In the last 10 years, great strides have been made in the global fight against HIV. However, to achieve further success, the successful strategies of the past must be altered.
During my last semester of high school in 1983, I had an internship with a pathologist. For my final report, he suggested that I write about a new disease. It was an exciting idea because no one knew the cause of the disease and it was so different from anything seen until then. That was the first time I had done any work related to AIDS.
The International AIDS Conference is a celebration of our successes, and there have been many. New tools for prevention have been discovered and developed, including pre-exposure prophylaxis, HIV treatment as prevention, which along with the social and behavioral interventions of education, condom promotion, and needle and syringe exchange, make achieving an end to the AIDS epidemic a possibility within reach.
You are right, it is both clear and difficult. It is difficult because first you need funding and political will. IDUs and sex workers are rarely considered priority populations from the point of view of governments, but in concentrated HIV epidemics such as there are in Central Asia, these are exactly the populations that need to be prioritized.
Next, the populations themselves are difficult to reach. Because of stigma and discrimination, as well as the criminalization of sex work and drug use, people who engage in these activities are hidden. To reach them, we have to draw them out to drop-in centers that attract them with needed services, or find them with outreach workers who know and understand the population.