Stop­ping the stigma and zero dis­crim­i­na­tion can lead to an end of the AIDS epi­demic

Malta Independent - - NEWS - World AIDS Day,

Since 1988, the World Health Or­ga­ni­za­tion has marked 1 De­cem­ber as a day ded­i­cated to rais­ing aware­ness of the AIDS epi­demic, caused by the spread of Hu­man Im­mun­od­e­fi­ciency Virus in­fec­tion, and to mourn­ing those who have died of the dis­ease.

GSK Malta is mark­ing this day by cre­at­ing aware­ness of HIV in­fec­tion and the im­por­tance of early di­ag­no­sis and op­ti­mal treat­ment. Un­for­tu­nately, many peo­ple are re­luc­tant to get tested, dis­close their HIV sta­tus or take an­tiretro­vi­ral ther­apy due to the stigma as­so­ci­ated with the dis­ease and fear of dis­crim­i­na­tion against peo­ple liv­ing with HIV.

Nearly half of all HIV cases are di­ag­nosed late (ECDC). As re­search is con­stantly lead­ing to bet­ter treat­ments, early di­ag­no­sis in­creases the chance of liv­ing a long, healthy life and re­duces the risk of trans­mit­ting HIV to other peo­ple. Fol­low­ing a pos­i­tive di­ag­no­sis, it is im­por­tant that pa­tients are of­fered posttest coun­selling linked to spe­cial­ist med­i­cal and so­cial care, and pro­vided with the best op­tion to start an­tiretro­vi­ral ther­apy, while of­fer­ing HIV test­ing for their partners.

There is still no cure for HIV, but life-chang­ing an­tiretro­vi­ral ther­apy, con­sist­ing of in­creas­ingly ef­fec­tive med­i­ca­tions that treat HIV, has helped sig­nif­i­cantly since the start of the epi­demic. ART is taken as a com­bi­na­tion of medicines to sup­press vi­ral load, or the amount of HIV in the blood. The goal is to achieve and main­tain an “un­de­tectable” vi­ral load, and to stop the virus from de­stroy­ing the body’s in­fec­tion­fight­ing CD4 cells.

In Malta, there has been a sharp and steady in­crease in the num­ber of re­ported HIV in­fec­tions over the past five years. In 2015 there were 50 newly di­ag­nosed per­sons in­fected with HIV com­pared to 17 new cases re­ported in 2010 (fig­ures were pub­lished fol­low­ing a ques­tion raised in Par­lia­ment in De­cem­ber 2015). This re­quires an ur­gent call for ac­tion to in­crease aware­ness of HIV in­fec­tion and en­sure that peo­ple at most risk of con­tract­ing the dis­ease are tested and, if re­quired, re­ceive op­ti­mal treat­ment early on in the dis­ease.

There are a num­ber of pre­ven­ta­tive means that may re­duce the risk of HIV trans­mis­sion. Th­ese in­clude the use of con­doms which may not be 100% ef­fec­tive, the use of ster­ile in­jec­tions for those who in­ject drugs, and preven­tion of trans­mis­sion through op­ti­mal an­tiretro­vi­ral ther­apy.

UNAIDS (www.unaids.org/en) has set an am­bi­tious goal to help end the AIDS epi­demic by 2030. Their 90-90-90 pro­gramme as­pires that by 2020, 90% of all peo­ple liv­ing with HIV will know their HIV sta­tus, 90% will re­ceive un­in­ter­rupted HIV treat­ment and that 90% of those re­ceiv­ing ART will main­tain con­trol of the dis­ease.

Ac­cord­ing to UNAIDS and WHO, men who have sex with men, trans­gen­der peo­ple, sex work­ers, in­tra­venous drug users, pris­on­ers and il­le­gal mi­grants are dis­pro­por­tion­ately vul­ner­a­ble and highly at risk of HIV in­fec­tion. Such HIV-af­fected pop­u­la­tions are al­ready marginalised and there­fore less likely to en­gage with their health sys­tems suc­cess­fully.

In its ef­forts to de­liver op­ti­mal care to per­sons with HIV, GSK joined Pfizer and Shionogi (a Ja­panese company) to es­tab­lish ViiV Health­care, an in­de­pen­dent, global spe­cial­ist HIV company equipped to move quickly in re­sponse to the needs of the HIV com­mu­nity. This en­ter­prise has al­ready launched in­dus­try-lead­ing ac­cess ini­tia­tives to help de­liver on WHO/UNAIDS 90-90-90 goals aim­ing to reach all those who need treat­ment. More on: https://www.vi­ivhealth­care.com/wha t-we-do/we-im­prove-ac­cess-to-ourmedicines.aspx

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