Thursday, November 30, 2017

World AIDS Day 2017 Is Tomorrow

By Alan Howell, MD, Temple Infectious Disease Specialist
Member, Texas Medical Association Committee on Infectious Diseases

The first World AIDS Day was marked on Dec. 1, 1988. The brainchild of two World Health Organization (WHO) public information officers, World AIDS Day serves to raise awareness of the AIDS pandemic. Dec. 1 also provides a day to mourn those whose lives were cut short by the disease.

During the past 29 years, significant strides have been made in respect to HIV/AIDS public education, diagnostics, treatment, and prevention. With the 2017 observance upon us, I thought this would be a great time to take stock of where we’ve been — and where we hope to go in respect to the pandemic.

HIV remains a significant global public health issue. To date, 35 million people worldwide have died as a result of the virus. In 2016 alone, 1 million people perished because of HIV. That’s approximately 2,700 people a day, or 114 per hour.

The WHO Africa region is the most affected region, where 25.6 million people live with HIV. This region also accounts for almost two-thirds of the global total of new HIV infections. Part of the problem is that far too many people are not aware of their HIV status.

Fewer than three out of four (70 percent) of people with HIV are estimated to know they are infected. The goal is for nine in 10 (90 percent) of people with HIV to be aware of their condition. To achieve this goal, an additional 7.5 million people need to have ready access to HIV testing. To this end, the Centers for Disease Control and Prevention (CDC) recommends HIV screening in the United States be performed routinely for patients aged 13-64 in all health care settings. Patients who continue to be at high risk for HIV need to undergo repeat screening at least annually.

Despite the grim statistics, antiretroviral therapy (ART) and education programs around the globe are working. Between 2000 and 2016, new HIV infections fell by 39 percent. HIV-related deaths fell by one-third, with 13.1 million lives saved because of ART. In 2016, 19.5 million people worldwide living with HIV were receiving ART.

On the topic of ART, many patients are surprised by the treatment’s convenience. For most people starting HIV treatment, one pill once a day will suffice. Occasionally, a physician or health care provider may determine two pills once a day or three pills once a day are necessary. Side effects are much improved compared to the medications used as recently as 10 years ago.

While there is no cure for HIV, treatment can successfully control the virus to the point it is no longer detectable in the bloodstream (viral suppression). This means people who take ART daily as prescribed, and achieve and maintain an undetectable viral load, have effectively no risk of sexually transmitting the virus to an HIV negative partner.

In addition to the aforementioned treatment as prevention, pre-exposure prophylaxis (PrEP) is another great option for preventing the spread of HIV. PrEP consists of a daily pill. When taken as directed, PrEP can reduce your risk of acquiring HIV through sex by more than 90 percent. Among patients who inject drugs, it reduces the risk by more than 70 percent. Additionally, PrEPcost.org is an online tool that can help individuals determine which plans offered in the Health Insurance Marketplace cover this prevention option.

World AIDS Day 2017 is a great time to celebrate the progress we’ve made curbing the pandemic. It also is a time to stop and reflect on the horrible human toll HIV has taken in the United States and around the world. To make this a truly successful World AIDS Day, consider these ways to show support:

  1. Wear red on Dec. 1;   
  2. Volunteer your time or make a monetary donation; 
  3. Take time to educate yourself and share your knowledge (hopefully this post helped in some small way, and I encourage you to share it); and 
  4. Get tested if you think you might be at risk.


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