Stigma remains as biggest challenge in fight against HIV

When I was in high school in the 1980s AIDS was terrifying. Change your life scary, change your behavior scary, curse earlier generations scary.

It was a life-ending plague, and we only knew enough about it to be scared. And some politicians and political leaders were even willfully ignorant or callous.

That fear and lack of information made the effects of the disease even more tragic, bringing out the worst in some people – and, notably, the best in others.

Leaders didn’t know what to do or say; many closed their eyes while communities were devastated.

Today, the world has changed, and when it comes to AIDS/HIV, it’s changed dramatically and for the better.

On Tuesday, World AIDS Day, the Frannie Peabody Center in Portland announced the creation of a campaign to end AIDS in Maine by 2030.

End AIDS in Maine? It’s a worthy goal, to be sure, but just reading the headline about the campaign my first impression was that it’s one of those aspirational goals that often get thrown about.

Big numbers thrown in with far out dates, like doubling tourism by 2020 or tripling the state’s farm revenue. Goals, sure. Worthwhile, you bet. But not really a plan for success; more like rhetoric about what we would like to see.

Looking a little closer, however, I found the truth in the small numbers.

The Maine Department of Health and Human Services estimates that there are about 1,800 people in Maine with HIV, and that on average there are between 50 and 60 new infections per year.

In public health, that’s not a lot of people. It’s small enough, in fact, that with a clear plan I believe that the Frannie Peabody Center is right. We can end AIDS in Maine by 2030.

Often times, problems seem insurmountable. They feel too big to be confronted. It happens when we talk about how we can fight climate change. It’s difficult to see how one person can make a difference on a problem that is so enormous and has such drastic, worldwide consequences. It’s hard to get started

Through the hard work, commitment and dedication of thousands of people in Maine and millions across the country, we have arrived at the point at which we can see – realistically – a day without HIV/AIDS.

The numbers in Maine are small enough, the medical advances significant enough, the strategies sound enough that finally the finish line is in sight.

It reminds me of another program with ambitious sounding goals that seem very achievable once you understand the data. Portland’s ConnectED initiative has set lofty goals: Increase third-grade reading proficiency from 69 percent in 2013 to 85 percent in 2017; improve high school graduation rates from 86 percent to 91 percent; and increase post-secondary completion from 37 percent to 50 percent.

When you break down the numbers and develop a real roadmap, you realize just how achievable the goals are. It’s 120 more proficient readers in third grade; 60 more graduates; 40 more finishers.

That’s it. That’s achievable. Not to diminish the problem or the hard work it will take to achieve the goals – they’re formidable. But we can get our minds around these numbers and we can make a difference, one kid at a time.

The same thing is true in the fight against HIV/AIDS.

With the collaborative approach launched today in Maine and other states, we have a real opportunity. And because Maine is a small state, the numbers show us that we can get there.

The rate of new infections in Maine has dropped in recent years. The trend is heading in the right direction.

And the state has had some success in educated young people about HIV/AIDS, with 90 percent of high school seniors saying that they have learned about the disease in school.

Most of the steps in the blueprint for action are straight forward: expand access to health care and treatment, increase testing, and support funding for research and education. All we need is the political will.

But one challenge stands out.

As Megan Hannan, the executive director of the Frannie Peabody Center, wrote Tuesday in a Press Herald op-ed: “Stigma still surrounds HIV and people living with HIV, and it is this stigma that must be reversed in order to help people get tested when they should. The world must recognize that HIV is just a virus, it is not a death sentence, it is not AIDS, and when controlled, it is not easily transmitted.”

Stigma and fear have a powerful grip, and they won’t let go easily. But we can get loose, and we can get to zero.

David Farmer

About David Farmer

David Farmer is a political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s campaign for governor and a longtime journalist. You can reach him at