My travels with autism started long before my diagnosis at the age of three years and three months.

My family noticed autistic features from around 15 months of age. I never looked at people and did not respond when called. I lined up toys instead of playing with them. When I wanted something, I took people’s hand to get it for me. I had frequent meltdowns in busy environments or when routines changed unexpectedly, but I couldn’t let people know why I was upset.

I was later diagnosed with autism. My family grieved to hear that I might never be able to lead an independent or full life.

But my mother wasted no time in organising supports. Soon, my days were filled with home-based intensive behavioural programs, speech therapy and other supports. But unfortunately, I never learned to speak.

But I learned to communicate another way

A turning point came when I was nine. I began learning how to communicate with a type of augmentative and alternative communication known as supported typing. I type on a machine with a keyboard, called a Lightwriter, which speaks what I type. Another person touches my shoulder as I type. This touch helps me be aware of my body, and helps me focus on communicating my message.

I used supported typing at school and now at university, where I am a PhD candidate. I’m researching neurodiversity in autistic people with minimal, unreliable, or no speech, or those with complex communication and high support needs.

With supported typing, I am able to live life more fully, to give a TEDx talk, one of the first by a nonspeaker, and to write my autobiography. I used supported typing to write this article.

How common is it for an autistic person to not speak?

Autism affects how people communicate, interact and perceive the world. Autistic people show differences in social communication as well as narrow interests, such as Lego or trains.

In 2022, there were 290,900 autistic Australians. About one-third are nonspeaking.

This nonspeaking autistic community is socially vulnerable and frequently experience nonacceptance and exclusion. As a member of this community, I am driven to bust some myths.

Myth 1: we don’t use language

Autistic nonspeakers cannot use speech to communicate. But many of us are verbal, that is, we understand and use language.

I am a visual thinker, and I sense my world in pictures and images. Initially, speech was just sounds without meaning. Around six years of age, I realised words were used to represent things and to communicate. By linking people’s speech to their behaviour, I began to understand the symbolic nature of language, which helped me communicate.

Because of sensory and movement differences, autistic people with complex communication needs require support to communicate, do routine activities and participate socially.

For instance, physical touch to our hand, arm or shoulder provides feedback on our position, balance and movement to help us point to pictures, spell or type. Support workers also help us focus and remain calm so we can communicate.

Myth 2: we don’t understand your mind

Autistic people, especially those with complex communication needs, need extra time to decode, make sense of, and abstract meaning from experiences.

But with effort and time, many autistic nonspeakers can empathise and understand other people’s minds.

This can involve using social stories to understand mental and emotional states. These teach us about social situations and how to participate. They can be used to describe what to expect ahead of time. They can give us time to rehearse and we can draw on them during the situation in real life.

For example, when meeting someone for the first time, we may feel overwhelmed. We use a social story to know what to expect, to sit at a comfortable distance to introduce ourselves, to ask and respond to questions. The story helps us process new information, and suggests how to tell people when we are overloaded and need space to chill.

Giving us the time, space and permission to process social situations helps us navigate social life.

Myth 3: we rock, hum and sometimes scream or run off for no reason

Autistic people, especially those with complex communication needs, can feel unsafe in busy environments. For example, bright lights or noises from people talking and moving around cause sensory overload and distress. This leads to increased stress levels and a reduced ability to respond appropriately.

Autistic nonspeakers may use various strategies to manage the overload and lessen this sensory distress. This may include lying down, staring at blinking lights or revolving objects, humming to block out overwhelming sensations, as well as rocking, spinning or weaving our bodies to restore a sense of balance. These behaviours allow us to self-regulate.

However, when these strategies are insufficient, autistic nonspeakers may behave in unconventional ways such as screaming, running off or having meltdowns.

Such behaviours do not arise because we don’t understand how to act appropriately. They occur when we feel highly unsafe and anxious in demanding situations.

When a quiet space is available, we will be able to chill and regain feelings of safety and control, without resorting to concerning behaviours.

The next time

So the next time you meet an autistic person who doesn’t speak, please meet us halfway. Give us the time and space to process and think about how to reply.

Timothy HoYuan Chan, PhD Candidate, Sociology, Faculty of Education and Arts, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

In January, the Trump administration ordered a broad pause on all US funding for foreign aid.

Among other issues, this has significant effects on US funding for HIV. The United States has been the world’s biggest donor to international HIV assistance, providing 73% of funding in 2023.

A large part of this is the US President’s Emergency Plan for AIDS Relief (PEPFAR), which oversees programs in low- and middle-income countries to prevent, diagnose and treat the virus. These programs have been significantly disrupted.

What’s more, recent funding cuts for international HIV assistance go beyond the US. Five countries that provide the largest amount of foreign aid for HIV – the US, the United Kingdom, France, Germany and the Netherlands – have announced cuts of between 8% and 70% to international aid in 2025 and 2026.

Together, this may mean a 24% reduction in international HIV spending, in addition to the US foreign aid pause.

We wanted to know how these cuts might affect HIV infections and deaths in the years to come. In a new study, we found the worst-case scenario could see more than 10 million extra infections than what we’d otherwise anticipate in the next five years, and almost 3 million additional deaths.

What is HIV?

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. HIV can be transmitted at birth, during unprotected sex or thorough blood-to-blood contact such as shared needles.

If left untreated, HIV can progress to AIDS (acquired immunodeficiency syndrome), a condition in which the immune system is severely damaged, and which can be fatal.

HIV was the world’s deadliest infectious disease in the early 1990s. There’s still no cure for HIV, but modern treatments allow the virus to be suppressed with a daily pill. People with HIV who continue treatment can live without symptoms and don’t risk infecting others.

A sustained global effort towards awareness, prevention, testing and treatment has reduced annual new HIV infections by 39% (from 2.1 million in 2010 to 1.3 million in 2023), and annual deaths by 51% (from 1.3 million to 630,000).

Most of that drop happened in sub-Saharan Africa, where the epidemic was worst. Today, nearly two-thirds of people with HIV live in sub-Saharan Africa, and nearly all live in low- and middle-income countries.

Our study

We wanted to estimate the impact of recent funding cuts from the US, UK, France, Germany and the Netherlands on HIV infections and deaths. To do this, we used our mathematical model for 26 low- and middle-income countries. The model includes data on international HIV spending as well as data on HIV cases and deaths.

These 26 countries represent roughly half of all people living with HIV in low- and middle income countries, and half of international HIV spending. We set up each country model in collaboration with national HIV/AIDS teams, so the data sources reflected the best available local knowledge. We then extrapolated our findings from the 26 countries we modelled to all low- and middle-income countries.

For each country, we first projected the number of new HIV infections and deaths that would occur if HIV spending stayed the same.

Second, we modelled scenarios for anticipated cuts based on a 24% reduction in international HIV funding for each country.

Finally, we modelled scenarios for the possible immediate discontinuation of PEPFAR in addition to other anticipated cuts.

With the 24% cuts and PEPFAR discontinued, we estimated there could be 4.43 million to 10.75 million additional HIV infections between 2025 and 2030, and 770,000 to 2.93 million extra HIV-related deaths. Most of these would be because of cuts to treatment. For children, there could be up to an additional 882,400 infections and 119,000 deaths.

In the more optimistic scenario in which PEPFAR continues but 24% is still cut from international HIV funding, we estimated there could be 70,000 to 1.73 million extra new HIV infections and 5,000 to 61,000 additional deaths between 2025 and 2030. This would still be 50% higher than if current spending were to continue.

The wide range in our estimates reflects low- and middle-income countries committing to far more domestic funding for HIV in the best case, or broader health system dysfunction and a sustained gap in funding for HIV treatment in the worst case.

Some funding for HIV treatment may be saved by taking that money from HIV prevention efforts, but this would have other consequences.

The range also reflects limitations in the available data, and uncertainty within our analysis. But most of our assumptions were cautious, so these results likely underestimate the true impacts of funding cuts to HIV programs globally.

Sending progress backwards

If funding cuts continue, the world could face higher rates of annual new HIV infections by 2030 (up to 3.4 million) than at the peak of the global epidemic in 1995 (3.3 million).

Sub-Saharan Africa will experience by far the greatest effects due to the high proportion of HIV treatment that has relied on international funding.

In other regions, we estimate vulnerable groups such as people who inject drugs, sex workers, men who have sex with men, and trans and gender diverse people may experience increases in new HIV infections that are 1.3 to 6 times greater than the general population.

The Asia-Pacific received US$591 million in international funding for HIV in 2023, which is the second highest after sub-Saharan Africa. So this region would likely experience a substantial rise in HIV as a result of anticipated funding cuts.

Notably, more than 10% of new HIV infections among people born in Australia are estimated to have been acquired overseas. More HIV in the region is likely to mean more HIV in Australia.

But concern is greatest for countries that are most acutely affected by HIV and AIDS, many of which will be most affected by international funding cuts.

Rowan Martin-Hughes, Senior Research Fellow, Burnet Institute; Debra ten Brink, Senior Research Officer, Burnet Institute, and Nick Scott, Head of Modelling and Biostatistics, Burnet Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.