I was an HIV doctor in the '80s. Here's what "It's a Sin" meant to me.
The drama series “It’s a Sin” has caused many of us to reflect deeply on what has happened since AIDS was first recognised almost 40 years ago. By telling the stories of this particular group of people the powerful and beautifully crafted series explores universal questions about love, loss, human connection, and the ways in our society responds at times of crisis. Themes that resonate powerfully in today’s world too. While taking us back to some of the darkest of times, we’re also reminded just how far we’ve come and there still remains much to be done.
HIV treatment advances
I have worked as a specialist HIV clinician for 30 years and over this time I’ve witnessed a breath-taking transformation in the treatment of HIV and approaches to prevention. As a newly qualified doctor in London back in the 1980s working in the AIDS ward at St Mary’s Hospital, and then as a Consultant at St Bartholomew’s Hospital in the 1990s, we were desperately trying to treat the severe infections occurring in people with HIV and which frequently led to their deaths.
Nowadays, thanks to the development of successful treatments, someone living with HIV who is using effective medication can live a long, healthy, and happy life and cannot pass HIV on to other people. We now have the knowledge and tools to completely prevent new cases of HIV. These are things we only dreamed of then.
As “It's a Sin” shows, the medical conditions of HIV and AIDS were accompanied by a social context of fear, shame, and prejudice; a deep and lasting stigma that still perseveres today. Although there’s evidence that attitudes towards HIV have thankfully changed since the ‘80s and ‘90s, there’s strong evidence the public’s knowledge has not kept up with the realities of HIV prevention and treatment. People don’t know enough, and this contributes to stigma and discrimination. And the brutal fact is, stigma kills.
There’s shocking evidence from around the world that HIV-related stigma has profound effects on people’s health, wellbeing, and on their ability to protect themselves and those they love. Stigma impacts on the care people get if they have HIV. In the UK we know that 1 in 8 people living with HIV have told no one about their status; 14% report experiencing discrimination in healthcare services; and 1 in 3 worry about being treated differently. We know people experiencing high levels of stigma find it harder to take their HIV medicines regularly. Stigma impacts on their mental health, the support they can get from loved ones, and from their community.
It’s important to remember that even with all the medical progress made, people are still acquiring HIV and some people are still dying of AIDS-related illness in the UK. There are deep health inequalities in our society which have a major impact on HIV-related health outcomes. HIV disproportionately affects communities already disadvantaged or marginalised. For many, if services are hard to reach then timely diagnosis and adherence to lifelong treatment can be very hard to achieve. The arrival of COVID-19 has unmasked pre-existing health inequalities and has magnified them. Many people and communities affected by HIV have been deeply affected by COVID-19. National AIDS Trust has pioneered a COVID-19 Network so HIV groups across the country can coordinate efforts in peer support, food delivery and campaigning. Early on, some members of the network told us that 2020 felt a lot like the early days of the AIDS pandemic, especially in terms of shame and stigma around certain behaviours. I understood exactly how they felt.
The power of storytelling is exemplified by "It’s a Sin”. There are so many untold stories about the reality of living with HIV in the UK. Currently, 18% of people newly diagnosed with HIV in the UK are among Black African people and more than a third are women. We need to hear their stories and amplify their voices and this series enables us to explore this further. National AIDS Trust’s currently in the middle of a pioneering project working with people born outside the UK about their experiences of living with HIV. A report of our findings will be published later this year.
For me, watching “It’s a Sin” has been a powerful and emotional experience. It’s a forceful reminder of the power of activism, and the continuing need for communities and professionals to engage in and take action to influence policy to achieve progress and change. The gains we’ve made are a direct result of our learning from the early years of the AIDS crisis and the many lives lost and damaged in this pandemic.
We must not let progress stall. We have a real opportunity to end new HIV infections in the UK by 2030 and to ensure people living with HIV live long and live well. We need political will for this to happen.
How you can help
National AIDS Trust is committed to making the difference we need to see. We’re determined to work to break down stigma and discrimination, ensuring HIV does not stand in the way of health, dignity, and equality. If you’d like to help us do this, you can join our HIV Activist Network or donate to our work here.
Let’s do this together so no-one has to face the sort of stigma, discrimination, fear and isolation experienced by Ritchie, Colin, Gregory, Jill, Roscoe, Ash and so many others.
Professor Jane Anderson CBE has been Chair of National AIDS Trust since 2016. Follow her on Twitter here: @ProfJAnderson