Commemorating World AIDS Day
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In 1981, the first five cases of a rare lung infection were detected in five young, previously healthy gay men in L.A. It would go on to mark the first reporting of what would later become known as the AIDS epidemic. By the end of the year the first case of AIDS had been reported in the UK. As the number of cases rapidly increased, stigma skyrocketed when it became known that most of the diagnosed were gay men. Officials originally termed the disease GRID – Gay Related Immune Deficiency. On July 4th 1982, former naval personnel, Terrence Higgins, became one of the first people to die of an AIDS-related illness in the UK.
By the mid-1980s, testing showed HIV to be highly concentrated in gay and bisexual men, people who injected drugs and people receiving blood products for haemophilia. Irrespective of this new evidence, the belief that HIV and AIDS only affected gay and bisexual men remained prevalent and held back essential developments in prevention and treatment. As the death rate continued to climb, people were forced from their homes, lost their jobs and were avoided by many medical professionals. Gay men were seen as immoral and terms such as “gay plague” were in frequent use. The Armed Forces issued a blanket ban on HIV+ positive joining and those who were already serving were medically downgraded. Seven years into the epidemic, the World Health Organisation declared 1st December World AIDS Day.
The Armed Forces considered those diagnosed with HIV or AIDS a risk to colleagues and operations, with each branch expression concerns that were wildly over the top.
As antiretroviral therapy drugs (ART) began to emerge on the market, the Armed Forces policies on HIV failed to keep up. While they did not offer a cure, they did effectively treat people with HIV and AIDS, enabling them to live longer. ART drugs have improved so much they are now able to decrease someone’s viral load to “undetectable”, meaning a person with HIV is unable to pass the virus on to others who encounter any bodily fluids if taken correctly. And after a series of successful trials in the UK, drug PrEP (pre-exposure prophylaxis) was made available for free on the NHS in 2020. The drug works by preventing HIV from entering the body and replicating itself.
In 2019, Lieutenant Commander Oliver Brown was diagnosed as HIV+. Whilst his naval colleagues were supportive, Brown was quickly medically downgraded after sharing his diagnosis, making him “medically limited deployable.” Brown sought support from the Terrence Higgins Trust, and came to realise how important it was that someone challenged the Armed Forces policies on people with the virus.
Brown began a relentless battle, meeting with the Government Equalities Office, the Department for Health and the Number 10 policy team. He lobbied MPs from the All Party Parliamentary Group, defence ministers and top military personnel. Once Brown had successfully laid out his case that people with HIV were not a danger, backed with medical science, the feeling that something needed to drastically change was unanimous.
In 2021, the Ministry of Defence put out the following press release: “Armed Forces make major changes to end HIV being a barrier to service.” The release featured a commitment to ensuring being HIV+ would no longer exclude anyone from the option to join the military. Candidates taking PrEP could now be welcomed; serving personnel with HIV could be recognised as fully fit.
This World AIDS Day we remember those who lost their lives to the disease, those who supported and cared for the sick, and those who campaigned for change. We also celebrate this major milestone in the accessibility of the Royal Navy and wider Armed Forces with the end of this barrier to service.
Terms
HIV – Human Immunodeficiency Virus. It damages cells in your immune system and weakens your ability to fight every day infections and illnesses. HIV can be transmitted to others through exposure to bodily fluids.
HIV+ - meaning someone has been diagnosed as carrying the HIV virus.
AIDS – Acquired Immune Deficiency Syndrome. The name given to several potentially life-threatening infections and illnesses that occurs when your immune system has been weakened by HIV. AIDS cannot be transmitted from one person to another.
ART – Antiretroviral Therapy. A group of drugs given to people who are known to be HIV+ that helps to treat the virus and decrease their viral load.
PrEP – Pre-exposure Prophylaxis. Taken as a single tablet, PrEP is a combination of two drugs; tenofovir disoproxil and emtricitabine. It is used to prevent the HIV virus entering a person’s body and replicating. The risk of contracting HIV from sex is reduced by 99% when a person is taking PrEP.
Viral Load – the measurement of the amount of virus in a specific volume of a person’s blood.
Undetectable – ART drugs can decrease a person’s viral load so much so that the virus becomes undetectable in their blood stream. This means they cannot pass it onto another person.
Gay/homosexual men – men who are romantically and/or sexually attracted to members of the same sex.
Bisexual – people who are romantically and/or sexually attracted to members of both the opposite and the same sex.
References
Aidsmap - https://www.aidsmap.com/about-hiv/hiv-uk-then-and-now
Terrence Higgins Trust - https://www.tht.org.uk/about-us/our-history/terry-higgins-man
Michael Segalov, The Guardian - https://www.theguardian.com/uk-news/2022/jun/12/sailor-oliver-brown-who-turned-the-tide-on-hiv-in-the-military
Terrence Higgins Trust - https://www.tht.org.uk/news/groundbreaking-hiv-and-armed-forces-policy-changes-come-force
NHS - https://www.nhs.uk/medicines/pre-exposure-prophylaxis-prep/about-pre-exposure-prophylaxis-prep/
iCaSH - https://www.icash.nhs.uk/contraception-sexual-health/hiv/prep#:~:text=PrEP%20(HIV%20Pre%2Dexposure%20Prophylaxis,about%20PrEP%2C%20please%20click%20here.
Top image: The Terrence Higgins Trust Quilt which is currently on display at the National Museum of the Royal Navy in Portsmouth.