A new era for HIV?
How has HIV changed since the 1980s? OU PhD student, Tom Witney, explains and tells us about his research into HIV and relationships.
Where were you in the 80s?
When you think of the 80s what comes to mind? Maybe it’s shoulder pads, stonewashed denim and questionable hairdos. Maybe it’s the music. Maybe it’s dramatic adverts featuring icebergs and tomb stones. Like many people, it was the first time I’d heard of HIV and AIDS, and I was terrified — I didn’t want to die from ignorance.
No longer a death sentence
Somehow the news in the late 90s of the first effective treatments and the dramatic drop in AIDS diagnoses passed me by and it wasn’t until much later that I learned that thanks to a combination of drugs (called antiretrovirals), it’s possible to stop the virus replicating, allowing people to live with HIV. In fact, now we know that if you have your HIV diagnosed promptly and are on treatment, you can expect to have as long, if not longer, a life than the rest of the population.
Can’t pass it on
HIV drugsThen, nearly 20 years after I first heard of HIV, I worked on a project to make doctors and community groups aware of new data that suggested effective treatment could reduce the chance of transmitting the virus. Everyone was excited that this could not only stop the virus spreading, but that it could end HIV stigma too: if you can live well and can’t pass it on, what is there to be frightened of?
Fast-forward to 2018 and although stigma hasn’t ended, the idea that someone who has a very low level of HIV in their system (so low that even the most sensitive test can’t find any, called by doctors an undetectable viral load) can’t transmit the virus has been proven beyond reasonable doubt and is sometimes summed up as U=U (or undetectable means untransmittable).
What does this mean?
The question of what these changes meant for the everyday lives of people living with the virus and their partners stayed with me. So when the opportunity to study this at The Open University arose, I jumped at the chance! Not only because the OU is a great place to learn, but also because at the OU, we’re committed to doing research that makes a difference in the ‘real world.’
Taking HIV away from the everyday
In my research, I have been talking to gay men in partnerships where one partner is HIV positive and the other is HIV negative (sometimes called being in a magnetic, serodifferent or serodiscordant relationship). And, thanks in a large part to U=U, they have been telling me that life is pretty ordinary: aside from the daily medication the positive partner takes, HIV and fear of transmission play little part in their lives. The things they worry about are the same as anyone in a relationship: whose turn is it to make the dinner or take out the bins!
For some, there were still occasional worries, like whether HIV could make it difficult for them to move abroad. And HIV stigma is still present: most were careful about who they told about their different statuses. Because of this, they were all clear that more people need to know that HIV has changed and, while it’s still better to stay negative if you can, that’s easier than ever and there’s nothing to fear from HIV.
A new era of HIV?
HIV hasn’t gone away but it has changed dramatically over the last twenty or so years. We now know that people living with HIV on successful treatment are unable to pass the virus on. And with advances like PrEP (pre-exposure prophylaxis) it’s possible to use the drugs that treat HIV to stop people becoming positive in the first place. However, these developments raise a lot of questions for those of us studying HIV in society. How do these developments change the meaning of being HIV positive or HIV negative? How are they affecting people’s sexual, intimate and social lives? How will they affect the course of the epidemic? And what impact are they having on HIV stigma?
At The Open University, we’re committed to continuing to explore these and other questions around HIV. So what will HIV look like in 30 years? Will it still be with us or will it be a subject for historians? We will have to wait and see, but you can be sure that the world (and hairstyles) will be as different as today was from the 80s.