Will we see an end to AIDS in our lifetime? - Crain's Cleveland Business

Recently, I had the honor of speaking to a group of LGBTQ+ youth about perseverance and bravery in the face of intolerance. Though generational experiences differ, we found commonalities between our cohorts. One topic we talked about was HIV and AIDS, and I related growing up during the peak of the epidemic in the 1980s and '90s, the immense loss of life that the disease inflicted, and the panic and lack of public empathy that followed.

In those days, contracting the virus was a veritable death sentence, as no true treatment options existed. Today, more options exist to control the lethality and spread of the virus. Still, hundreds of Clevelanders suffer infection every year, and the risks are highest for young men of color and LGBTQ+ youth. Those who cannot access medication often do not survive.

Thus, the question still remains: Can Cleveland see an end to AIDS in our lifetime?

Perhaps one of the most promising research studies in HIV/AIDS prevention is Case Western Reserve University's MOSAICO study. In partnership with University Hospitals, the study seeks to discover a much-hoped-for HIV vaccine. Scientifically, the medication seeks to boost anti-HIV antibodies in recipients, thus creating an antiviral firewall that prevents the virus from taking hold in the body.

The initiative is part of a global study that includes some 55 cities worldwide with 3,800 participants, ages 18 through 60, who are HIV-negative and not on PrEP (a medication that helps to prevent the transmission of HIV). Participants will undergo monitoring during a two-and-a-half-year study window that includes some 14 clinical visits.

One aspect of the MOSAICO study that researchers find so exciting is that it is a Phase III trial, which means this is the final phase of the research. Hence, a working vaccine could be available within only a few years.

Individuals interested in learning more or wanting to take part in the MOSAICO study should contact the Cleveland AIDS Clinical Trials Unit.

Of course, there is no guarantee the MOSAICO study will be successful; after all, similar attempts in the past have failed. Moreover, even if the study results in a safe and effective vaccine, this in and of itself will not bring an end to AIDS. After all, a vaccine is not a cure, so those living with the virus would still require continued treatment to stay healthy.

Moreover, better policy is needed to ensure that all HIV negative individuals can gain access to the potential vaccine. Currently, public policy in Ohio falls short, particularly concerning the legal landscape.

Many of Ohio's laws continue to criminalize those with HIV/AIDS. Borne from the height of the AIDS epidemic, HIV criminalization laws formed from fear, ignorance, racism and homophobia — often targeting communities of color and LGBTQ+ people in particular. Even today, those living with HIV/AIDS can suffer imprisonment of up to eight years for failing to disclose their status during a number of activities, many of which carry zero or negligible risk of transmission, including: protected sexual activity, spitting and/or exposure to bodily fluid (even if the virus cannot live in it), and engaging in or soliciting sex work (even when no physical contact is made). In many cases, those convicted are forced to register as sex offenders.

Such laws stigmatize and victimize those living with the disease while causing the virus to spread. Fear of conviction causes many to avoid getting tested and discourages open conversation about the disease. Moreover, imprisonment increases the likelihood of sexual assault against those living with the virus while behind bars.

To learn more about HIV/AIDS criminalization laws and efforts to change them, individuals can research the Ohio Health Modernization Movement.

Public policy needs to recognize the realities of HIV/AIDS. Socioeconomic marginalization forces individuals to engage in high-risk activities, such as survival sex. Better policy should empower at-risk communities through increased funding and resources.

One option Cleveland should consider is to sign onto the Paris Declaration on Fast-Track Cities, a global coalition of 300-plus municipalities dedicated to ending the AIDS epidemic through adherence to UNAIDS 90-90-90 targets: 90% diagnosis of all persons living with HIV, 90% sustained antiviral therapy (ART) for all diagnosed persons, and 90% viral suppression achievement for all receiving ART. The initiative's fourth goal is elimination of all social stigma.

Currently, no cities in Ohio have joined the coalition and only three in the Midwest have done so: Chicago, Minneapolis and St. Louis. This is Cleveland's opportunity to step up and take a stand.

Turan is director of development at the LGBT Community Center of Greater Cleveland.