How to End AIDS Once and For All

For pediatricians like me, creating an AIDS-free generation seemed like an unachievable dream. While each needless loss reverberated through families and their communities, losing infants to AIDS was especially heartbreaking.

Throughout my residency in Washington, D.C. during the 1990’s crack epidemic, each HIV-positive baby I took care of was a lesson in not losing hope. Pediatricians across the globe celebrated each birthday as we shifted our energy to keeping children with HIV not just alive, but well. Back then, blowing out candles was a revolutionary act for families often suffering the dual loss of parent and child after what is normally a joyous occasion—giving birth.

Today, we are celebrating more than ever. New York City, the place where the AIDS epidemic began, has reached an awe-inspiring milestone–no babies have been born with HIV within the past year.

This accomplishment is a hard-fought battle that activists, families and physicians have been waging for decades and throughout my entire clinical career. Twenty-nine years ago as a young medical student in Newark, N.J., there was little medicine could do to stem the tide of the AIDS epidemic’s devastation of some of the most stigmatized groups in society—the LGBTQ community, intravenous drug users and low-income people of color.

The cost of not knowing what to do was catastrophic. Thousands of infants in children’s hospitals across the nation were born with little to no options for treatment and survival. We did what we could as clinicians, but most important, we listened. We learned about how the racialized stigma around poverty, addiction, gender identity and sexual orientation conspired to fuel HIV diagnoses, a lack of access to quality care and death.

After over 30 years and an estimated 35 million lives lost, the clinical community is arriving at a key approach that will ultimately reduce health inequities within the AIDS epidemic. We are finally advancing patient-centered medical care, which normalizes the radical notion that patients, irrespective of race, sexual orientation or neighborhood, are people whose humanity should be affirmed in support of reaching their full life potential.

At its core, affirming humanity is the cornerstone of New York City’s Plan to End the Epidemic—that means focusing on expanding access to testing and Pre-Exposure Prophylaxis (PrEP) and maximizing viral suppression in communities that need it the most. We’re also supporting New Yorkers’ sexual and reproductive choices and creating the necessary social supports for all children to thrive.

With coordinated strategies to keep parents HIV-free or virally suppressed, we can end mother-to-child HIV transmission not only in New York City but across the nation. While there’s more work to be done, achieving zero mother-to-baby HIV transmissions helps honor the sacrifices of the thousands of family members that lost 1,255 of our littlest New Yorkers to an entirely preventable disease, according to an NYC Health Department analysis.

It reinvigorates our city’s commitment to fighting for the health of all children, who are the manifestation of their families’ dreams. It renews our determination to bridge public health and health care to end all parts of the epidemic. By working together, we look forward to celebrating the next milestone that manifests our longstanding dream of creating an AIDS-free generation in our lifetime.