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Forty years after the U.S. documented its first cases of HIV, Christopher Garcia-Wilde says a focus on basic essentials can help vanquish the worlds most persistent pandemic.

At 25, Christopher Garcia-Wilde has never known a world without AIDS, but the University of Miami medical and public health student envisions onethrough the kind of social activism that closed the worlds first prison camp for refugees with HIV.

Garcia-Wilde was not yet born in the fall of 1991. Thats when the U.S. imprisoned Yolande Jean and more than 200 other asylum-seeking Haitians who tested positive for the virus that causes AIDS in a detention camp on the Guantanamo Bay Naval Base in Cuba.

But the fourth-year student at the Miller School of Medicine, a seasoned activist who studies the impact of social movements on public health, sees parallels between how the world treats many people living with HIV today and how the U.S. treated Jean and other refugees who fled the wave of terror that followed the military overthrow of Haitis first democratically elected president.

Christopher Garcia-Wilde

Yolande Jean and fellow refugees at Camp Bulkeley experienced unsafe, unsanitary, and deplorable living conditions that were oppressive and diametrically opposed to their health, Garcia-Wilde wrote in a student perspectivefor the July print issue of the American Journal of Public Health (AJPH).

Similarly, Garcia-Wilde continued, many people living with HIV are affected by government policies, corporate patents, health care systems, and discriminatory social conditions that are in opposition to their health. This reality holds true around the world, with millions of HIV-positive people facing daily food insecurity, poverty, language barriers, racism, sexism, homophobia, and criminalization.

The July issue, which is dedicated in part to the 40th anniversary of the first reported cases of HIV in the U.S., also includes an editorial by the Universitys graduate school dean, Guillermo Willy Prado, vice provost for faculty affairs and professor of nursing and health studies, public health sciences, and psychology, on the inequities of HIV prevention and treatment among Latinas.

Since June 1981, when the Centers for Disease Control and Prevention described the first U.S. cases of HIV, the virus has infected 76 million people around the world, killing nearly half of them. And despite the introduction in 2012 of pre-exposure prophylaxis (PrEP) medications that can prevent HIV transmission, the virus still infects about 1.7 million new people every year.

As such, Garcia-Wilde contends that efforts to end the worlds most persistent pandemic wont succeed if they focus on the development of vaccines, sex education, biomedical prevention, or antiretroviral medications. Instead, he argues, ending HIV/AIDS will depend on broad coalitions demanding a social transformation to provide housing, health care, healthy foods, clean water, and other basic essentials to those who live without.

We can end HIV. We will end it, insisted Garcia-Wilde, who, as an undergraduate brought free HIV testing to students at the University of Florida. But we have to change peoples social context. A lot of the things we see in our hospital and clinics come from a lack of housing, health insurance, healthy foods, and from exposures to occupational or environmental riskswhich are often created by systems, structures, and laws that require power to change. So, we have to confront the people in power who can change them. Just like the people in the first prison camp for HIV-positive refugeesand their supportersdid.

As Garcia-Wilde documented in his AJPH commentary, Jean was arrested and beaten during the September 1991 military coup that ousted President Jean Bertrand Aristide. An organizer of adult literacy programs, she was pregnant at the time, and suffered a miscarriage. In hopes of seeking asylum in the U.S., she joined thousands of Haitians who fled in rickety boats.

Intercepted by the U.S. Coast Guard, she was among hundreds of refugees taken to the Guantanamo Bay camp and, after testing positive for HIV, confined in tents that offered scant protection from the elements. The detainees received even less care or comfort for their trauma. Their meager belongings were burned. The women were physically abused and forcibly injected with a long-acting contraceptive. Soldiers in riot gear regularly swept the compound.

After 15 days of a hunger strike to protest the abuse, Jean was placed in solitary confinement. But as news of the protest spread, law students at Yale University coordinated rolling hunger strikes that moved to universities across the nation. As lawyers challenged the detentions in court, a broad coalition of religious leaders, immigration groups, and HIV/AIDS activists organized demonstrations, petitions, and media blitzes. Movie stars condemned the detentions at the Academy Awards.

When a federal judge finally ordered the detainees released into the U.S. in June 1993, their lawyers credited the legal victory in part to the outside organizers and their agitation strategywhat Garcia-Wilde calls confronting power.

The son of South Florida public school teachers, Garcia-Wilde became interested in the power of social movements after the 2012 death of fellow high schooler Trayvon Martin. The 17-year-old Miami-Dade student was shot by neighborhood watch volunteer George Zimmerman while visiting his father in Central Florida. Not much came from the walk-out Garcia-Wilde helped organize at his Miramar High School to compel Zimmermans arrest, but he soon found his ideological home with the Dream Defenders.

Launched by mostly college students after Zimmermans acquittal, the civil rights organization didnt succeed in its initial goal of repealing Floridas Stand Your Ground law. But it has evolved into a broader movement focused on bringing housing, health care, jobs, and upward mobility to all.

Last year, during the height of the coronavirus pandemic, Garcia-Wilde spent three days a week at St. Johns Baptist Church in Miamis Overtown neighborhood, where Dr. Armen Henderson, an assistant professor of medicine at the Miller School and fellow Dream Defenders volunteer, ensured the homeless could find free food, showers, clothes, and hygiene products as the rest of the world hunkered down.

Garcia-Wilde, who plans to specialize in pediatrics and internal medicine so he can help "everyone from newborns to elderly folks," said his St. John's experience reinforced the beliefs he expressed on the 40th anniversary of the first HIV cases in the U.S. I met a lot of people there who were concerned about their next meal or about losing their things if they used the bathroom, he said. They werent concerned about taking their meds to prevent or treat HIV. That wasnt a priority because they were just trying to survive.

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Medical student urges social transformation to end HIV/AIDS - University of Miami