By Lee Storrow
The minute I arrived at this year’s International Conference on AIDS, I knew that this time, it was going to be different.
The conference, held this year in Amsterdam, is the largest convening of any global health topic in the world. When I attended the conference in Durban, South Africa in 2016, over 12,000 people from 155 countries were in attendance.
In many ways, Amsterdam may be the perfect city to hold this convening. Both Durban in 2016 and San Francisco and Oakland, the hosts for 2020, have been critiqued by activists as inappropriate locations for the conference.
No such controversy has emerged in the selection of Amsterdam, which has set a goal to end AIDS by 2030, and is on track to meet it. Legalized sex work in the city provides a level of security to the women engaged in the world’s oldest profession. Syringe exchange programs have been legalized for more than 20 years (North Carolina legalized syringe exchange programs in 2016). The city also has legalized drug consumption rooms, and a culture of health radiates through the city. Bicycles easily outnumber cars, and next to the train station there were bicycle racks stuffed with bikes that seemed to go on as far as the eye could see.
While waiting for the opening session to start on Monday, I chatted with my colleague Carolyn McAllaster about what North Carolinians should expect to get out of the conference. McAllaster is a law professor at Duke University School of Law and the director of the Southern HIV/AIDS Strategy Initiative.
“Many countries face the same issues that we face in the U.S. South: HIV-related stigma, funding inequities, challenges in the equitable delivery of HIV-related medication and services,” she said. “We can learn from the many innovative approaches used by advocates and providers around the world to overcome these barriers.”
Steps forward and back
As the conference began, I sensed greater hope than I did in Durban in 2016 that we could live in a world without new HIV transmission yet alarm that the global community might not be doing enough to sustain the gains of the last two decades.
At the start of the conference, a major scientific announcement was made about the PARTNER 2 study, a follow-up to the breakthrough PARTNER 1 study (which was led by UNC researcher Dr. Myron Cohen) that scientifically proved that individuals with an undetectable viral load would not transmit HIV to their sexual partners. Because the first study included a large number of heterosexual couples, there was some lingering doubt about possible differences in transmission rates between vaginal and anal sex.
After PARTNER 2, that doubt is gone.
“The science is really clear, there is new data that has come out here at the International Conference about the PARTNER 2 study,” said Murray Penner, the executive director of NASTAD (formerly the National Alliance of State and Territorial AIDS Directors), about this new breakthrough. “[During the study], there were 75,000 condomless anal sex acts and no new infections. The data is just becoming clearer and clearer.”[sponsor]
While attendees celebrated this news, a UNAIDS report released in advance of the conference painted a bleaker picture about our ability to increase treatment levels and stop HIV-related death. There is a 20 percent shortfall in funding needed to meet the UN’s 2020 goals, which would lead to a 75 percent decline of HIV illness and death and pave the way to end the HIV epidemic by 2030.
“We can’t afford to become complacent. We have the science, and are on the verge of ending the epidemic,” said McAllaster.
There are a number of North Carolinians attending AIDS 2018, including medical providers and researchers who are presenting on their work. I’ll be featuring their stories over the course of the coming week.