Bridging the Gap: Gilead’s Work to Help End the HIV Epidemic – The Hollywood Reporter

Advancing HIV Prevention through the Lens of Sustainable Development Goals

Introduction to Current Challenges and Global Goals

Medical advances, particularly Pre-exposure Prophylaxis (PrEP), have been instrumental in transforming HIV from a potentially fatal disease into a manageable chronic condition. PrEP, a daily oral pill, can reduce the risk of sexually acquiring HIV by approximately 99%. However, significant barriers to its universal adoption persist, including stigma and access disparities. This report analyzes these challenges and the strategies being implemented to overcome them, with a specific focus on their alignment with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities).

SDG 3: Ensuring Good Health and Well-being

The Efficacy and Stigma of HIV Prevention

Achieving Target 3.3 of the SDGs, which aims to end the epidemics of AIDS and other communicable diseases by 2030, requires effective and accessible prevention tools. While PrEP is a highly effective intervention, its uptake is hindered by social factors.

• Stigma as a Barrier: According to Dázon Dixon Diallo, founder of SisterLove, the concept of taking medication preventatively is stigmatizing, as it deviates from the norm of treating an existing illness. This is compounded by the specific stigma surrounding HIV.
• Long-Acting Solutions: To address issues of stigma and adherence to a daily regimen, long-acting HIV prevention options are being developed. These alternatives can increase adherence and efficiency for healthcare providers. An FDA-approved long-acting injectable, for instance, offers a new modality that could transform the prevention landscape.

SDG 10: Reducing Inequalities in Healthcare Access

Disparities in HIV Incidence and Prevention

Significant inequalities persist in the fight against HIV, directly contravening the principles of SDG 10. These disparities are most pronounced along racial and geographic lines, particularly affecting historically underserved communities.

Key Statistics on Disparities:

1. PrEP Prescription Rates: According to the CDC, 94% of white men who could benefit from PrEP are prescribed it, compared to only 14% of Black men.
2. New HIV Diagnoses: Black Americans continue to account for the highest rates of new HIV diagnoses among all demographic groups.
3. Geographic Concentration: The Southern United States, home to nearly 60% of the nation’s Black population, accounts for 52% of new HIV diagnoses and 47% of all HIV-related deaths in the U.S.

Systemic Barriers to Access:

• Social Stigma: Deborah Wafer, an executive director at Gilead Sciences, notes that individuals, particularly women, regularly face stigma related to their HIV status or their decision to take PrEP.
• Provider Bias: Women may face moral judgment from physicians when requesting PrEP, hindering their access to preventative care.
• Logistical Challenges: Adherence to a daily oral pill can be difficult for individuals without stable housing or a secure place to store medication.

SDG 5: Achieving Gender Equality and Empowering Women

The Intersection of Gender and the HIV Epidemic

The HIV epidemic disproportionately affects women, especially Black women, highlighting the urgent need for gender-responsive health strategies as outlined in SDG 5.

• Prevalence Among Women: Women account for approximately one-quarter of individuals living with HIV in the U.S., with Black women having the highest diagnosis rates among all women.
• Empowerment Through Agency: SisterLove’s messaging emphasizes that PrEP provides women with individual and autonomous agency over their sexual health, a critical step toward empowerment.

Culturally Competent Outreach for Women:

Effective HIV prevention requires tailored educational approaches. Strategies must be culturally competent and meet communities where they are.

• Targeted Messaging: Educational outreach for Black women requires a different approach than for other demographics. It involves delivering practical information in trusted community settings, such as hair salons and churches.
• Community Initiatives: Programs like “Risky Dinner Conversations,” supported by Gilead, engage influential Black women to discuss and dismantle stigmas that fuel HIV disparities.

SDG 17: Fostering Partnerships for the Goals

The Role of Public-Private-Civil Society Collaboration

Recognizing that medical solutions alone cannot end the epidemic, multi-sector partnerships are essential for achieving public health goals. This aligns with SDG 17, which promotes collaboration to support the achievement of all SDGs.

Examples of Strategic Partnerships:

• Philanthropic Support: Gilead has provided nearly $35.8 million in philanthropic support to Black women-led and/or Black women-serving organizations in the U.S. since 2010.
• Community-Based Organizations:
  • SisterLove: A grant recipient that has expanded its services in Atlanta, using a new mobile clinic to bring healthcare and education to medically underserved areas.
  • Baltimore Safe Haven: An organization providing vital HIV resources to Black trans women in Maryland.
  • Waco Theater Center: A California-based arts organization that combats HIV stigma through visual and performing arts.

Conclusion

The ongoing effort to end the HIV epidemic requires a multi-faceted approach grounded in the principles of the Sustainable Development Goals. By advancing medical innovations like long-acting PrEP, addressing deep-seated inequalities, empowering women, and fostering robust partnerships, stakeholders can work collaboratively to provide all communities with the resources necessary to overcome this public health crisis.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

   The article discusses issues related to health, inequality, gender, and partnerships, which directly connect to several Sustainable Development Goals (SDGs). The following SDGs are addressed:

   • SDG 3: Good Health and Well-being: The core subject of the article is combating the HIV/AIDS epidemic, which is a primary focus of this goal. It discusses prevention methods (PrEP), treatment, and access to healthcare services.
   • SDG 5: Gender Equality: The article specifically highlights the unique challenges faced by women, particularly Black women and trans women, in accessing HIV prevention and care. It addresses issues of stigma, discrimination from healthcare providers, and the importance of empowering women to have agency over their sexual health.
   • SDG 10: Reduced Inequalities: A central theme is the disparity in HIV outcomes and healthcare access based on race and geography. The article contrasts the high PrEP adoption among white men with the low rates among Black men and points out the disproportionate impact of HIV on Black communities, especially in the Southern United States.
   • SDG 17: Partnerships for the Goals: The article itself is a product of a partnership and extensively details the collaboration between a private company (Gilead Sciences) and civil society organizations (like SisterLove) to achieve public health goals. It emphasizes that “medicines alone won’t stop this epidemic” and highlights the necessity of these multi-sector partnerships.

2. What specific targets under those SDGs can be identified based on the article’s content?

   Based on the article’s content, several specific SDG targets can be identified:

   • Target 3.3: “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases…” The entire article is focused on strategies and tools, such as PrEP and long-acting injectables, aimed at combating and ultimately ending the HIV/AIDS epidemic.
   • Target 3.8: “Achieve universal health coverage, including… access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines…” The discussion revolves around improving access to PrEP, which is an essential medicine for HIV prevention. The mention of mobile clinics bringing services to “medical or service deserts” directly addresses the goal of universal access to healthcare.
   • Target 5.6: “Ensure universal access to sexual and reproductive health and reproductive rights…” The article highlights how PrEP provides women with “individual, independent, autonomous agency” over their sexual health. The work of organizations like SisterLove to empower women in this area directly supports this target.
   • Target 10.2: “By 2030, empower and promote the social… inclusion of all, irrespective of… sex… race, ethnicity…” The article focuses on the need to include and empower Black women and other historically underserved communities who face the greatest disparities in HIV prevention and care.
   • Target 10.3: “Ensure equal opportunity and reduce inequalities of outcome…” The article explicitly details the inequality of outcome with statistics comparing PrEP prescription rates between white men and Black men. The efforts to provide culturally competent education and services are aimed at reducing these inequalities.
   • Target 17.17: “Encourage and promote effective public, public-private and civil society partnerships…” The article is a clear example of this target in action, detailing the financial and strategic partnership between Gilead Sciences (private sector) and community-based organizations like SisterLove (civil society) to address the HIV epidemic.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

   Yes, the article mentions several quantitative and qualitative indicators that can be used to measure progress:

   • New HIV Diagnosis Rates: The article states that Black Americans “account for the highest rates of new HIV diagnoses” and that the Southern U.S. accounts for “52% of new HIV diagnoses in the U.S.” This data serves as a direct indicator for Target 3.3 (ending the AIDS epidemic) and Target 10.3 (inequalities of outcome). A reduction in these rates would indicate progress.
   • PrEP Prescription and Coverage Rates by Demographics: The statistic that “while 94% of white men who could benefit from PrEP are prescribed it, the rate is only 14% for Black men” is a powerful indicator of unequal access to essential medicines (Target 3.8) and inequality of outcome (Target 10.3). Closing this gap is a measurable sign of progress.
   • HIV-related Mortality Rates: The article notes that the Southern U.S. “accounts for almost half (47%) of all HIV deaths.” This mortality data is an indicator for Target 3.3.
   • Financial Investment in Partnerships: The article quantifies the financial support provided by Gilead, stating it “has provided nearly $35.8 million in total philanthropic support for Black women-led and/or Black women-serving organizations… with $28 million granted to organizations working to end the HIV epidemic.” This financial data is a direct indicator for Target 17.17, measuring the resources committed to partnerships.
   • Reach of Educational Campaigns: The mention that the “Risky Dinner Conversations” series “engaged 32 micro-influencers and generated more than 300,000 social media impressions” is an indicator of the reach and engagement of culturally competent educational initiatives aimed at reducing stigma and empowering communities (relevant to Targets 5.6 and 10.2).

4. SDGs, Targets, and Indicators Summary

   SDGs	Targets	Indicators Identified in the Article
   SDG 3: Good Health and Well-being	3.3: End the epidemics of AIDS… 3.8: Achieve universal health coverage… access to quality essential health-care services and… medicines…	– Rates of new HIV diagnoses (e.g., “52% of new HIV diagnoses in the U.S.” occur in the South). – HIV mortality rates (e.g., “47% of all HIV deaths” in the South). – Disparity in PrEP prescription rates (e.g., access for Black men vs. white men). – Provision of services via mobile clinics to underserved areas.
   SDG 5: Gender Equality	5.6: Ensure universal access to sexual and reproductive health and reproductive rights…	– Emphasis on PrEP as a tool for women’s “individual, independent, autonomous agency.” – Support for Black women-led and/or Black women-serving organizations. – Addressing stigma faced by women from healthcare providers.
   SDG 10: Reduced Inequalities	10.2: Empower and promote the social… inclusion of all, irrespective of… race… 10.3: Ensure equal opportunity and reduce inequalities of outcome…	– Disparity in PrEP prescription rates: “14% for Black men” versus “94% of white men.” – Disproportionate rates of new HIV diagnoses among Black Americans. – Geographic disparities, with the Southern U.S. being heavily impacted. – Implementation of culturally-competent education to address racial disparities.
   SDG 17: Partnerships for the Goals	17.17: Encourage and promote effective public, public-private and civil society partnerships…	– Financial contributions from a private company (Gilead) to civil society organizations: “$28 million granted to organizations working to end the HIV epidemic.” – Collaboration between Gilead and organizations like SisterLove, Baltimore Safe Haven, and Waco Theater Center.

Source: hollywoodreporter.com