In the early days of the AIDS epidemic, treatment options were limited at best. Most who were living with HIV/AIDS, the majority of whom were gay men, attempted to find and use treatments that would save their lives and control the virus from causing further physical deterioration. Sadly, most Americans were blind to the efforts of the AIDS generation, yet a discourse around these efforts is beginning to enter the mainstream consciousness of our society. David France has beautifully captured the efforts of ACT UP, the leading activist group that fought bravely for the development of treatments, in his 2013 Oscar-nominated documentary, “How to Survive a Plague.” In a new film to be released at the end of this year, Hollywood actor Matthew McConaughey portrays Ron Woodroof, an electrician from Dallas who worked with underground pharmacies to smuggle alternative treatments for himself and other afflicted with AIDS in what became known as the “Dallas Buyers Club.” It is within this backdrop that thousands of gay men of all races and ethnicities first found out that they were living with HIV in the United States. Until 1985, when the virus was identified, most who were infected lived in fear and apprehension, and were often very progressed in their disease by the time they were diagnosed. As a result, life expectancy was extremely short after diagnosis. For most who had developed full-blown AIDS, and in the absence of any effective treatments, life expectancy was a matter of years.
Close to 30 years later, the landscape of the epidemic has changed dramatically. Testing for HIV is now as simple as a rapid oral antibody test that can be administered at home with a kit one purchases from pharmacy. A vast array of effective antiretroviral treatments helps to keep the virus at bay. In fact, a young gay man who is diagnosed shortly after infection, and who uptakes a treatments regimen to which he consistently adheres, can by all calculation have a close to normal life expectancy. Yet despite these medical advances, HIV remains a stigmatized disease and some 200,000 Americans are living with the virus undiagnosed. The perpetuation of the AIDS epidemic among a new generation of young gay men is anathema, made all the worse by the fact that a subset of these men remain undiagnosed and that among those diagnosed only some 20 percent adhere to their treatments such that their virus is reduced to undetectable levels.
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