Today, 36 million people live with HIV and nearly 1 million die every year die because of AIDS, so it’s important to raise awareness of it, support people with it, and remember the 35 million who’ve died from it. The PARTNER study announced this year tested 100,000 people taking ART to achieve an undetectable viral load, and there were zero cases of transmission – this means HIV may no longer mean a death sentence, and it can be stopped from spreading to others, so could be stopped once and for all. In spite of that, there is still heavy stigma surrounding it.
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I don't have HIV, but there is still stigma around it. I've made this to try and explain the key points about it and AIDS.
As I wasn't taught this in school, and this isn't something provided through the news, I've had to research and understand this all myself, as I was stigmatised of HIV as well.
- HIV is a virus that infects your immune system, bonding itself to your DNA. At some point after this, either months or years, the virus replicates and it triggers AIDS which leaves your immune system vulnerable, which, if left untreated, may result in death
- HIV is transmitted through contact with bodily fluids such as blood, and typically during sex e.g. oral, anal, or vaginal sex, but also includes breast milk
- Mothers can pass it on to their children if no treatment is taken
- Straight people can get it just as well as gay people
- There are 36 million people living with HIV in 2017 globally
- About 1 million die from HIV-related causes yearly globally
Treatments and cures
- There is no cure for HIV yet, though some people are naturally immune
- A drug was developed in 1987 known as an antiretroviral therapy (ART), which stops the virus from creating copies of itself by inhibiting the enzymes that allow HIV to replicate
- This has been improved upon every year. Someone who is HIV-positive but is strictly adhering to taking the drug will have an undetectable viral load, meaning the tests can't detect any HIV, so they are essentially HIV-negative when it comes to sex
- It takes up to 6 months for someone taking ART to have an undetectable viral load
- HIV-positive people will still visit a doctor on a regular basis to check they are still undetectable
- Half of the global HIV-positive population are receiving treatment
- There are multiple strains of HIV and so different variations of the drug, it can vary from 1-4 pills per day
- In rare cases the standard drug may not prevent transmission (4/1763 cases, 0.22%, in the HPTN 052 study), however the virus was still detectable using tests in all these cases
- When the treatment does work so that people have remained undetectable, there are zero cases where HIV has been transmitted (the PARTNER study of over 100,000 people, or Opposites Attract study of 12,000 people)
- Even in the presence of other STIs or using condoms, an undetectable viral load still has been proven to prevent HIV transmission
- The tests in Canada may be less accurate
- PrEP reduces the risk of getting HIV if taken before sex by blocking it from taking hold. This trial started September 2017. It can either be taken on demand or daily.
- PEP is similar, but is typically taken immediately after a potential risk of transmission, and is available for free on the NHS. It needs to be taken for a month after sex and strictly adhered to.
- You can get a free HIV test from Terence Higgins Trust, or your local sexual health clinic.
- As will all drugs, viruses can become resistant due to mutation. It's important to regularly be tested.
Summary and thoughts
HIV is still a problem, as it kills nearly a million people every year. The best treatment is for everyone sexually active and negative to take PrEP, and positive people to take ART and strictly adhere to the daily treatment. The sooner the treatment is taken after transmission, the more likely the treatment will work.
To prevent further transmission, it is important to check with all sexual partners on their HIV status and if they are positive, whether they are adhering to taking ART and regularly being tested to ensure an undetectable viral load. Using condoms also prevents other STIs so are recommended.
The ultimate goal is still to eradicate HIV. Abstaining from sex would resolve this, however this is very hard to prevent. The next best option is to educate people, provide protection, and reduce the chance of transmission as much as possible. Even with all this, the treatment does not work in rare cases, and like any virus, it may become resistant. It's possible bacteriophages may able to cure it one day.. It's important to remain vigilant, continue research and to keep it under control.
The wider public need to be informed of the stigma and also how to be safe.