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July 2018

The Challenge of Vanquishing HIV for the Next Generation—Facing the Future

Author Affiliations
  • 1Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore
  • 2Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut
  • 3Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • 4South African Medical Research Council, Cape Town, South Africa
JAMA Pediatr. 2018;172(7):609-610. doi:10.1001/jamapediatrics.2018.0389

At the 2017 International AIDS Society Conference on HIV Science, a 10-year-old girl asked if we thought that HIV would be controlled within her lifetime. The answer hinges on the steadfast commitment of the global community to prevent and treat HIV with the tools currently available as well as to invest in continued innovation. Thirty-five years into the HIV pandemic, the greatest threat to curtailing transmission may be complacency.

When HIV was first recognized in the 1980s, widespread panic erupted. The virus ravaged young adults who, only months before, had appeared to be in excellent health. Without therapy beyond the treatment of opportunistic infections, the mortality rate was as high as 50% within a year of diagnosis. Irrespective of repeated reassurance from experts that transmission did not occur via casual contact, overblown fears fuelled heartbreaking stigma for people living with HIV (PLHIV). Often regarded as pariahs, PLHIV faced discrimination at school, the workplace, and even in hospitals. In Africa, many women and children were expelled from their homes. This stigma escalated into atrocity, exemplified by the stoning of a woman in South Africa after she disclosed her HIV-positive status.1