HONOLULU (KHON2) -- As the world observes World AIDS Day, the focus turns to reflection, remembrance, and redoubling efforts in the fight against HIV/AIDS. The theme of World AIDS Day, which is held annually on Dec. 1, resonates strongly in Hawaiʻi where both public health professionals and community members have worked tirelessly for decades to combat the virus. Get Hawaii's latest morning news delivered to your inbox, sign up for News 2 You In the islands, this day of reflection is not just about memorializing those lost to HIV/AIDS but about acknowledging the ongoing battle and looking ahead to a future free of new infections, deaths and stigma. Dr. Cecilia M. Shikuma, M.D., director of the Hawaiʻi Center for AIDS Research at the John A. Burns School of Medicine, has been at the forefront of this fight for over 30 years. “I started this journey in the early 1990s. At that time, I had young children, and I was looking for a way to be involved in the medical field that wasn’t just about being in hospitals at all hours,” she explained. Her initial decision to become involved in AIDS research in 1990 was prompted by the University of Hawaiʻi's development of an AIDS clinical trials unit, and it marked the beginning of a lifelong commitment to the cause. From those early days, when an HIV diagnosis was essentially a death sentence to the present when HIV is increasingly seen as a manageable chronic disease, Dr. Shikuma’s work has been instrumental. “It’s a long road from where we started, with treatments that could only offer comfort, to today, where we have antiretroviral therapy that can allow people to live a near-normal life,” she said. Dr. Dominic Chow, M.D., a professor of medicine at the same center, shares a similar perspective. His own journey into the fight against HIV was personal. “My mom, a very well-known artist in New York City, lost many friends to HIV during the 1980s and 1990s,” he recalled. “Watching that devastation firsthand made me want to contribute in any way I could.” He joined the Hawaiʻi Center for AIDS Research after his time with the Pan American Health Organization, eager to bring his international experience to a local context. For both physicians, the progress in treatment has been monumental. Dr. Chow described the shift from AIDS being a death sentence to a manageable disease. “What we’re seeing now is a result of decades of effort from researchers, clinicians, and activists," she said. "People with HIV are living longer and healthier lives, thanks to the development of more effective medications and treatment protocols.” In Hawaiʻi, the collaboration between local clinicians, the Hawaiʻi Department of Health and community-based organizations has been key to achieving some of the lowest HIV rates in the United States. Dr. Shikuma credited the collective efforts of the state’s health system, researchers and community and medical activists like Dr. David McEwan for creating a unique environment of support and care. “When we started, there was so much to be done. There were physicians, community organizations and state health officials working together to find solutions," she recalled. "The local community was incredibly supportive." One critical component of Hawaiʻi’s success in managing HIV is the state’s pioneering needle exchange program which was the first state-wide program in the U.S. Dr. Shikuma explained that the program, which was initially controversial, has been crucial in reducing the spread of HIV through shared needles. “We’ve shown that harm reduction works. There is no evidence that providing clean needles encourages drug use; instead, it decreases the transmission of HIV,” she asserted. The data from the program has shown a significant drop in HIV cases linked to needle-sharing in Hawaiʻi. But despite these successes, both Drs. Shikuma and Chow emphasized that there is still work to be done. “HIV is still with us,” Dr. Chow noted. “More than 33 million people worldwide are living with HIV, and more than a million in the U.S. alone. We are not done yet.” He pointed to the importance of continued advocacy and research, particularly in the areas of prevention and potential cure. “We need to keep pushing the boundaries of science," he emphasized. "HIV cure research is still in its infancy, and we need to remain vigilant in our efforts to prevent new infections.” The ongoing battle includes not only research into new treatments but also initiatives like Hawaiʻi’s “HIV Zero” campaign which aims to eliminate new infections, new AIDS-related deaths and stigma surrounding the virus. “Hawaiʻi has made significant strides, but we still have more to do,” Dr. Shikuma said. “We’re aiming for zero new infections and zero deaths, and we’re committed to making that a reality.” In addition to research and medical care, community involvement has been essential in Hawaiʻi’s approach. Dr. Shikuma acknowledges the vital role of local participants in research studies. “Our HIV population is unique. Many of our participants have been with us for decades since they enroll in study after study to help advance research,” she said. This level of trust and commitment to the cause has been crucial for Hawaiʻi’s research efforts, especially given the historical mistrust that some communities, such as Native Hawaiians, have toward medical research. “We’re grateful for the trust our participants have shown," said Dr. Shikuma. "They understand the importance of what we’re doing, and they’ve been incredibly supportive.” Dr. Chow agreed as he emphasized the importance of community support in the fight against HIV. “Without our patients, we wouldn’t be where we are today,” he said. “Their advocacy has led to advancements not just in medications but in how we approach patient care. HIV has taught us so much about health care, especially the importance of addressing social determinants like housing, food security, and financial stability.” This advocacy extends beyond the patients themselves. Dr. Shikuma recalled a pivotal moment in 2007 when the National Institute for Health (NIH) threatened to cut funding for Hawaiʻi’s research program. “The NIH called and told us that our site was going to be cut due to the cost of maintaining it," she explained. "They thought we could be replaced by California, and our population was too small to justify the expense.” In a show of solidarity, Hawaiʻi’s community advisory board took action. “They worked with legislators to introduce a bill that would secure funding for our program. The bill passed, and within months, we received the money we needed,” Dr. Shikuma said, clearly proud of the outcome. “I can’t think of another disease where the community would step in like that to support research. It’s a testament to the bond we have with our patients and the broader community.” As World AIDS Day 2024 approaches, Dr. Chow offers a simple but powerful message: “It’s a time to remember those we’ve lost, to honor their contributions to science and our understanding of HIV, and to renew our commitment to continue the fight.” He stressed the importance of awareness and action, as the global HIV/AIDS pandemic is far from over. “We still need a cure, and we need better prevention methods. The fight isn’t over, and we can’t stop now,” he added Dr. Shikuma echoed this sentiment and added that Hawaiʻi has a unique opportunity to be a leader in the effort to eliminate HIV. “We’ve made incredible progress, but the work continues," she cautioned. "We still need to push for new treatments, work towards a cure, and strive to reduce stigma and new infections. And we’ll keep doing that, together with our community, until we reach our goal of zero.” As Hawaiʻi memorializes World AIDS Day, the state’s progress in combating HIV serves as both a reflection on how far we’ve come and a reminder of the work that still lies ahead. The collective efforts of researchers, clinicians and community members have brought us to this point, but the battle against HIV is far from over. You can click here to find out more information about the Hawaiʻi Center for AIDS Research. Click here or here for Department of Health resources. You can watch the full interview in the video above. So, as you reflect on the things you are thankful for through this holiday season, remember that Hawaiʻi has a unique place in the HIV/AIDS research world due the incredible foresight of Dr. David McEwan and the quick action of community members who heeded his call more than 40 years ago. Get news on the go with KHON 2GO, KHON's morning podcast, every morning at 8 However, we do not need to allow this to deter us from ensuring that HIV/AIDS continues to be treated and approached as the world destroying disease that it is. Be prepared and use the medical tools (i.e. syringe exchange programs) and medications (i.e. PrEP) that prevent its spread.