To four visiting scholars in Pittsburgh, curing the global AIDS epidemic might have nothing to do with medicine. They're not working in laboratories on the next generation of antiretrovirals, or looking for a breakthrough vaccine. They've been on the front lines of a problem that is at once both more elemental and infinitely complicated.
It's why an engineer-turned-activist from Pakistan, who despite his attraction to men didn't hear the word "gay" until he was 18, is trying to figure out why HIV-positive men in his home country often never seek treatment — even if they know their status. Or why the first person to speak publicly about being HIV-positive in Belize is trying to understand the barriers to HIV-testing there, despite threats of assassination.
"They see the barriers in their work is not giving pills to people, it's getting them to take the pills," explains Ron Stall, director of the Center for LGBT Health Research at the University of Pittsburgh. "We now have the tools that we need to stop the epidemic, but what we don't have are ways to break through the stigma."
Under Stall's direction, four visiting scholars from China, Pakistan, Belize and South Africa are spending the next five months devising research projects to address HIV-related health crises in their home countries. The projects range from understanding the barriers that keep people from receiving care to testing the efficacy of at-home HIV screening.
The program, funded by the Foundation for AIDS Research (amfAR) and hosted by Pitt, is designed to take people who are already part of organizations that are connected to LGBT populations in their home countries, so they can take advantage of that social infrastructure to conduct research.
"We get applications every year from people who say, 'There's a price on my head, and if you don't pick me I might die,'" Stall explains. "One of the commonalities of the global HIV epidemic is that it's a very rare country indeed where gay men are not doing worse than the background population. What we're hoping, of course, is that the scholars we're training turn into leaders."
But before they could begin breaking down the stigma that contributes to one of the world's worst public-health crises, they had to first escape it themselves.