Checking your tweets and Facebook news feed this morning, you may have noticed your favorite celebrities were unusually silent. Or perhaps eerily silent. That’s because numerous plugged-in celebrities, from Elijah Wood to Lady Gaga, have donated their lives — or at least their online presence — for one day, or until grieving fans reach the goal of raising $1 million for the AIDS charity Keep a Child Alive. In keeping with the digital approach to fundraising, people can donate $10 by texting one of the “Buy Life” campaign’s numbers, making donations easy on World AIDS Day. While I usually find celebrity interventions somewhat annoying, the “Buy Life” campaign is refreshingly clever, not limiting itself to the purchase (digital or otherwise) of the traditional red support ribbon. The project embraces the idea of using silence as a way to speak more loudly, and combines the frivolous with the most serious in a way that reveals the paradox, but without alienating its fundraiser base. It’s just morbid, and maybe fun, enough to get you to contribute.
Thinking about how my $10 might help, I considered the larger (and perhaps obvious) question: What is the best way to fight AIDS? I don’t pretend to know the answer — and there probably isn’t only one — but two recent clinical trials of drugs used to successfully prevent AIDS transmission hint at one approach.
From a numbers perspective, the global war on AIDS is best fought by reducing transmission of HIV. While this may seem obvious, it’s an important point. In 2009, there were over 33 million people living with HIV, according to the latest World Health Organization statistics. That’s a staggering number, but even more frightening is that nearly 8 percent were infected within that year, and about 7,000 people continue to contract HIV each day. This is why rather than working hard to “cure” the disease, I believe understanding HIV transmission (both at a basic research and clinical level) is the most pragmatic way of combating the epidemic.
This July, after many failed clinical trials, a vaginal gel containing a microbicide proved effective in reducing HIV transmission. Tested in South African women, the gel reduced HIV infection by 39 percent. Just last week the New England Journal of Medicine published a study showing that an oral pill made of two drugs (one of which was the one used in the gels), was able to reduce the risk of HIV infection by 44 percent in gay men. These are both significant achievements. Both have been criticized, however, because they may not be ready yet for widespread adoption for various reasons, particularly because the drugs in question are antiretroviral drugs — the very drugs that are used to keep the disease at bay in those who are already infected. First and foremost, the drugs are expensive and are already unavailable to those who need them; secondly, prophylactic use may spur drug resistance. It’s a very dangerous game, but it’s also very good to know that they work.
Efficacy, surprisingly enough, is not the problem. In fact, the recurring theme from both of these studies is that the drugs work for most people, but people simply aren’t taking them regularly or using them properly. Some negative side effects were reported for the pill, but even so, within the trial, low adherence emerges as the biggest problem.
I’m not sure how to tackle this problem, but it strikes me as something mobile devices and social networking sites could help with. If the absence of celebrities on Facebook and Twitter can trigger mass donation, maybe a tweaked version of this kind of campaign could stimulate drug adherence and other HIV preventative measures in those at risk.
For now, let the silence begin.
Jessica Mcdonald is a fifth-year student in immunobiology.