Can New Tools End the AIDS Epidemic by 2020?

In 1995, Perry Halkitis watched as New York City’s AIDS crisis unfolded around him and quit his job to focus full-time on the plague killing thousands of gay men. Professionally, it probably wasn’t an advantageous move, but he never doubted that it was the right thing to do. Halkitis, who, at age 18, came out to his Greek immigrant parents in 1981, is now a professor of public health, applied psychology and medicine at New York University. Two years ago, he completed a book about HIV+ gay men who survived that era, and he’s now working on a book about the experience of coming out across generations. Speaking to NationSwell in his Greenwich Village office, Halkitis recalled the experience of witnessing two devastating decades of the AIDS epidemic and his hope of finding a cure.

What innovations in your field are you most excited about right now?
I do work in gay men’s health, part of which is HIV. I emphasize that because too often people think about gay men’s health work as being synonymous with HIV. The thing that is most exciting me is that there are biomedical interventions that have been developed over the course of the last decade that provide another way to fight the epidemic. Now what do I mean that? We have something called PrEP now, which is administering an antiviral once a day to people who are HIV- that prevents them from becoming infected. It’s miraculous. We also know very clearly that HIV+ people — now living longer, fuller lives — who adhere to their treatment have viral suppression and are un-infectious. That is remarkable to me that these biomedical advances enable people to deter both acquiring and spreading the infection. We haven’t fully realized the power of these tools, and there are some challenges with them. But in the absence of a cure, it is the best thing we have.

Are these tools powerful enough that we can talk about ending the epidemic?
There are conversations about ending the epidemic. In New York, two years ago, Gov. Andrew Cuomo put forward a mandate to end AIDS by 2020. By that, he meant making infections go from 3,000 to 750 a year by use of these tools. So, do I think these tools are, in and of themselves, enough to bring an end to AIDS? They can get us near the end. We know perfectly well that people don’t finish their antibiotics and that people don’t exercise regularly. Being dependent completely on administering medicine on a regular basis is challenging reality. So I’m going to say that we’re going to do a really good job at deterring new infections.

What motivates you to do this work?
My decision, about 25 years ago, to enter this field was purely directed by the loss I experienced in my life. I was trained as an applied statistician working at a testing company, and at night, I was an activist. I was in New York City; AIDS was all around me. I witnessed friends dying. I decided to merge the two: to take my skills as a researcher and combine them with my passion as an activist. I find my motivation in the memory of the people who I’ve lost. I find my motivation in making sure that a new generation is free of this disease. And I find my motivation in training my students who are going to continue the good work once I’ve finished. I want gay men to be healthy, and I’m going to do everything in my power to see that.

What do you wish someone had told you when you started this job?
Don’t expect it to get easier over time. It’s going to get harder and more complicated. The more I learn and the more writing and research I do, the less I think I actually know. Which is good: it opens up more questions. I would have told myself in 1995 to be prepared for any possibility that might happen in this epidemic. I would tell myself to keep hope. I don’t think I had a lot of hope in 1995 that there was going to be an end to this epidemic. I was going to fight the battle for as long as I needed. And I would have told myself to be better about writing about my day-to-day life, which I haven’t done. It would have been an interesting story.

What’s your proudest accomplishment?
My book “The AIDS Generation,” where I documented the lives of 15 men who were long-term survivors. It could be the period at the end of the sentence of my career, if I did nothing else. (Surprise, I’m doing more.) I’m incredibly proud of that book, because it got a lot of attention in the popular press, and it inspired a conversation. Sean, one of the guys in the book, reminds me all of the time: “You started all of this.” I don’t really know if that’s true, but I like to think that I contributed to the beginning of the dialogue about long-term survivors.

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This interview has been edited and condensed.
Homepage photo by Mark Wilson/Getty Images.