December 1st was World AIDS Day, certainly a day dedicated to AIDS Awareness, but also a day dedicated to remembering those we have lost and who continue to live on in our hearts and memories.

UNAIDS, the United Nations’ committee dealing with the world-wide fight against HIV and AIDS, recently stated in a report that "the unpararalleled global response of the past decade has already forced the AIDS epidemic into decline."  It went on to state the total number of new infections in sub-Saharan Africa, still the world’s most severely affected region, has dropped more than 26 percent from the height of the epidemic in 1997.  South Africa has had its numbers drop by one third.

In the Caribbean, one of the first regions to be identified as dealing with AIDS (specifically at the time in Haiti), new infections have also dropped by one third since 2001.  In South and Southeast Asia, there has been a 40 percent drop between 1996 and 2010 with India seeing a 56 percent decline.

However, the epidemic has recently taken a stronger hold in Oceania (Polynesia and Australia), Central Asia, the Middle East, North Africa and Eastern Europe.

The report attributes these significant declines to what it calls "historic political agreements" such as the 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS.  Both of them endorsed universal access to HIV prevention, treatment of the disease, and the care and support of those with HIV and AIDS.  When world leaders met in New York City during the United Nations General Assembly’s Special Session on AIDS in 2000, only three countries - Senegal, Thailand, and Uganda - had any sort of national plan in place to respond to AIDS.  Not even First World nations such as the USA or Canada, Great Britain or the countries of Western Europe had any sort of coordinated plan in place, leaving it up to AIDS Service Organizations (ASOs) and various other community organizations to formulate local or regional plans and engage in education and awareness, often with limited funds.

In North America, it was the gay men’s community which spearheaded a response to HIV/AIDS and continued to do so for at least the first decade of the epidemic.  The first cases of what became known as AIDS started to appear in North America primarily within the gay men’s communities, especially in New York City and San Francisco, decimating those communities in a matter of months.

Even in Calgary, it was for many years not unusual for those of us in the community to attend at least one funeral a month, often more.  We all lost friends, lovers, and ex-lovers. Many of us were involved in the care of these men and watched them become sicker and sicker, fading away before our eyes, seeing once vibrant and vital young men shrivel and grow old before their time; their faces sunken in and their bodies emaciated and wracked with pain and scarred with lesions, suffering the indignity of being diapered and soiling themselves, then holding them when they died. Others died, frightened and alone, in cold sterile hospital rooms, estranged from those who mattered most to them.

It was individuals within the gay men’s communities who launched education programs, safer sex programs, and made a point of educating health care professionals, many of whom did not understand how AIDS was spread and through that fear and ignorance too often treated our people poorly, refusing to enter the hospital room of an "AIDS patient" unless decked out in some bizarre hazmat-like suit, covered from head to toe in protective shielding and gloved.  Food trays would be left outside the room because housekeeping refused to enter.  It was a devastating and horrible period and it continued that way for over a decade, even as the medical establishment formed a better understanding of the transmission of the HIV retrovirus and began to understand it could not be transmitted "casually".

The transmission of HIV requires very specific environments in order to infect.  The normal course of events that cause its transmission during sex was of little or no consequence until the Age of AIDS, when it suddenly became a concern.  This is why condom use is so heavily promoted by those involved in safer sex education work.

We are now over 20 years into the epidemic and while the news coming out of the UNAIDS report is good news...great news, actually....there is still no end in sight.  Safer sex education is now, at best, taken for granted and has lost much of its impetus and "edge" and is too easily dismissed by the very people it seeks to inform.  At worst, it has ceased, having come under considerable attack by the social conservatives and right wing for being ‘too graphic’, ‘pornographic’, and ‘obscene.’  Some of the early, gay-created, safer sex initiatives were very creative, and yes, graphic.  They had to be.  We were trying to save lives and ‘get through’ to people on how to protect themselves and when dealing with a population within which the primary mode of transmission was certain sexual behaviours, clearly the message needed to be sexual as well.  As ASOs evolved into health service providers, heavily dependent on government funding, a definite conservatism crept into the delivery and bit by bit, the voices of gay men were lost.

Part of this, of course, was the reality that HIV/AIDS was no longer a "gay men’s disease" - a message many of us fought hard to dismantle - and that many of the new infections were to be found amongst those who shared needles and other drug paraphernalia in which the virus could incubate, or those infected via transfusions, or other nonsexual means.  New messages needed to be developed to reach these populations.  And funds were limited.  Something had to ‘give’ and, predictably, it was our concerns that took a back seat.

This is not to minimize the work agencies such as AIDS Calgary or certainly The SHARP Foundation, both of which I was heavily involved with at one time, have done and are doing.  But between serving on the first Board of Directors of AIDS Calgary and working as the Coordinator of Volunteer Services a couple of years or so later, I could see a definite swinging away from the grassroots, one might even say radical, messaging those of us who got the organization up and running had put out and what was then being promoted.  The process of playing it safe in order to not alienate funders had begun and continued despite the resistance of some of us.

HIV/AIDS no longer carries the same stigma it once did.  Those who are HIV-positive live with a chronic health disorder, not the death sentence being sero-positive once heralded.  People living with HIV/AIDS are living for years, even decades, whereas in the early years it was a matter of months between diagnosis and dying.  HIV/AIDS is simply a part of modern living, like cancer or diabetes.  That is not necessarily a bad thing, if it has to be in our lives at all.  However, we now have a whole generation, even two generations, who have been born into and grew up with the reality of HIV/AIDS and who tend to be complacent about it as a result.  We can never afford to be complacent.

For those of us who came of age in the early years, lost entire friendship circles and chosen family members to this disease, World AIDS Day is a time to remember, to bring back the faces of those we will not see again in this life, and to once again feel them touching our lives, if only by a shadow.

I will always love you guys.