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HIV infection in the 1980s was a near-certain death sentence with widespread fear, stigma, and no effective treatments, contrasted sharply with today's era of effective antiretroviral therapy (ART), which allows people with HIV to live long, healthy lives and prevents transmission, though disparities and stigma persist. Incidence rates were rapidly increasing then, whereas now, new infections have significantly declined, though the epidemic is far from over globally.

Nowadays, treatments are highly effective. Antiretroviral therapy (ART), a combination of daily pills, suppresses the virus to undetectable levels, preventing it from destroying cells and stopping sexual transmission. A long, healthy life is now possible for those infected, similar to someone without HIV.

Whilst fear and stigma has significantly reduced, stigma does remain a major barrier to prevention, testing, and treatment for many. Comprehensive choices of drug include ART, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP) have all helped reduce the number of people affected by HIV.

World AIDS Day - December 1st

Global initiatives such as the current campaign by the The National AIDS Trust aim to end the epidemic by the end of this decade, but challenges like racial and ethnic disparities, political barriers, and stigma hinder progress in reaching at-risk populations.

PRE-EXPOSURE PROPHYLAXIS (PrEP)

PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use. When taken as prescribed, PrEP is highly effective in preventing HIV and comes in two forms.

Truvada is for all people at risk through sex or injection drug use. Descovy is for people at risk through sex, except for people assigned female at birth who are at risk of getting HIV from vaginal sex. PrEP is safe, but some people experience side effects like diarrhea, nausea, headache, fatigue, and stomach pain. For most people these side effects usually go away over time.

It's not just adults that can benefit from the protection that PrEP can offer. A study led by a researcher at the Chicago health and hospital system, showed that PrEP is safe for young men and boys under the age of 18 if the medication was administered correctly on a daily basis.

The research focused on 78 young people between 15 and 17 who were considered to have a high probability of contracting HIV. They were given doses of PrEP for 48 consecutive weeks. Only 3 of the 78 young people had contracted HIV after the 48 weeks. Clinical analyses carried out on those who had contracted the virus showed had not followed the instructions precisely, as their average consumption of PrEP was only twice a week, when they should have taken the medication every day.

The researchers concluded that for some people it might not seem like a good idea to make a drug like PrEP available to teenagers. One of them said "I shudder to think what the HIV infection rate would be if we hadn't offered PrEP. If we encourage the use of condoms for HIV prevention, why not encourage them to use another highly effective tool like PrEP?"

They went on to emphasize the importance of taking PrEP on a consistent basis every day no matter what age the person who takes it is. The protection rate of the drug is considerably impaired if people don't stick to a rigid every day routine.

If you think you've been exposed to the virus, post-exposure prophylaxis (PEP) medicine may stop you becoming infected. PEP must be started within 72 hours of coming into contact with the virus for it to be effective. It's only recommended following higher risk exposure, particularly where the sexual partner is known to be positive.

PEP involves taking HIV treatment every day for 1 month. It may cause some side effects. You should be able to get PEP from sexual health clinics or accident and emergency (A&E) departments of hospitals.

The new injectable HIV drugs are Cabotegravir (also called Vocabria and made by ViiV Healthcare) and Rilpivirine (also called Rekambys and made by Janssen) are given as two separate injections every two months, after an initial phasing-in period. The treatment is only suitable for those who have already achieved undetectable levels of virus in blood while taking tablets. It has only recently been licenced for use by the NHS, but is the most significant step forward in the fight against HIV of the past few years.

HIV VACCINE


Image by rawpixel.com

So what about a vaccine to protect against people getting HIV in the first place?

The first vaccine to protect against AIDS could be administered as early as next year, says UNAIDS Executive Director Michel Sidibé in an interview in which he painted an optimistic picture of a future where the disease would cease to be a global public health concern.

"I believe the injection can begin to be administered sometime during 2026 because the discovery has already been made." The new vaccine is already being tested on patients in different parts of the world, and their aim is to achieve what doctors call a "functional cure" which would allow patients to stop daily antiretroviral treatment, to have their immune system left intact, and for their viral load to normalize.
Michel Sidibé went on to say that, "A few years ago, a person with HIV had to take 18 pills a day. Today they only need to take one, and tomorrow an injection every six months may well be enough". He is convinced that recent scientific advances are beginning to transform the fight against the Human Immunodeficiency Virus (HIV).

One of the great victories in the fight against HIV has been to control the epidemic and drastically reduce the number of new infections, which is why he predicts that, although the virus will never disappear, in a short time it will "cease to be a topic that focuses the health concerns of governments."


Executive Director Michel Sidibé
United Nations Development Programme
CC BY 2.0 via Wikimedia Commons
"We have made unimaginable progress," the representative declared, expressing pride that the world had managed to break the conspiracy of silence and curb the virus's trajectory.

"People used to die, hospitals were full of AIDS patients, and today we can proudly say that we live in a completely different context," Michel Sidibé went on to say. However a false sense of security regarding AIDS may be one of the worst enemies the disease will have to face in the coming years, a rival that can only be defeated with a firm and sustained investment over time in preventive programs, universal access to treatment, health care and support for those infected.

"AIDS will not end until we manage to build inclusive societies where there are fewer risks, because it is not just about fighting a disease, it is about changing society and respecting the dignity of people," he stated.

RELATED INFORMATION

FOUR DECADES OF AIDS
ICEBERGS AND TOMBSTONES
CONDOMS AND COCKTAILS

See OutUK's OutReach for a full listing of HIV and AIDS resources and advice organisations

Visit the National AIDS Trust Website for details of this year's campaign.

 

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