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My Life with HIV

HIV: We've come a long way, baby!

Alabama HIV activist Kathy Hier's reflects on 25 years of work.

I have been working in the HIV arena for about 25 years, and what a wild ride it's been!  I vividly remember the horrible, early days of the epidemic, when an HIV diagnosis was a death sentence.  We could do little more than help folks to die with some dignity intact.  I lost many dear, brilliant friends who didn't live to see the enormous scientific strides we have taken.

In 1996 effective medication became widely used, and we saw the death rates plummet.  The drugs were far from perfect, however, with many terrible side effects, an unbelievable number of pills required, and an equally daunting price.  As the years progressed, these difficult medications became better and better, and the pill burden was dramatically reduced.

Fast forward to today: we have tests that can detect a new infection in a minute and screenings that can reveal acute infections, meaning recent exposure.  This new technology is important, because scientists have found that half of all new infections are transmitted from people recently infected, when the virus is working overtime to get established.

We have effective medications without devastating side effects that can be taken as one or two pills, once a day. We have medications that can prevent a person from getting HIV. We understand the medical protocol that allows HIV-positive women to have HIV-negative babies. The lifespan for a person living with HIV is now within five years of a normal lifespan.

Most surprisingly of all, we have discovered that a person living with HIV who is on medications and who has a suppressed viral load, meaning very little HIV virus in the blood, cannot transmit the virus to others! This new scientific information is a real game changer! Persons living with HIV can now have long, healthy, normal lives. A new campaign, Undetectable = Untrasmittable, is taking off around the country.

Unfortunately we still have one major obstacle: stigma. From the beginning the HIV epidemic has been fueled by ignorance and stigma, including ridiculous laws that punish people for being HIV-positive, even if they are doing everything right. Politicians were afraid to even say the word AIDS.  In the South this barrier is rampant. People are afraid to go to local health departments where someone might see them; gay men pretend to be heterosexual to avoid condemnation; and some churches even demonize this disease, despite the fact that their congregations are being impacted. 

Everywhere you look in Alabama you can find strong women making a difference in their communities.

The problem of stigma is hurting the South. We are now the epicenter of the country's HIV epidemic. While my colleagues in New York and San Francisco are making plans to end the epidemic, we in the South are home to half of all the new infections. We in the South see the highest death rates in the country from a disease that can now be managed!

I have heard about a time when cancer was met with suspicion and fear. I remember when women were condemned for taking birth control pills. I know that one day we will look back on the HIV epidemic with the same puzzlement. How did a disease become so vilified? The time has come to move HIV from the moral arena to the medical arena, where the progress is undeniable and exciting.


Kathie Hiers, is the  CEO of AIDS Alabama. Hiers has devoted her career to ensuring that people living with HIV/AIDS get the necessary care and housing they need to live full lives.

30 Years of Out100Out / Advocate Magazine - Jonathan Groff and Wayne Brady

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Kathy Hiers