The 1980s paid a surprise visit recently, when actor Charlie Sheen revealed that he’s HIV-positive. The inaccurate, speculative and just plain ignorant comments that followed the announcement showed that many of us haven’t caught up with the reality of HIV in the 21st century: that people who are tested and treated for the virus can manage and live with it for years.

The shame that’s still associated with HIV is standing in the way of proper care for people who have been diagnosed with the virus. But that barrier could be lifted. The state’s HIV community is launching the Campaign to End AIDS in Maine by 2030: intended to eliminate not only the stigma of HIV but also new infections and deaths from AIDS. Though these are ambitious goals, they’re not impossible ones, given the energy and focus that Mainers working together can summon.

Preventing new HIV infections is the only way to end AIDS in Maine. And since only people with HIV can transmit it, stopping its spread depends on their knowing that they’re infected and seeking medical care to control the virus.

HIV-POSITIVE, BUT UNAWARE OF IT

But in Maine, as in the rest of the country, 20 percent of people who have HIV don’t know it, according to Portland’s Frannie Peabody Center, the largest HIV/AIDS service organization in Maine.

Why? Some don’t have access to primary care, while those who do may not know that they should be tested.

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Men who have sex with other men account for half of those diagnosed with HIV in Maine in the past 10 years. Family doctors, however, often shy away from asking patients (especially those over 60) about their sex lives or their sexual orientation.

Sharing needles to inject opioid drugs is another common way to transmit HIV — but despite the rise in opiate use in Maine, assumptions about who is or isn’t an addict can forestall conversations about patients’ drug use.

Though awkward, these discussions offer opportunities to stop the spread of the virus. Whether they’re in primary care practices, urgent care clinics or emergency rooms, doctors who know that a patient may have been exposed to HIV can prescribe a pill that’s been shown to cut the risk of getting HIV by up to 92 percent.

DOCTORS NOT ONLY ONES INVOLVED

But the challenge of ending AIDS in Maine encompasses more than just the medical community. Educators and policymakers have a role to play, too. It’s troubling that although state law mandates HIV education, there was a steady decline between 1997 and 2011 in the percentage of Maine middle and high school students who’d ever been taught in school about HIV infection.

Age-appropriate, comprehensive sex education should be a priority. Young people need to know whether what they’ve heard about HIV is a myth or the truth — and they can’t always depend on adults to know the difference.

For example, after Sheen announced his HIV status, he was slammed online for saying that his level of the virus was “undetectable.” But he’s right. The medications he’s been taking have suppressed the virus to the point where blood tests can’t register it. Sheen isn’t cured of HIV, but if he keeps up his drug regimen, he can lead a long, healthy life.

An HIV diagnosis is not a death sentence, as long as people have access to care. HIV drugs cost a lot of money, so it matters that low-income Mainers who are HIV-positive but earn too much for regular MaineCare can get publicly funded treatment. Providing affordable substance abuse and mental health treatment would be good next steps toward HIV prevention. Expanding MaineCare eligibility would help, too.

HIV/AIDS service groups have been educating Mainers and connecting them with treatment and support resources for several decades. Now that these organizations have asked for assistance in bringing the epidemic to an end in Maine, everyone reading this should think about how they can help turn this vision into a reality. It’s the least we can do.


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