying a viable microbicide than they are today. Next steps include confirming these results. Some experts believe that a microbicide for women could be on the market by 2014. Efforts to develop a rectal microbicide are also under way; however, vaginal and rectal tissue are very different from each other, so this research may take significantly longer.

2. Vaccine Research Takes Steps Forward

U.S. government scientists discovered new AIDS antibodies last year, one of which neutralizes 91 percent of known HIV strains. This remarkable discovery was found in a 60-year-old African American gay man (aka “Donor 45”), making him the world’s secret weapon in the race to create a vaccine.

What to watch: Donor 45’s body produces these potent antibodies naturally. The next steps include replicating this work in a living being rather than just in the lab. Yet this and other discoveries have created momentum (pdf) and excitement in vaccine research.

3. Preparations Made for Pill-a-Day Prevention

Forget about that apple. Someday a pill a day may help keep the HIV away from those at high risk for contracting the virus. Late last year, scientists proved that a daily dose of the oral antiretroviral drugs tenofovir and emtricitabine (brand name Truvada), used as pre-exposure prophylaxis (PrEP), help prevent HIV transmission among men who have sex with men by 44 percent on average—as high as 73 percent for those who protected themselves most consistently. So instead of having to negotiate with a (perhaps unwilling) partner about wearing a condom, with PrEP you would have the ability to protect your own body independently—without your partner even knowing it.

What to watch: The study ends in March of this year. Even then, additional research must be done before oral PrEP hits your local pharmacy’s shelves. About 20,000 people are participating in PrEP trials around the world.

4. Funding for HIV/AIDS Programs

Historically, America’s economic stability has been one of its greatest strengths; however, 2010 saw coffers continue to be depleted nationwide in federal, state and local government. The budgets of lifesaving AIDS service organizations and AIDS Drug Assistance Programs (ADAP) continued to experience cuts, resulting in service reductions and longer waits for antiretroviral medications. With more than 5,000 people now wait-listed nationwide, the lives of people living with HIV/AIDS (PLWHA) are being jeopardized, as are decades of effort to contain the disease’s spread.

What to watch: There’s hope that 2011 will be better. Economists predict that companies will begin hiring and consumers will start opening their wallets again. The hopeful view is that some municipal and state governments, along with the federal government, should resume allocating monies to HIV/AIDS health programs. But state budget crises are still unfolding, there’s concern that newly elected conservative leaders at the state level will cut social spending across the board. The president’s budget proposal is expected in coming weeks.

5. The End of the Travel Ban

After 20 years, the federal government has lifted its ban prohibiting HIV-positive people from traveling and immigrating to the United States. It also removed HIV from the nation’s list of communicable diseases.

What to watch: This policy change clears the way for the International AIDS Conference—the world’s largest scientific conference on HIV/AIDS, which hasn’t been hosted in the U.S. since 1985—to convene in 2012 in Washington, D.C. The country will gear up efforts to show that America not only can lead in HIV/AIDS research, programs and prevention, but also can end discrimination and stigma against PLWHA.

6. Federal Funding for Needle-Exchange Programs Resumes

Being an injection drug user (IDU) or having unprotected sex with one has been the number two way that HIV has spread among Black Americans. In 2010 the ban prohibiting federal support for needle-exchange programs—harm-reduction efforts that swap out dirty needles for unused syringes—was lifted. Not only does needle exchange prevent HIV’s spread, drug users with access to such programs also engage in less risky behavior broadly and are more likely to get into recovery.

What to watch: Syringe-exchange programs should receive more funding, a big step toward curbing the epidemic in black communities.

7. The Rollout of Health-Care Reform

The Health Care and Education Reconciliation Act—America’s largest health-care overhaul since 1965—may be the most important legislation benefiting PLWHA that Congress has ever passed. This legislation will help many people with HIV/AIDS who are uninsured or underinsured gain greater access to care and treatment.

What to watch: House Republicans have already voted to repeal this legislation (which its members have pejoratively labeled “ObamaCare”), and with Congress’ rightward shift, it could get a vote in the Senate as well. The president is expected to veto any repeal that makes it through Congress.

8. Drilling Down on the National HIV/AIDS Strategy (NHAS)

In July the Obama administration released the National HIV/AIDS Strategy, the U.S. government’s first-ever plan for fighting the virus domestically. In theory, African Americans will become a priority as the government allocates resources to the “highest-risk populations” in order to reduce the annual number of HIV infections by 25 percent. Still, the initiative must be adequately funded.

What to watch: We will learn how serious Washington is about the strategy—and about doing right by people of color—as accountability is established in all areas of government.

9. Social Media Campaigns Target Audiences

Social media provide the latest tools to take the AIDS movement to the streets, as programs like Greater Than AIDS and GMHC’s New York-based “I Love My Boo” campaign have helped spread messages designed to increase preventive activities and reduce stigma, for instance.

What to watch: This year, HIV/AIDS social media campaigns will target black gay men, black women and faith leaders, among others.

10. Berlin Backpedals

Does a cure for HIV really exist? That’s what many media reported when German researchers who had performed a stem-cell transplant on Timothy Ray Brown, an HIV-positive man with leukemia (often called “the Berlin Patient”) claimed to have destroyed his HIV cells. Brown’s virus has been suppressed, making it undetectable; however, doctors can’t guarantee that it has been eradicated. Furthermore, the procedure is both expensive and dangerous—you have to be very sick to receive it—and only 1 percent of white people in Northern and Western Europe carry the genetic variety of stem cells needed for this procedure. Still, the findings do point to another possible trail: Can genetically modified stem cells destroy HIV cells? If so, might this one day become a viable treatment?

What to watch: Don’t hold your breath, take off that condom or expect media organizations to admit that they overhyped the story. Researchers remain early in the process of engineering stem cells that might “cure” the virus.

Read this online at http://colorlines.com/archives/2011/01/the_10_stories_you_need_to_know_as_hiv_enters_its_fourth_decade.html


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