The past few years have been a rollercoaster for those of us most impacted by HIV. The use of pre-exposure prophylaxis (PrEP) by people who are HIV-negative has gone from being discredited and shamed to become one of the keystones of a renewed and revitalized push to “end the HIV epidemic”. The other life-changing piece of research is the landmark PARTNER study that showed us, once and for all, that the sexual transmission of HIV does not occur in people whose viral loads are undetectable. The joyous global uptake of the U=U message has been nothing short of inspirational.
Effective modern treatment and PrEP have changed how we can now think of HIV, and how we can think about our lives. We can now imagine a world where people with HIV live long, healthy lives and HIV transmission is a rare event. We can imagine sex as something that unifies us, rather than divides us along serostatus lines. We can imagine a time for healing. If there is anything that could mitigate the devastation of the early years of the AIDS epidemic, it might be a community-led push to end the epidemic within the next decade.
This may sound like an HIV prevention initiative. And it is. But the use of treatment as prevention sends out a powerful message about people living with HIV. It is an antidote to the stigma, shame and fear that has accompanied us. It announces new, previously unthinkable possibilities in our social and sexual relationships. It gives us more initiative to start treatment and stay adherent. These are the reasons, as an HIV-positive woman, that I agreed to become the co-chair of Toronto’s Fast-Track City Initiative.