The Board of County Commissioners Thursday proclaimed Dec. 1, 2021 World AIDS Day 2021 in Multnomah County. The annual commemoration marks 40 years since the first cases of HIV were reported in the United States. Since then, more than 700,000 people have died of HIV-related illnesses.
“World AIDS Day is a solemn occasion. It is also a celebration of resistance, community and resilience,” said Erin Grahek, community services manager for the County’s Aging, Disability and Veterans Services Division. “Activism brought about advancements in treatment.” And, she said, those community leaders shaped and improved services, including by serving on local advisory bodies such as the Aging Services Advisory Council, and the County’s HIV Services Planning Council.
When HIV is managed, it stops being a disease that kills and becomes a chronic condition. Someone with a low viral load might have no higher risk of other illnesses than the general population. And people living with HIV who take antiretroviral therapy can maintain an undetectable viral load that allows them to have healthy intimate relationships.
But sweeping racial inequalities in society extend to racial disparities in HIV and AIDS.
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About 13 percent of the people in the U.S. are Black, but 41 percent of people living with HIV in the United States are Black.
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About 18 percent of people in the U.S are Latinx, but Latinx people make up 23 percent of new diagnoses.
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White people are six times more likely than Black people to be prescribed pre-exposure prophylaxis (PrEP), the drug that helps prevent transmission of HIV.
Multnomah County programs seek to narrow those disparities through its programs including culturally-specific case management, meal deliveries, housing navigation, medical case management and peer support.
Jenny Greenberg, the housing navigator for Multnomah County’s HIV Health Services Center, said when the first cases of HIV were reported in the U.S., federal and state governments did nothing to sound the alarm.
“Forty years ago there was silence. But communities fought to be seen and to be heard,” she said. And it was that community activism that pushed the federal government to fund safety net clinics for people seeking low-barrier comprehensive care for HIV and AIDS. Clinics like the Health Services Center.
Scott Moore, community affairs and policy officer at Quest Center for Integrative Health said that as a white man, he received quality healthcare and that has allowed him to remain healthy for decades, despite a diagnosis of HIV.
“As a white, cisgender male, I have been privileged to get medical care without stigma or discrimination. My immune system is stronger than it has ever been,” he said. “But I will always be a person living with AIDS.”
He applauded the strides science has made in treatment and prevention of HIV, but gaps remain in accessing healthcare, especially for people aging with HIV. A person on Medicare, for example, may not be able to get treatment for a substance use disorder or chronic pain.
Community also heals, and grassroots and nonprofits have sprung up to support people living with the virus. Organizations like the Cascade AIDS Project, Quest, and Portland Two Spirit Society.
Lorne James, chair of the Portland Two Spirit Society and member of the HIV Services Planning Council, said compassionate communication is key to empowering people to care for their own health and care for others.
James is originally from New Mexico, and a member of the Diné Nation.
“In my Navajo language there is no word for art or beauty. One word, Hózhó, encompasses all of it—beauty, order, harmony. Every aspect of life is related to this word,” he said. “Appropriate use of language can bring awareness, prevent harm and empower the spirit. Compassionate use of language is a medicine that heals.”
Commissioner Lori Stegmann said it’s a privilege to share in the national Day of Remembrance, and to see over time that medical advances allow people living with HIV to live full lives. “I’m grateful for the scientific advances and services through Ryan White (grant funding),” she said. “And still there is so much work to be done… A tremendous amount of work to do.”
“Thank you, Loren for being here and sharing your full identity with us. And Scott, I appreciate you sharing your story,” said Commissioner Sharon Meieran.
Among those who spoke during Thursday’s proclamation was Jim Clay. At 74, Clay is the coordinator for the Aging Well program at Cascade AIDS. He lost his husband to AIDS in 2007.
“Thank you for the support you have given long-term survivors. The recognition is wonderful,” he said and handed commissioners a card signed by other long-term survivors. Clay has recognized World AIDS Day for 33 years now. It has become a time to celebrate new treatments and medications that allow people with AIDS to enjoy long healthy lives, to focus on “Ending the Epidemic.”
But he encouraged the Board to remember the original intent of World AIDS Day.
“It began as a solemn time of remembrance, an opportunity to grieve our losses,” he said. “It seems fitting that we set aside one day to remember the horror and those who are gone.”
He quoted the late playwright William Hoffman, who described the AIDS epidemic as a time of mass death, brutality and human indifference.
Commissioner Susheela Jayapal recalled the early years of the epidemic, when she worked as a young litigator in San Francisco. “I remember the friends and colleagues I lost. The miasma of fear and stigma,” she said. “I’m grateful that 40 years later we’re in a different place.”
She thanked Clay for calling out the horrors of the early response—the death, brutality and indifference.
“I find myself thinking that human indifference is the worst of them all. It’s the hardest to combat,” she said. “And the antidote is activism.”
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