Bailey House CEO Gina Quattrochi speaking at the World AIDS Day rally in Times Square on 12/1/13.
We’ve all heard the phrases “get to zero”, “an AIDS-free generation”, “test and treat” – they are, I fear, hopeful but empty promises. I say that because in the last two weeks, I have attended three different high-level HIV/AIDS symposiums and not one speaker – several of whom are globally famous – talked about what actually drives the epidemic.
I’ve been waiting and hoping to hear the two most important words in the HIV/AIDS lexicon – “structural drivers” – because until we do, HIV incidence will continue to rise. Volumes of research show that what fuels the epidemic is not really sex and drugs or individual behavior but rather the “perfect storm” of poverty, homelessness, racism, homophobia, sexism, intimate partner violence and criminalization of drug use that set the stage for risk behavior.
While “structural drivers” may never be popular enough to be on an eye catching bus shelter poster, shouldn’t our leaders at least understand the concepts and say the words? Isn’t it time for us to realize that the job is even bigger than we thought? Addressing poverty and the rest may seem overwhelming but I’d say it’s time.
Putting condoms in the hands of young adults, without addressing family poverty and unstable housing, will no longer do. Telling young women to insist on safer sex without addressing intimate partner violence won’t do either. Neither will allowing NYC’s homeless number to grow as it has for the last 12 years. End AIDS? Maybe, but not until we are willing to let the “structural drivers” out of the closet and roll off our tongues. No one ever promised it would be easy.