sex education programs

>> good morning everyone. thank you so much for joining us today, i'm richard sorian, assistant secretary for public affairs.

sex education programs, it's a pleasure to welcome you here today. we have a very full program so i'm going to introduce our

assistant secretary for health dr. howard koh, who will begin the program. thank you very much. d. >> thank you so much mr. sorian, welcome everybody, it's so great to see you here. i'm dr. howard koh, the

and we're happy you are joining us for this important commemoration for 30 years of leadership in the fight against hiv/aids. today we honor the lives of those we have lost, whose life journeys are literally stitched into these aids quilts you see

around us. today we honor the dedication and persistence of advocates here and around the nation who have ushered in a new era of action on behalf of the country. the today we honor the continued commitment of medical and public health professionals that's

everyone here for advancing vital work and hiv awareness prevention, diagnose, and treatment, not just here in the country but indeed around the world. and most important of all, perhaps, today we reflect on stories over the past 30 years.

because this epidemic has touched all of us. you don't have to be infected to be affected by hiv/aids. i remember so clearly at 30 years ago, this month, i was the medical chief resident at boston city hospital, a young physician trying to help patients and i

remember so clearly studying that first wave of scientific reports on hiv, trying to comprehend what seemed to be an incomprehensible condition. i will never forget the bitter stigma that surrounded the patients that were struggling to care for.

and i'll never forget the courage of people across this country who stepped forward and try to make a difference in the face of this new threat. since then we all know how this virus has literally exposed the fault lines of our society and now, 30 years later, ironically,

we have a new generation that has arisen that has little to no knowledge of of those early dark days. so today, we share stories, not only past fear and confusion, but also of tremendous caring, passion, compassion and leadership.

today you will hear the perspectives and the stories of the secretary and many other leaders in this room. you will hear tremendous stories of scientific advances and progress and we want to celebrate with you, your commitment and the unveiling of

a new generation of leaders who care deeply about these issues and share with you passion and compassion, understanding of the worried passion means to suffer and the word compassion means to suffer with. it's so critical we share these stories today to build our

community. there's a wonderful thing that a sorrow shared is half the sorrow and a joy shared is twice the joy, so that's why we are hold thanksgiving important meeting today and--holding this important meeting today and working closely with you as we

try to put this epidemnick our past, of course--unveiled, the national hiv/aids strategy, a great pleasure to work with leaders like jeff crowley, and we want to thank all of you for your hard work on implementing, and very honored to be part of the effort of the assistant

secretary on behalf of the secretary, i want to particularly acknowledge the contributions of our office of hiv/aids and infectious disease policy. the work of aids .gov, led by miguel gomez and i want recognize dr. ron who is heading

the implementation of that office. is ron here? just wave and stand up and get a wave of applause, thank you. >> so in closing we note that the history of hiv/aids began some 30 years ago in an era of fear and death and we hope with

this anniversary, we mark a new chapter that is marked more by hope and promise for the future. we need each of you now to do more than ever before, to deliver your healing touch and rich education, advance research, promote prevention and advocate for the vulnerable.

we have made so much progress in this past 30 years, we look forward to the day then together with you we can say that this devastating disease is part of our past and not our future. thank you very, very much. [ applause ] so i am delighted now to

introduce a tremendous community leader, miss dazon dixon diallo, founder of sister love inc. corporated this, is an important women based corporation in the southeast. she is a woman with tremendous passion and compassion and i want to thank her for joining us

here. thank you. >> oh, thank you, so much, dr. koh, and thank you all for being here and for being here. alverna denise, konn, debbie thomas, janis geroh, martin delainey, willie brown, pandora singleton, are--administrativure

ash, so many hundreds of thousands of others are also glad for you being and being in the summer of 1981, i was a 16 year-old rising senior at peach county high school, that's how we say it in ft. valley, georgia. one of those places where it

took a bit longer to get the word about this strange new deadly illness that we same came to know as aids. now by 1985, i was a college sophomore in atlanta, but i was also ready and working and advocating for women's reproductive rights and by the

end of that same year, thanks to rock hudson's famous disclosure, that's another longer story, i was volunteering at our local aids service organization. now since that time, i have founded and confounded several organizations including sister love, which will be 22 years old

next month. i've planned and participate in demonstrations with everyone from act up to the treatment action campaign. i've work wide community planning for prevention andrian white planning for treatment and care.

i've buried more friends and colleagues than most of my college classmates will ever bury before they become seniors. i've married and divorced a man who loved me but not enough to hang with me in this fight. i have foregone spending summers and some holidays with family to

sit with sick clients or write another grant or attend another meeting. i have met and work wide so many amazing, smart, dedicated and giving souls and i have a community, that's y'all, that really understands and identifies with me and my

passion to thepbd disease and its terrible impact on individuals, families, communities, and even nations. and i've learned to keep looking forward and envisioning a future in which there's no hiv or aids and to keep working to bring that future into my presence

because that's what all those people for whom the end of this pandemic comes too late, i have learned that love really does conquer all even when we don't know it, see it, or feel it. know, you know we've been in this for a very long time and i swear i thought, back in the

mid80s, that by this time in my life, i would be running a bed and brunch on a beach somewhere writing what i call nonfiction erotica. i think that's still in nigh future. --my future. [laughter]

but we have still come a long way. despite how far we've come with creating evidence based strategies, with having life saving, quality of life giving treatments, and a network of social service providers and educators and supporters and

peer leaders, finally having a national stat edge a plan that we can all get behind and work with reguardless of some of the challenges we still put to that plan, we still have a long way to go. why i live and work in the south, no, the deep south, which

is way more than a geographic distinction stigma still exists, i'm still waiting for my more than magic campaign, y'all got that one? discrimination has not yet been eradicated and people living with hiv/aids are still a target of discrimination, and

disclosure in terms of family, employment and dignity. and while our strategy is not a perfect tool, it is the tool we have to work with. we're also having to keep the fight and defending the prioritization of hiv/aids. that's why i'm still here.

because even though i know i'm in the business to put myself out of business, i'm not here to go out of business. and given the fact taken--they we have thousands of people on the eight appspace list, halfful whom are in georgia and florida, the news today and usa today

tells us that we're still not catching them early enough to keep them alive longer. we still have a lot to do. which means you yet, cannot rest. you still must find your inspiration and your energy, you still must call the name and

remember them and call on them as your own soul guides. we must continue to figure out ways to lift up the importance and meaningful engagement of people living with hiv. i am reminded that from the beginning of this epidemic community has always, always

been in the forefront. we've been in the front of science, in the front of policy, social, cultural, attitudes and ideas. we have affected change in every seconder. we have galvanized systems, but it seems to me in the last

couple of years, at least where i live and work, some, it's like a be careful what you ask for thing, where community has now fallen a little bit behind the science and the policy. policy in s in front of us, that doesn't necessarily mean, we're going to solve all of these

problems just with science and just with policy. i want to hear--i'm here to remind you that while science, research and policy, might be the body of the end of this epidemic, the community, civil society, civil service, people living with hiv are its soul.

body and soul, we work it, we work it together, we work it as one. so i'm going to be here till the end of this thing, and i'm just going to continue to wake up every day, call on our collective ancestry of people who are no longer here as a

result of hiv and aids and do the good work that we need to do together. now it is miable absolute pleasure and--absolute pressure and distinct honor to introduce a woman who may not need an introduction but you're going to get one anyway.

in her two years as secretary of health and human services, secretary kathleen sebelius has been a champion for improving our healthcare system and fighting the hiv/aids epidemic. in fact, she combined these sites to make clear that comprehensive healthcare

americans, that help people living with hiv and aids and as a person who has fought for reproductive justice since the age of 17, i personally thank her for fighting to protect reproductive health and family planning services for youth and for women across this great

nation. ladies and gentlemen, comrades, secretary sebelius. >> well, i want to start by thanking dazon for not only that kind introduction but for her amazing work over years. she has tireless leadership in the fight against hiv/aids and

every day through her work and her example gives hope and courage to some of the most vulnerable women and families around the world so let's thank her again please for being with us today. and i also want to thank dr. koh, howard koh, who has the

assistant secretary of health has tackled a number of issues and has taken leadership roles in a number of areas but i can tell you his experience and passion has inspired him to be particularly focused on our continued battle our national strategic plan, our efforts on

hiv and aids and thank howard for continuing that battle. you will hear from some remarkable health leaders who have been generous enough today to share their personal stories with us and i'm struck by looking at this audience that we have an interesting combination

of health expertise and some of have you been in this battle from day one and we're going to talk about for others were not awhen this story first began. so some of this is important history for you to understand and know about. but today, we're here to

remember those we've lost to the pandemic and to honor those who continue to fight against the virus and fight for a cure. we're here to mark the gains made over the last three decades and to look ahead with hope and purpose at the next steps swraoe to take in this fight in the

battle. the story of the first 30 years has been one of great commitment, discovery and collaboration, but it's also a story of great uncertainty and terrible loss. more than 600,000 americans have died long before they should

have, 600,000 these quilt squares represent just a few of those souls. world wide more than 30 million people are living with hiv today including two and half million children. it can be easy to focus on all the data, the dollars, the

scientific milestones that we so often use to measure our progress and they're important but we can't ever forget that the story of hiv/aids is one of countless individual human lives. now there's so many of us in this room today who never

thought this disease would still be with us three decades later. and as i said earlier, there's some of you here who weren't alive when this epidemic began and just think about that, a generation of people who have never lived in a world without this virus being present.

and in this age of advanced treatments when hiv is no longer a deth sentence for many, it can be easy to forget how scary those early years were. when it was first discovered no one new how the disease was spread and we didn't know what caused the disease.

what we did nonapoptotic know is that it almost certainly meant death. when advocate compare these early years to live nothing a war zone, we were never sure when the next bomb would drop and with that uncertainty came a lot of fear and with the fear

came enormous prejudice. children likerian white were turned away from their schools because they were hiv positive. tenants were locked out of their apartments and forced to live on the streets. workers were fired from the jobs they had held for decades.

sons and daughters lying in hospital beds were abandoned by their families and loved ones. and treatment was very hard to come by unless you qualified for medicaid or could keep a job that provided insurance. and the treatments that we had were not very effective and

certainly not as effective as anyone would have wished. and our national government was frankly very slow to act and so, it was community organizations, springing up on street corners, around the country, the soul that dazon just talked about that connected people, educated

them about how to protect themselves, battle discrimination and got this nation's attention employed and they taught us most poignantly that silence equals death. now many of you know this story because you lived it. you went on to build strong

coalitions that included government, community based groups, employers health professionals and individuals with aids coming together with a sense of urgency to develop better approaches for treating and reducing the spread of the disease.

no single narrative can do justice to our journey over the last three decades. there are instead a million individual stories, sewn together by a shared hope for progress. science must keep moving forward, prevention must reach

even further and be even more effective and all people living with hiv and aids must have better access to treatment and care they need whether they live in washington d. c. or in a village outside of naorobi. in over some time, short time, science took who was once an

impenetrable mystery and get answers. the kind of answers that worked in the lab but also save lives and thanks to the work and ingenuity of scientist and doctors if at places like the centers for disease and control prevention and national intuitys

of health and food and drug administration and our own hrsa, new effective therapies and treatment and tools for prevention came online. today there are more than 30 license drugs that are widely available in the developed world and have begun to transform hiv

into a chronic disease adding years to people's lives. but we know that that progress is not enough and it's why presidenpresident obama has made the fight against hiv and arounded world a top priority for his administration, including the first ever development of a

national aids strategy that's providing direction and focus to our efforts. the battle isn't over, as long as this virus threatens the health and live lives of people here and around the globe, the struggle continues. and so, on this had day in this

place, we need to remember the words of mother jones who told us to pray for the dead and fight like hell for the living and that's what we're going to do. thank you and now i'd like to turn things back over to richard and you'll hear from some of our

terrific leaders. >> thank you madam secretary and thank you for joining us. the secretary is now going to an event to promote childcare and healthy childcare for children, so she's fighting on every level, so we appreciate our--her taking time.

let me welcome you again to the great hall. we call this the great hall but until today i never really thought of it as great. i wish we could keep these quilt panels forever because this--this is life. this is what this is all about.

so, take a moment when you can to just look at the quilt panels and remember, these people and all the people that were close to you. ellie b sells was an author and a survivor and he taught us that whatever you survive the test, must also tell the story and

that's in part why we're here today. when hiv start indeed 1981, i was 23 years old, i was in nigh first job, and i was a journalist here in washington, writing about healthcare policy, who knew? and i wrote some of the earlier

news stories about a disease that didn't have a name or didn't have a descent name near a period of time and i never thought that 30 years later, i would still be working in some or part of my life on this epidemic, not just working, but living through 30 years and so

many people and i'm glad. i'm glad that i am not because the epidemic has lasted this long, but because it's changed my life the way it has changed the lives of of everybody, not for the worse but also for the better. so one of the things we need tow

do is remember remember and not forget. and as a secretary remind the us, there's a generation of of people who have grown up in this world never knowing a day without hiv in our lives. and there will be generations to come and we need to make sure

that today, but also when the epidemic is over, they remember where we came from. so, we've got a short video before the rest of our speakers join us and i hope you'll find this to be both informative and enriching. so i think they're going to cue

that up. >> june 5th, 1981, the cdc published a morbidity and mortality weekly report describing cases of a rare pneumonia in otherwise healthy young gay men in los angeles. >> but it was from those reports that the great epidemic of aids

began to mushroom and we were in the midst of it before we knew it. >> didn't know what it was but i'd made a decision then in the middle of the summer of 198 1981 that i was actually going to change the direction of my career and start bringing into

the hospital and studying these unusual situations of gay men who had this strange disease. >> when the pattern went from gay men to injecting drug users and then finally to persons with hemophilia, there could really only be a unifying hypothesis, a viral agent that could be

transmitted through a variety of means. >> once we got the virus in our hands, namely in 1984 and 1985, then we began to study in earnest some of the pathogenic events. >> by the time the virus was discovered, there were more than

500,000 people infect indeed the united states and millions world wide. >> we saw really, ended up follow negligent aids clinic about 25,000 patients with hiv. the average person we would see would have four or five oportunistic infections and more

to come. >> aids was and is a public health problem but one with many social and political facets. >> the aids communities response was a mixture of insider and outsider tactics. so sitting down with policy makers and trying to sit down

and find out a solution. at the same time street demonstrations. >> the activists were making extremely good points about the uniqueness of this, the need to do more, the need to be less rigid in our regulatory approaches towards the approval

and testing of new drugs and the rigidity and lack of flexibility in how we design clinical trials. >> 1985 was the year that a boy with hemophilia withrian white was barred from attending school becausely was infect wide hiv. the same year actor rock hudson

died of aids, bringing attention to the disease in a way no one had before. in 19 ketch the aids memory responsor--1987, the aids memorial quilt was displayed at a national mall. the following year, dr. coop's message: happening aids was

mailed to every household in america. >> in 1990,rian white died at the age of 18 and kong pass theletrian white care act providing access to treatment for uninsured people with because of the hiv virus that i have attained, i will have to

retire from ... >> the following year basketball star magic johnson held a press conference that changed the way many people thought about the early 90s were marked with progress, despite some set backs. in 1994 an nih trial found azt

was shown to prevent transmission from mother to infant during child burg, the first protease inhibitor was approve indeed 1995, a huge advance in managing hiv infection. however, aids remained the leading cause of death for

african americans. >> we were 25% folks impacted by hiv in 1986 and yet, you know the response in black communities and the delivery of services at that time primarily prevention and awareness, the black communities were disproportionately low.

>> by 2002, half the people living with hiv world wide were women. >> for women to recognize the risk espegsz especially for heterosexual women and latino women in the u.s., i think risk awareness is still a very, very, very big challenge.

>> as the epidemic entered its third decade is turned global. in 2003 president bush announced the president emergency program for aids relieve or pepfar, providing millions of dollars to treat aids around the world. >> pepfar, is remarkable, we were now at two th-pbt three

million people on antiretroviral treatment, all of whom would have died. it's a remarkable contribution that the american people would feel proud of. >> now it's part of president obama's health global issue and it's taken a bigger

impact now because it's been linked to other health problems. >> today we're releasing our national hiv/aids strategy. announce indeed 2010, president obama's aids strategy was aimed at preventing infections, preventing access to care and reducing disparities.

i think we are in a period of time where we have the tools to end aids epidemnick america today and across the globe and it's critically important and it's exciting. >> wow, 30 years and five minutes. i think i got a few more gray

hairs and several of the people who are kind enough to participate and give us their memories and their thoughts are here today and i want to thank them as well. the the word hero is overused so i'll try not to use it too often.

i'll just say our next speaker is a hero of mine and a leader throughout this epidemic. let me introduce tony fauci. >> thank you very much richard. it is an honor and a privilege to be here this morning to commemorate this extraordinary time in our history.

30 years of hiv/aids. looking around the room, i don't know whether it's true or not, but i may be the only person here who has spent his entire professional career in the department of health and human services. --for a very long time so it's

really good to be here with you in this building. i just want to take a couple of minutes to share with you the kinds of reflections that those of us who were there from the very first day had when we saw the unfolding of this historic and extraordinarily tragic

event, the emergence and evolution of the beginning of this hiv/aids pandemic. as i often say when i talk to people about subjects like this and similar subjects. it is really quite true that when you're living through or beginning to live through

historic event, you don't really appreciate that it's historic until you actually reflect back on it. it's sort of a quirk about history. you don't say wow, i woke up today, this happened. it's going to be historic but it

really has been a historic event that has brought out in many respects, the best and the worst in people throughout the world, but having been through it from the beginning, i can say now, that the ultimate experience is one that has brought out some of the fineasty qualities of man

kind. i--you saw in the clip there, i remember, very clearly there are things in your life that you remember and know exactly where you were. i was sitting in my office at the national institutes of health in bethesda doing my job

of working on basic and clinical research when this mmwr that you saw on the screen landed o landed on my desk. june 5th, 1981, and i remember reading it, what a curiosity, five men from los angeles curiously all gay, otherwise well, with a disease that i knew

very well is an infectious disease physician is only seen in people with suppressed immune systems. i thought it was a curious that would go away and then one month laterot fourth of july of 1981, a similar mmwr landed on my desk, now reporting 26 men again

curiously all gay men now from la, san francisco and new york city, not only from pneumocystic nope ownia but also with capper cyst onoma. i got goose bumps because i knew this was something new and something horrible but i never in my wildest dreams what would

imagine for us what would unfold in this country and throughout the world. i'm very proud to have been in this organization, in the services and at the nih, during those early years, when we were struggling from both the scientific and public health

standpoint about how we were going to address this pandemic. i refer to it, as the dark years of my professional career because unless you've done it, it is difficult to describe what it's like to have people come in who are suffering and dying and you don't have it, an idea or a

clue about what is going on with them, you suspect its an infection, epidemiology tells you it's sexually transmitted. also later on injection drug use but yet you don't know what to do with the patients except palliative care and it was over the period of those three

decades with support from so many groups here in the department, through the department at nih, through multiple administrations and multiple turnovers of congress that we had the resources to put into effect a scientific research both basic and clinical

attack on this pandemic to the point where we now, 30 years into it have the capability of really putting an end to the aids epidemic. there are certainly scientific gaps. we still don't have a vaccine. there are implementation gaps,

we still have not been able to get penetration into communities, voluntary testing, linking to care and treatment of individuals which we know now treatment conserves prevention, so there are many, many challenges ahead. it's both humbling but also

energizing to realize that we've come a very, very, long way. but in the same breath as we realize that in the same thought that we assimmulate that, it is clear that we have a very long way to go. so although we are now three decades entering into our fourth

decade of this pandemic, i would hope that a day like today where we come together and remember the experiences we have that we reconfirm and recommit ourselves to the important tasks ahead because as i've said very often, we as a global society are going to be judged as much as the

advanced that were made over the previous 30 years. we're going to be judged even more by what we do in the coming years because we now have the opportunity from both a domestic and a global standpoint to put an end to this pandemic and i can tell you all in this room

that i will do everything i can to stay in this fight as long as i can and hopefully one of these days, i'm going to come down to this great auditorium and talk to you about not the challenges of the future but a commemoration of something in the past that is now over.

>> thank you, tony. one of the things that dr. fauci's remarks reminded me, its become fashionable again lately to use public employees as punching bags, to talk about bureaucrats and about government people needing to work harder and all that.

we have to remember that, you know many of them, not all, but many of the scientists in the public health professionals and caregivers and others that were working on this epidemic from the beginning worked here at this department in various parts of it, worked in other parts of

the government, work indeed state government, so there are a lot of public service heroes, that continue to do that work every day and we need to remember that there's scientists, physicians, public health officials but they're also colleagues.

so thank you for that. i first met daniel montoya when he first came to his work here in washington d. c. and we worked together over at the white house national aids policy and did traveling around the country and find out what was going on on the ground.

of course daniel knows better than most anyone i know and he has been an advocate and an outspoken leader on this epidemic for a number of years and now serves as the deputy director of nmac, the national minority aids council at one of our leading organizations.

daniel will share his thoughts. >> thank you, richard, and good morning to everyone. i would certainly like to thank the department of health and human services for hosting today's symposium. it's fortunate take a moment to reflect and 30 years is that

moment to reflect. this administration is demonstrated a laudable commitment to fight thanksgiving epidemand i can will be a critical ally as we enter the fourth decade of the struggle. i would also like to thank my distinguished panelists, some of

whom i worked with and for. i'm extremely honored to be in the presence of such an amazing and and so many of you and--i started that opportunity here in january hyde like to recognize the staff of the national minorities council especially executive director paul who

allowed me the opportunity to come back in this role to be able to advocate more directly. the national minority aids council represents faith based and community based organization, as well as aids service organization as well as advocating and delivering

hiv/aids service of of communities nationwide. since 1987 nmac has delivered a variety of campaign, advocacy, public campaign programs, national conferences, research programs, capacity building, technical assistance and treatment and training and

digital and electronic recourse materials. like so many gay men of my generation, i got involved in aids advocacy because of the epidemic impact on me directly. i was diagnosed with hiv 24 years ago. and i make the point to say

diagnosed instead of living with because for years after aids was first discovered there was no test for the vermen infectederous. i fine--for the virus. i finally tested and got the courage for it in 1987 but no idea how long hibeen positive

before that, because up to that we had already been practicing safe sex and using condoms which was spear headed a lot by the luckily i responded well to treatment and have lived a relatively healthy life. however many of my friends, family members and loved ones

were not so lucky. after being diagnosed, i reevaluated my priorities, abandoning a job i had looked for and longed for in terms of working on wall street to come back to texas and work for change. and while i haven't looked back,

i do look back in terms of remembering why it is that i continue to fight this fight for all those neme i sat at their bedside who were dying and for the promises i made to them to continue this fight. i think it's important to note some aspects that i think has

happened over the 30 years that are significant because there has been significant progress over the last three decades and i also must take time to really thank some of the trailblazers i mentioned earlier in the gay community and organization like account up, the gay men's health

crisis, project inform and several others because of them, the public was forced to address the growing epidemand i can as a result of these early efforts and support of the nation's medical community, today infection rate vs dropped from a peak of 130,000 a year in the

1980s to about 56,000 currently. unfortunately, the annual infection rate has not budged for about a decade holding study at 56,000. our nation's prevention efforts seem to have hit a wall and while there are many reasons for this including adequate funding,

lack of efz based and age appropriate sex education programs and general complacency about the disease is an issue that we need attention on. the continued disproportionate of the impact of the virus on minority community itself also proposes challenges.

in the african american community where infection rates are seven times as high as caucasian, a prevalence of the virus makes each encounter considerably riskier. this is why idebtifying evidence based prevention tool is so critical; it's easy to aassume

that everybody will use condoms 100% of the time. whatever the excuse for use not using condoms whether it's lack of intimacy, education or prevention, it's critical to expand our judgment. if white heterosexual men or women have unprotected sex just

once, that chance for contracting the rihave you seen is significantly lower than two black men having a homosexual encounter. as long as those exist, those in the prevention community will face an uphill battle. but this is where science has

provided potential break throughs. the promise of preand post exposure prophylaxis could prevent in transmission, of course the cost associate wide wide implementation of p. r. e. p. pose significant challenges. but recent studies point to the

efficacy of treatment as prevention offer possibly the best hope for a practical approach to expanding prevention efforts. a study released last month reviewed serodiscord ant couples found that early and sustaped treatment of antiviral

medications reduce the risk of transmitting the virus to your partner by as much as 90%. for minority communities facing sieve 95 cantily higher load and prevalence, this is a hugely promising development. assuming we can get everyone diagnosed on hiv, this could

significantly reduce the risk of transmission with each sexual encounter even in groups with highest viral burden like gay black men. the critical point in that last statement is whether we can insure that all people live pregnant hiv can get on drug

therapy. currently more than 2 million people living with hiv in the united states are unaware of their status. any effort to enroll all those into antiretroviral therapy would require a renewed push around testing.

it would also require avenues to insure that people can access care once they're diagnosed. current programs are simply inadequate. medicaid for example requires at least currently a person is disabled by aids before they can access the program and most

recently we were pleased to see that there will be some guidance release office of diversity the 1150 waivers that will be helpful in building a bridge in 2014 when medicaid will face this opportunity. rian white faced funding shortages in the aids program,

these medications prosighted medicaid--lykes dazon, said earlier, there are states in the south that are incredibly accountivated and those are communicatess of color that are impacted. currently 13 states have instituted wait lists for

programs while 17 other vs introduced a variety of cost containment measures like capped enrollment and reduce the form illegalsarys. there is great hope, and i think that was referenced in the viedman yee you all saw earlier in some of the fact that we've

been participating early on and itsomes about through the importance of healthcare reform through the strategy, the passage of healthcare reform and the release of the strategy will go far in addressing these challenges, healthcare reform will improve insurance companies

from dropping enrollees when they're diagnosed with hiv. you will also keep private insurance companies denying coverage on hiv diagnosis or capping spending on treatment. so healthcare reform will also expand medicaid eligibility eliminating the requirement that

a person be disabled by aids prior to being eligible for the program. the national aids stat knowledgey aims to increase access to care and minimize health disparities. one of the ways it aims to achieve these goal system by

focusing resources on those communities where the impact of the epidemic is most severe, namely minority communities. in other words, it calls for funding to follow the epidemic. this will go far in addressing the prevention challenges proposed by the disproportionate

epidemic on the color while at the same time we must be careful that we do not abandon one's community health for another. for example, while the asian and specific islander community has the lowest infection rate of any racial and ethnic group in america it is also the only

group with infections that are actually on the rise. if we based our reallocation of funds solely on the viruses burden in the community, we can risk the epideprivationic and others. this is why the need to continue fund suggest so important.

while programs like p. r. e. p. and the use of treatment of prevention holds significant promise we must insure continued funding of traditional prevention programs. any additional weapons in our preventionarsinal are only effective in concert with safer

sex practices and regular condom use. in today's political climate, efforts to reduce the deficit have occasionally put fund nothing jeopardy to the credit of this administration, it has continued to push for sustained prevention funding but efforts

in congress to cut family planning funding including funding for planned parent hood could have a devastating effect on our nation's fight against this epidemic. instead of cutting these programs, it is critical to note that each infection that is

prevented saves over 350,000 in lifetime medical costs much of which fallsot taxpayer. in fact, preventing all 56,000 annual infections for just one year could save as much as 20 billion in lifetime medical costs. if you multiby that figure out

over the period of a decade and you are looking at potentially savings in the hundreds of billions of dollars. prevention is an investment and it is something we must really work towards. it is not just an investment in the citizen of this country, it

is investment in our economic security. and finally, i think the most important thing they could say is someone who's been living with hiv in the advanced in treatment over the past 24 years and that i'm able to be standing here and doing this work and

advocating for the needs of people living with hiv and aids. but there is also benefit they know of that is really important to me that i've been able to be able to paritate in and that is being able to be around to see my parents get hold and take care of them in their twilight

years as they've been taking care of me when i was dealing with this when i turned 23 ask they were there as my support. and for that, and the science, and for all the work that's been going on, that's been the greatest gift for people living with hiv and aids that we can be

there for others to do the work including our own families to take care of them in their own twilight years. thank you very much [ applause ] - >> thank you daniel, thank you so much. you know it's easy for us to

focus in on the domestic epidemic, it is so devastating and continues as we talked about, but one of the most important things i think we've done in this country is look outward at the pandemic and as the video talked about a little bit, the pep far program program

launched is one of the most amazing health initiatives is a global health init whyative in our time--initiative of our time. mark was able to help get that program going and we owe him a debt of tkpwratitute and he is now the distinguished scholar at

georgetown university, inaugural global health fellow at the george w. bush institute and he's joining us today to talk about the global pandemic. >> good morn everyone, i would like to begin by thanks secretary sebelius and dr. koh for hosting us today and keeping

the spot light on aids as many things are going around and many other important issues on everyone's plate. it's good to be back here at hhs, i served for 14 years so it's good to be home. leadership starts with humility and service and no one is

that--where is that more important than the global hiv/aids epidemand i can how people are responding globally. the opportunity to serve is often a series of accidents and in my own life, the first accident was in the mid80s reading the cover story on news

week, in news week about global hiv/aids and like tony there was something just inside of me that told me i should leave, the academic career i was pursuing in the humanitys and pursue the second accident was tony, tony was--i was fortunate that he picked me up and shepherd me

and mentored me in his lab ratorscheas president bush turned to him and a small team to develop pepfar, tony was kind enough to include me in that process and then president bush launched the single largest fight against hiv/aids. and with randy tobias, the first

aids coordinator was fortunate enough in other accident to be there as he moved on and to be named coordinator. now president's bush's leadership was sorely needed and it's difficult to remember looking back, given how far we've come that just two years

before pepfarwas launched we h. i.t almost global leadership and we had global efforts that was blocked at the united nations as a millennium development goal and it was blocked as a millennium development goal as pernicious arguments and it was that african americans were

uneducated and poor and could not do something as strong as treatment despite having the treatment there. that slander was compound the by something that was being promulgate thad africans were so permiss cuous that there was nothing that could be done to

turn the epidemic around. we now from sentence science that africans now have fewer sexual partners than americans do over the course of a lifetime and in the context of that general, we can't do this, or the africans can't do this, president bush and the american

people stepped up and said, yes, they can. we actually believe in that saying in the last administration too. , i knew the truth and tony new the truth that was a shorthander and untrue because we were doing work in atricka with colleagues

there who were delivers antiretroviral therapy already and we knew that what they needed was support and that comes back to leadership being about humility and service and understanding that africans actually can not only solve their problems but among those

talented dedicate and innovative people and if you support them and give them a chance, they will solve their problems and that's precisely what they did with pepfar. pepwas about americans not dog but supporting africans from the village level to state houses to

solve their hiv problem and that's why 10s of millions of people had their lives lifted up and saved. president obama is continuing this theme and it carrying the torch. the his acra speech was on point and fully part of bush's view

point and so continuity to say that africans must lead and will lead and americans will support and president obama's global health initiative in a health view is a natural evolution of what was the administration and not a break. and so much though that the bush

institute is focused on similar efforts and working with the administration and his extraordinary team of people in development and global health, eric being one of them, many you in this room being among them as well from across the government at the white house, the state

department, usiad here at hhs, the peace corps and department of defense. now perk ep far came at a unique memory cloneinent history where the science gave us the opportunity to support people for prevention, treatment, and care in combination which is

what pepfar was all about. people focus on the treatment but that wasn't the only issue there and the science was there, and as president bush said at the time that if we h. i.t the science, it was a moral imperfive t-r us not to let people die.

we are now at a similar cross roads on prevention. while we could do some combination prevention when i was in office we had behavior change including condoms where we could have a cop binnation approach as we're ending our term in office male circumcision

cameot stage reducing infection by 50 or 60%. we now have treatment prevention. we hope for prophylaxis we have it for men who have sex with women, and we hope it will help others including young women in africa.

we have a microbicide coming on stage. we now have the science that will allow us to drive this epidemic into the ground. and just as we have the science with treatment, and we could have done as many people said, here are all the reasons for

implementation and financially we can't do it we thursday suspect why we can do it, we now have the opportunity not only to say here are the problems and challenges with combination prevention and using science, here are the problems financially, here are the

problems on implementation, we have the opportunity to grasp this moment in history again and say this is why we can do it and this is how we will do it. and we will do it is by supporting africans who if we support them, will solve this problem.

they will figure out how to do what we need to do is support them. and so, pep far grasp the history, we are now hopeful we will drive this emdeprivationic into the ground through prevention, care and treatment and for an hiv-free generation.

and all of us who have been on this stage and privileged to service and privileged to have the opportunity and humility to serve look forward to supporting all of you and future generations of leaders as you tackle this problem as you own this problem supporting africans

to solve their problems. >> thank you mark, i had the pleasure to work with haline gail and in the mid90s and i got to work with her for the cdc, and i got to see leadership at work and i got to see advancement of a frontal assault on infections in this

country. she is now the president and ceo of care usa. and she also serves as the chair of the president's advisory counsel on hiv/aids. dr. gayle? >> thank you so much, richard. and as always when you're the

last speaker many people have already made some of your points soime going to try to be relatively brief so we can start the panel but before i start i would like to thank secretary sebelius and assistant secretary koh, for having us here and for the leadership that they

continue to show not only for hiv, but health around the country and i have the opportunity to work with both of them in my role with the president's aids advisory council and it really just so appreciate the the support we get from them, dr. veldasarie,

and christopher weight who is is there and i want to thank jeff crowley who is my partner in crime in all of this who heads the white house aids office so there's a lot of people i could call out but just to say, how thankful and how privileged i am to be back here again as many of

the people on this stage have already said, i spent 20 years as a commissioned officer at centers for disease control and on a few other assignments and so this building is home for me and it's great to be coming home like this. i also will say this is--i have

to mark this day, this is the first time ever ever heard tony fauci, be called an accident. but i'll remember that. a good accident! so richard just asked me to say a little bit about my path and more from a personal perspective so i'll do that and you know

when hiv was first discovered before it was hiv, when the first cases of aids were reported, i was doing my pediatric residency not very far from here at the children's hospital and clearly pediatric aids and hiv was not on the radar screen so you know i

finished my pedeiat rake training without ever really having heard much about hiv or training or having much experience with aids other than to read about it as a medical professional. i then went on to the the centers for disease control

because i wanted to have some experience in public health and thought i was going to stay there for two years but ended up staying for 20. so when i first went and you had this opportunity to choose your different assignments, i thought about hiv because i thought this

was an interesting fascinating, new issue and everybody, almost everybody told me to stay away from it because they said this is a strange political disease and by the way, you know it's not going to be very serious and you 99 a couple of years we'll have figured out a cure and

treatment and you know, why don't you go spend your time on something that's a real public health challenge. obviously i didn't take that advice and and soon--although the first couple of years i did something else but i asoon got drawn to work on hiv and aids,

and by that time, i think we were all beginning to realize that this was going to be the defining, not only public health issue of our time but in many ways the defining humans and humanitarian issue of our time as i think several of the speakers have mentioned.

and for me, hiv, i often say, i did too hiv, hiv chose me because it was fascinating scientifically but it also had social imperiaatives that i thought were very--that called to me and i've always been a person who was very involved as an activist, really wanting to

work on social change issues and so, hiv which does not on one hand does not discriminate on the other shorthand not randomly distributed and we know that in many ways, hiv does show us the fault lines in our societies whether it's in this country and the disproportionate impact it

has on people of of color, people who inject drugs, gay men or whether it's around the world where it has its biggest impact on those live nothing extreme poverty and particularly--living in extreme poverty scheon women who often have no ability to negotiate safer sex in the

context of their lives and relationships. so for me hiv was a calling in many ways as many people here have said and you know i'll just end by saying for me as others have said, i have marked my life by many of the chapters in this epidemic whether it was--when we

first started talking about the disproportionate impact on communities of color, heterosexual spread, perinatal transmission, the global epidemic, i also mark hide life by the the aids conferences and you know, every year, there's a different flavor in the

environment in the conference and often times that has to do with whether the discoveries are limited or whether they're very hopeful like the vancouver conference in 1996 where anti--where combination therapy was first rolled out. so you know i think we've all

come to mark our lives and luckily, we're marking our lives less by the number of people who are dying in our live who is we love and more by the advances that people have already talked about and i think that's what's hopeful about this epidemic and i think the other part about it

that i always find hopeful is that there are people like the people on this stage and people in the audience and others who are part of a caring community and i think all of us can say that as a result of works on hiv, our lives are richer than they would have been before

where more human in many ways than we ever were before and more equaled and think about society in a more equal way than we might have before and so, you know while this has been a horrendous epidemand i can has affected people in and around the globe and horrendous ways, i

think it's also helped to form a more human approach to life, to health and to medicine in ways that i think we will never turn back from. so those are just my few comments and i look forward to the panel. >> thank you dr. gayle, and

before we start the discussion and we also have a mic up front and i will ask people to come forward and ask their own questions, i just want to thank all the people and i can't name them because i won't remember all the names who worked so hard to put this together.

it's been a couple of months of very hard work and most of them are in the back, not taking up seats because that's the way they are. they're terrific colleagues and meas join me in thanks them for the work they've done. and this is my oprah moment.

so i'm going to ask the first question to get it started but if you have a question or comment, please feel free to do so. i will ask two questions of the first is what makes you the most optimistic about the epidemic as it stands today?

what gives you the most hope? >> well are there are several things richard. one of them is that over the last couple of years it's clear we have already within our grasp, the scientifically proven capabilities of really, as i say getting our arms around this

pandemic in turning around the dynamics of the epidemic so instead of seeing this, we're really going to be started see thanksgiving and it has to do with what i mention, with mark and others mentioned is the issue of combination prevention, modalities there has been in the

past understandable but not appropriate tension between treatment and prevention and we know now that treatment is prevention and in addition to the things we know work, circumcision works even better than we thought it did in the beginning.

we clearly know that under certain circumstances preexposure prove laxic works. we know that interventions such as topical microbicides even with modest adherence, work with greater adherence work even better, if you put all those things together, right now, we

need to imlevel things in a way that we get the best bang for the buck. so i'm--i'm enthusiast and i can optimistic that before there were so many scientific gaps, that even if we were able to implement them, we wouldn't have the tools to do that.

our tool kit is getting more full and more full. and it's really up to us to implement that now. both domestically and internationalally so i feel good about that. >> any other panelists want to add on that?

>> i would agree with that, i guess i would flip it around a little bit and you know what am i most pessimistic about because i agree that we have now more than ever an opportunity to--with all the tools we have both for prevention as well as for treatment, you know but i

think we also had the potential for taking our eye off the ball and not continuing to keep the resources that are necessary to really go that next and hopefully sooner or later last mile. so i think it is easy to get too optimistic and to take the heat

off and i think that's--you know there are lots of other issues. you know we have a huge economic crisis on our hands still. you know there's a lot going on, but i think we just cannot for the 30 years that we have poured into this and into people's live who is have been lost, we cannot

blow this taoupt to put these taouls to use and make sure that they get used by those who need the most and that's going to--you know that's going to take a lot of political will. >> i'd add two things that make me optimistic, first is the number of people people and this

is true with the united states and the people on the ground and the communities in the health clinics and hospitals that are there to do the work and the creatativity and innovation and if we just support them they will actually figure it out. they have for the last five

years in africa accident seven years and in the united states in the last 30 years. if we support them they will figure it out. the thing that makes me incredibly optimistic i share, and, hiv/aids--we have common ground, and so we have a real

opportunity for using that for partnership and some of that grows from,--there are very few programs and so that's a life saved in united states or in as we move into health in general that, is true, not just in hiv/aids and certainly globally with the global health

initiative and integration which we did some of the the bush administration and this administration and the natural evolution is carrying on, we can make the arguments in a way and there is a sense in the united states that we are even in our most difficult financial times

we are part of a global community and we care about our brothers and sisters in the world that we're not a self-centered nation for the most part and we're not self-centered individuals and that was demonstrated clearly in the days of hiv/aids here and

i'm optimistic that we can if we're careful and do it well and right, achieve what we need to achieve and grasp this moment in >> [speaking at once ] >> so, richard, i have first to say that i absolutely share the same hopes and concerns and i have two more.

and one is particularly every single day that another person who has been diagnosed or living with hiv is able to lift their head in dignity, come out, disclose, share what their concerns are, share what their experiences are and bring others along with them means we're

going to continue to link arm in arm with people who are experiencing the brunt of this epidemic with folk who is are looking for all of the solutions to the end of it. they give me hope ever every single day. the second thing is within my

organization of sister love, we have ever not located hiv in the larger framework of human rights and we know for people who are most impacted or most vulinarrable, they're experiencing some of the worst human right suppression whether it's violence or proveerty or

disenfranchisement or no access to housing or support themselves in their families and that because we know have moved a little bit further down the road with the the affordable care act, with understanding, that maybe we could agree that health is a human right.

that hiv will be integrated into much larger framework and a much larger effort to make sure that and, and that hiv isn't this exceptional issue that's only reserved for a certain number of people, i think that that's really where the hope lie system when we realize that, respect it

and put the resources to responding to that that we will see the end a lot sooner. >> i think to really underscore, it's people that are going to make the difference in the investigation. i think more importantly it's the younger generation that

there are so many trailblazers back in my day, but there are many people in this audience and many people who i work with now who are not around when the epidemic started and yet who have taken up the mantel who are not living with hiv but who are still fighting for those people

that i've been fighting for for all my life and i think that's the biggest hope for me because i think that no matter what, you know if we have to continue fighting this, you know for as long as we have to fight this, we've got a new generation that is really taking up that mantel

and that is what i think gives me the most hope. >> i just want to remind folks if they would like to ask a question? just to come to the microphone fyou want to address the panel let us know. otherwise we'll all take it.

>> i'm prudence goforth. so some nearly 20 years ago, i didn't know i would be working at hhs and i am now. and i have two special heroes here today dr. fauci, my son justin go forth. let me connect the dots and you will see that we are a part of

this story that you're telling today and there was a time some 20 years ago when i thought my son would be a piece of that quilt. it is because dr. fauci, was his first doctor and he was a part of the experimental treatment at nih that he is living today that

he is in this audience, justin, you want to stand up? dr. fauci has gone on to saving many as you have, he is in the medical field at whit man-locker treating individuals with during those days of his treatment at nih hospital, i was mother to many young men whom

their partners rejected them, whom their parents did not know -frpl.and i thank all of you very, very issues much for the trepl end out work you've done and especially for my wonderful son. good morning everyone, i'm deputy editor of p. a. w. s. magazine, i am a person living

with aids not hiv, thankfully. so as a person living with hiv, i have always been hopeful for the cure. i have been waiting 30 years, i hear a lot of good news but i would like to hear how hopeful each of you are about the cure? >> very!

>> how much of a chance to we have for a cure in the near term? >> when you talk about a cure there are a couplele of ways of looking at a cure. there's a true eradication of all the virus in the body so that when you discontinue

therapy, there's nothing there to rebound. that would be a true microbiogical eradication cure. right now we are in the stage of scientific discovery to even determine if that's feasible and we are encouraging by request for application and innovative

ways to do that because the drugs that we have are spectacular in suppressing the replication of the virus but they don't get rid of the virus that hides in the reservoirs. the other approach is what we call a functional cure, in other words to suppress the virus or

get that reservoir small enough that by a number of means, boosting the response or another mechanism yet to be determine thad you could stop therapy and the virus won't rebound back. so that will be what we call a functional cure. to be honest with you, i don't

know how long that's going to take because we're still in the in the face of what we call discovery of mechanisms of how we can do that as oppose to imp lemming that. we know we can stop the implication of the rihave you seen, we haveiate drugs, now,

but it is still a scientific challenge about whether we can really cure so that's really the answer, we're going to try really hard to do that so hang in there and maybe you'll get the medication too do that out of your reservoir. >> one of the greatest

opportunities we have in front of us are some of the structural interventions that are out there, including the affordable care act and national fight stat edge so if i can allow myself to redefine the definition of cure. one of the goals of the strategy is to look at how we increase

care, and actions for care. and we know there are treatments and preventions. and there are opportunities to work at eliminating virus as much as possible so that we can get to a different type of cure in the sense that we could really have communities really

not worried about hiv as they happen in the past. so i think there's also ways that i think we need to be looking at this from the standpoint of not just the science but what are the policy opportunity that are in front of us that could allowitous get to

that point. --allow us to get to that point. >> thank you. >> good morning and thank each of you for all that you've done individually and collectively. for debwest with the racial and ethnic disparities coalition and the african american alliance.

know tag one size does not fit all, what in each of your, however best you can answer it, professional judgment really needs to be done to better address the the academ in blacks and in hispanics among the hardest to reach and more at risk than i think hardest to

reach? >> i'm going to start from a community perspective, when i--in my earlier comments, i sort of facetiously alluded of how i dream of more than magic and it's not fetal compartment saoerbgs at all,--facetious at all, our community, the

leadership, not just the hiv/aids leadership but many of us look to and work with but our communities leadership, our civil rights leader, our political leader, our education leaders, when those folks are celebrities, you know the people that our youth will listen to

and then go and get the information advice and treatment from our approximately and our social service provider that when our whole community embraces this epidemic and response to a very much in the same way they'll respond to when a tv show gets taken off that

they're really interested in or when a pastor has to settle a lawsuits because of some sophisticated lakers stuff he's been involved in and they get up in arms about that, when we begin to get on television and demand what is right for us with us by us then that's when we're

going to see a trickling down and a trickling off of the exchange of hiv, the transmission, the incidents and also the lack of services that are available to us in our we'll be able to address that but without the proper lead shepand the community that the

embrace that leadership ideas ideas and implementation of of the programs and policies that we need for ourselves, then we'll stay way behind in this epidemic once we actually embrace and ecinize that this is an emergency, it is an urgency and that we don't look to black folk

in africa to be the only one who is are coming together and solving african problems with african solutions, it's going to be black and brown people using black and brown solutions to solve our problems in this and until then, we're going to still be looking for someone

else to come and save us and it's never going to work. >> i maybe i'll add a couple more points. i mean, i do think that as greater access to treatment and we know the impact that treatment has on prevention, you know i think all the things

we've already talked about *fs greater access to the tools that are available and to the extent that the community gets access and demands access as dazon said, you know that will be helpful. but i also think that not only is it important that there

is--there is leadership coming out and claiming this as an issue, but also the willingness to talk about the issues that are related to hiv. you know you cannot talk about hiv in the african american community without talking about homosex y'allity and we don't

want to talk about homosex y'allity. we don't want to prethat he understand it exists, i mean young african american and gay hispanic men are the ones who are disproportionately at risk. we have to talk about what's happening to women and why women

aren't in the situation where they feel they can negotiate safer sex and that means talking to young girls about sex. we've got to be willing to talk about the the issues that are related to it and talk about them openly and honestly and we're not willing to.

and until we are, you know, i remember back in the day when we would say, you know talk about the "risk groups" for hiv and aids and we would say gay or black as if there weren't gay black people. you know? and so, we have to be open and

honest in the dialogue and until we do that, until we're willing to talk openly and honestly about sex and sex y'allity in the african americans and community then it's--because we had the leaders getting up there and talking but, you know they haven't been willing to say the

words. there's also a scientific and medical response to that question also or is it only just social? >> well i think there's a substance and medical in the sense that these are the same communities that are

disproportionately impact bide other diseases that have poor health services that have poor access to health information so it's no surprise on kind of on the medical and the health side that those same disparities would be the case for hiv but beyond that, there are these

other issues as well. >> we have time for one last question. >> justin, i think i got introduced earlier. my question's about stigma and how it relates to especially the new modality for prevention and we live in--and we are really

excited about becoming a demonstrate site for preexposure prophylaxis and i'm excited about now there are world class leaders talking about treatment and prevention, but treatment and prevention and press and pep, all come with their own unique teug ma that--stignathat

comes from preicidersa well as patients community and so on. risk compensation issues where providers will say we shouldn't go down that road because then it'll just be a free for all, everybody's not going to stop using condoms and so on when there's solid research that

shows that the more you engage people in care, the less risk they actually take along with getting on treatment as prevention and i appreciate your at the same time about homosex y'allity because we use the word stigma so much and have for 30 year thaeus think we sometimes

forget what that means and the majority of that is homophobia and so, how do we deal with the unique--the new enique stigma around treatment and prevention and how do we find leadership to address homophobia so that we can start breaking down some of those barriers.

my job at whit man walker is to figure out how to break down those barriers and there's a list of barriers this long, kimap almost every single one of them back to stigma, so i just wanted to see what your thoughts were about treatment and prevention in the stigma related

to that. >> i think one of the biggest opportunities that people have and they can do in terms of stigma it's one thing that one of my former bosses, president clinton said, was that if you're gay to come out. impact of of that is tremendous

in being able to let someone know you are gay it's not easy to do, but it will have a tremendous impact on who someone, they might know what being gay is. i think it's it is same thing with living with hiv and aids, was that is takes a lot of

courage but it's important that you come out about your status. because you have to work to educate others about the fact that it is still there. and so those are important things they think can help in that site but it takes a lot of courage and it's a burden in

some respects because it really impacts those who are probablily the ones that are being stigmatized the most. >> you know when i was in offsite, i used to be asked questions that annoyed me, but one ofa annoyed me the most is why is there so much stigma in

africa, as if we don't have any here? and you know we all up here remember and i was looking around a good chunk of the audience and some don't remember that in the early days of hiv/aids the incredible stigma that was associate wide hiv/aids

where you had--when i was a medical student down the road at the va, people would not touch hiv positive patients, literally would not touch them we had to sue surgeons and dentists to operate on hiv positive people. as your mother pointed out parents disowned people,

partners disowned people. misinformation about how you got it so bad that the white house security people were wearing plastic goffs when hiv people went through it but we got through it all and you're living proof and congratulations what you're doing to what you do

serving your life story. we got through a lost it but not all of it and just as in africa they are a bit behind, because they started later are working through these issues, but they're complicated and difficult. to me the situation comes back

to what we talked about, go back to the people in the community and ask them, talk with them about how they would get over the cigna of preexposure of prophylaxis, talk with them about how they will get over the sigma of treatment and what are they hearing and it's

remarkable and over and over again where we make these big procclammations globally and then we go over and have hearing and they hear differently and spending a bunch of money stuff we just learned about. again, going to the community, they will will figure out their

problems and they will solve their own problems of the it's not an easy journey. but look where we are from 25 years ago, if we look and continue on that pathway and as helene, and stay o gba it and listening to these people, we can solve these problems.

>> can i also ask that the question of sigma for me when we're talking about homophobia, is not actually only centered with homophobia, for homophobic hear home hoe sex y'allity sake, if we draw back the lens, the real stigma is on human sex sexuality, to be sexual is--we

saw a lot of that this week. you know it's so funny and sad at the same time and i talk to face leaderthis all the time. you talk about--faith leaders all the time. you talk about god and the gifts of faith and the gifts that god gives us and all these tools,

well, why else would he give us sex as a means to get here if it wasn't a gift? in order to get life from anything, from the the plant, to the human, that something has to engage and to be able to normalize that conversation in such a way that there's no

stigma around sex and sexuality that we all know we have to engage in it, if we're going to procreate or if we're just going to enjoy ourselves, if we're going to destress, if we're going to stay around till tomorrow, we're going to have to get some at some point.

am i wrong? i mean, you know celibacy is a choice, it's not natural. so, i want us to be real clear about that because in all seriousness, young women who are sexually active are stigmatized. teenagers who are sexually active are not only stigmatized

but discriminated against in the aids zone. gay black men who are sexual active or stigmatized. and men who are stigmaifiesed with having sex with more tan one person are stigmatized old people having sex at 85 and 90 are stigmatized.

so it doesn't matter, it means a right and the recognition of thing same sex relationship and they're not given the right and the equal access and the equal respect that oppositions or heterosexual relationships are given but sex itself is the stigma and until i can talk

about my sexual fluids and my sexual position and my sexual preferences and my orientations, the same way i talk about what color lip stick i'm going to wear today or which high heels i need to put on today or what kind of ear wax i have coming out of my ears, until we can

make it all the same part of the same conversation then autogoing to continue and continue and continue. >> i think i have to make that the last remark.

sex education programs

thanks to our panelist, thanks to our audience and thanks to your commitment.

have a really great day.

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