WORLD AIDS DAY
It’s been more than 30 years since a disease now called AIDS was first recognized in the United States. Back then, it was considered a death sentence. No treatments were available, its cause was unknown, and people often died within a few months after being diagnosed. Today, people infected with HIV—the virus that causes AIDS—can live full, healthy lives.
The world is poised to end the AIDS epidemic by 2030 – provided it can accelerate the pace of progress achieved globally over the past 15 years, according to a new World Health Organization (WHO) report. By 2014, the number of HIV deaths was reduced by 42% – from a peak of more than 2 million in 2004 to an estimated 1.2 million.
The terms HIV and AIDS can be confusing, because they’re related but different. HIV is a virus that harms your immune system by invading and then destroying your infection-fighting white blood cells. AIDS is the final stage of an untreated HIV infection. People with AIDS can have a range of symptoms, because their weakened immune systems put them at risk for life-threatening infections and cancers.
If you get a diagnosis of HIV infection, and you begin antiretroviral therapy in a timely fashion, before your immune system becomes substantially compromised, your prognosis is excellent,” says Dr. Anthony S. Fauci, NIH’s infectious disease chief, who first began treating AIDS patients in the early 1980s. Studies show that with early treatment, HIV levels may become so low that the virus becomes undetectable in the blood. That lengthens life and reduces the risk of spreading HIV to others. If those who are infected stay on therapy, they can save their own lives and also help keep HIV from infecting their sexual partners.
Some people avoid getting tested because they’re afraid of the possibility of being HIV-positive. Others may feel embarrassed or uncomfortable talking about sexual issues, and so they don’t get tested. But the earlier HIV is diagnosed and treated, the better the outcome. Recent findings from clinical trials have confirmed that the early and expanded use of antiretroviral treatment saves lives by keeping people living with HIV healthier and by reducing the risk that they will transmit the virus to partners. The same drugs that help people living with HIV to remain healthy also prevent people at substantial risk of contracting HIV from becoming infected. Pre-exposure prophylaxis, or PrEP, is the use of an antiretroviral medication to prevent the acquisition of HIV infection by uninfected persons. In a quest to step up prevention, WHO now recommends PrEP be offered to all people at substantial risk of HIV infection.
At the UN General Assembly in September, world leaders endorsed the Sustainable Development agenda. This agenda includes the target of ending the AIDS epidemic by 2030 – by reducing new infections by an additional 75% by 2020 and by ensuring that, in the coming 5years, 90% of people living with HIV are aware their infection, 90% of those are on ART, and 90% of people on ART have no detectable virus in their blood (UNAIDS’ “90-90-90” target).
Safer and more efficacious ARV drugs are becoming available, and a newer class of drugs – integrase inhibitors – is becoming more affordable for low- and middle-income countries.
- New point-of-care viral load testing technologies have the potential to expand access to viral load testing
Efforts should be made to reduce the time between diagnosis and ART initiation to improve health outcomes.
HIV tests involve a simple check swab, finger prick, or urine sample. Experts recommend that you get tested for HIV if you answer yes to any of these questions:
- Have you had sex with someone who is HIV-positive or whose HIV status you didn’t know since your last HIV test?
- Have you injected drugs and shared equipment (such as needles or syringes) with others?
- Have you been diagnosed with, or sought treatment for a sexually transmitted disease, like syphilis?
- Have you been diagnosed with hepatitis or tuberculosis (TB)?
- Have you had sex with anyone who has any of the risk factors listed above or whose history you don’t know?
“Despite the significant progress, half the people living with HIV globally do not know they have acquired the virus and do not receive treatment that can save their lives and avoid infecting others,” said Dr Winnie Mpanju-Shumbusho, WHO Assistant Director General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases. “We must now step up our efforts to reach the missing half with testing and treatment and the prevention of new infections, or we will miss the unique opportunity to end the AIDS epidemic within a generation,” she added.
Dr. Rajib Paul MD
Consultant Physician & Intensivist,
Apollo Health City,
Jubliee Hills, Hyderabad