Lita Wills, Mayor Justin Bibb, Andre Brown, Dave Margolius, Roderick Harris, José Zuniga and Chris Ronayne sign the Paris Declaration to end HIV, on Thursday at City Hall. Credit: Mark Oprea

In a rare meeting of city, county and board of health officials, Cleveland signed a commitment to cease HIV infections and AIDS-related deaths by 2030.

The agreement was signed by eight persons, including Mayor Justin Bibb and County Executive Chris Ronayne. It’s an offshoot of the 2014 Paris Declaration, a global movement aiming to eliminate the inequities in healthcare that allow AIDS deaths to still occur. Cleveland joins some 500 other municipalities that have signed on board as a Fast-Track City.

On Wednesday morning in the City Hall Rotunda, all ten speakers, from Cuyahoga County Board of Health officials to HIV-aware social workers, combined testimony about personal stakes in the three-decade epidemic with insight into how Cleveland’s sign-on will help it achieve the United Nation’s lofty goals.

Those being the so-called 95-95-95 targets: 95 percent of persons with HIV knowing they have it; 95 percent able to get antiviral drugs; and 95 percent of the latter having minimal amounts of HIV in their bloodstream.

“Our goal is to have zero new HIV infections and zero AIDS deaths by 2030 — that year is going to be here before we know it, and it’s going to take a whole lot of work,” said Roderick Harris, health commissioner at the Cuyahoga County Board of Health.

Unified leadership across sectors — a primary way the city can accurately monitor those infected — will inevitably result in more marginalized communities being connected to care programs, Harris said. Mostly, he said, in Latin and Black neighborhoods.

“Regardless of where they live, who they are,” Harris said, “they should have every opportunity to get tested, know their status, get medications if they are positive.”

Dr. Barbara Gripshover, an infectious disease specialist at University Hospitals, has been studying HIV/AIDS since the 1990s. Credit: Mark Oprea

While the CDC published its first paper discussing five immunocompromised gay men living in Los Angeles in June 1981, the HIV/AIDS epidemic grew into a national and global panic in the late 1980s and early 1990s.

As tens of thousands died in the U.S. per year, infected people endured a rough stigma. HIV was wrongly titled “gay cancer” by the misinformed. A national hotline was created. Physicians were ostracized for treating dying patients. Magic Johnson got it. Freddie Mercury died from it.

Despite antiviral drugs being widely available by the early 2000s, the CDC dubbed HIV/AIDS “one of our greatest health epidemics.” It’s killed roughly 500,000 in the U.S. since 1985, and 1.1 million Americans still live with the disease. Although advancements in antiviral drugs have tempered HIV’s reputation as a death sentence, doctors and social workers repeatedly advocate prevention as the best salve. Pre-exposure prophylaxis pills, a sort of HIV “birth control” commonly known as PrEP, are known to decrease infection by about 99 percent.

But prevention only works for the knowledgable. It’s why Jen McMillen-Smith, a social worker who’s guided HIV patients through their diagnoses for 20 years, said that specific outreach must be orchestrated for Cleveland’s Black and transgender population.

Pop It To Block It, a joint venture by MetroHealth and University Hospitals to destigmatize and promote PrEP resources, was created precisely for this knowledge gap.

“Right now, the most people who just go and get prep on their own are older, white gay guys, people in relationships with people with HIV,” McMillen-Smith told Scene after the signing. “We want to increase trust in the healthcare system. ‘Hey, PrEP is a good thing.'”

Andre Brown, director of Equity, Diversity & Inclusion at the County Board of Health, echoed McMillen-Smith’s arguments in his comments to the press.

“We know that Black and brown folks and trans folks are the ones who are most impacted by HIV,” he told the crowd. “We should see them in leadership, they should be the ones making the decision, they should be the ones telling us what needs to be done, what is and isn’t going to work.

“And so we need to make sure that the leadership reflects the epidemic.”

For Bibb, like others in attendance, the HIV epidemic is personal: his cousin Chris struggled with HIV up until his death in 2016. “I think Chris will be happy about what we’re doing in the city and the county,” he said. Credit: Mark Oprea

Mayor Bibb himself delved deeply into a personal account of the epidemic, leaning into a more complicated anecdote Clevelanders heard often on his campaign trail. Chris, Bibb’s cousin who was murdered in 2016, struggled with an HIV infection up until his death.

Bibb said his mother, Charlene Nichols, leveraged her social worker career to lessen the depression HIV wrought on his cousin.

“She was able to help navigate the system for [Chris] before his life was cut short,” Bibb said, solemn. He paused for reflection. “Today, I think Chris will be happy about what we’re doing in the city and the county to make sure that we end this epidemic by 2030.”

Following Thursday’s signing of the Paris Declaration, it’s likely that Bibb and Ronayne will convene again with the Board of Health to fine-tune an HIV/AIDS prevention strategy, a plan that could be released to the public later this year, or in 2024.

This article appears in Jun 14-27, 2023.

Mark Oprea is a staff writer at Scene. He's covered Cleveland for the past decade, and has contributed to TIME, NPR, Narratively, the Pacific Standard and the Cleveland Magazine. He's the winner of two Press Club awards.