Ending AIDS

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There's much to be encouraged about the ongoing fight against the AIDS epidemic.

Ambitious targets set up by UNAIDS have galvanized the world: 90% of everyone infected with HIV will be tested and know their status, 90% of them will receive effective medications, and 90% of those will see their virus so suppressed that their health is better and they're unlikely to transmit to others.

We've also reaped the rewards of three decades of AIDS research - a remarkable array of effective HIV prevention, treatment, care and support strategies. These are responsible for real progress in saving lives throughout the world, and especially here in San Francisco, which has always been a leader in developing these strategies. 72% of San Franciscans living with HIV have lowered the amount of virus they carry to an undetectable level. That's real progress toward the 90% goal.

But the good news isn't all good. To truly 'end AIDS' we have to address the 10% who are left behind by the 90/90/90 approach. That 10% includes the most vulnerable among us: trans females, Latinos, the young, the homeless, injection drug users, and especially African Americans and women, who don't meet that 72% level of viral suppression. They are the 10% who very likely won't be reached by the 90/90/90 targets.

Elections have consequences, and we face the likelihood of reduced federal support for medical and social services. But we must stay committed to adequate and easy access to culturally appropriate HIV services. We must continue to invest in community-level programs that we know work, such as addiction treatment, syringe exchange, housing, and sexual health services.


90/90/90 is a good bar and a high bar. But if we don't address the other 10/10/10 we will not 'end AIDS'. Instead we will be left with a continued HIV epidemic increasingly concentrated among those already most underserved and, at this moment, highly vulnerable to being left behind.

With a Perspective, I'm Judy Auerbach.

Judy Auerbach is a sociologist and Professor of Medicine at the Center for AIDS Prevention Studies in the UCSF School of Medicine.