Achievements and challenges 40 years after HIV
December 1st, World AIDS Day, is the last great date to be commemorated in 2021, the year that marked the 40th anniversary of the appearance of the first AIDS cases in the world. In the midst of a new pandemic, that of COVID-19, it is time to reflect on the achievements and challenges that humanity has faced since HIV broke onto the world scene.
Three experts from various Latin American countries give us their perspective on what has been achieved, but also on the obstacles that need to be brought down to continue directing the response to HIV in this new reality.
The lessons from four decades of living with HIV have been both positive and negative, activists say. For example, Miriam Ruiz, Director of Prevention and Rapid Testing for Latin America and the Caribbean at AHF, highlights that, on the positive side, HIV demonstrated that when you really want to respond to a pandemic, you can. “This was done with relative speed, going from something that was a death sentence in many countries to seeing that more people are in treatment and thinking ‘yes you can’.”
However, an unfortunate lesson, says the Mexican native, is that discrimination is a burden that has not been overcome, and today there are still cases of people who are categorically rejected in their communities.
For his part, Leonardo Arenas, AHF Chile Country Program Director, acknowledges that advances in biomedical research on HIV “have been spectacular” although a vaccine has not been achieved, since treatments have been developed which improve people’s health.
However, the COVID-19 pandemic came to revive something that had already been experienced with HIV: the segregation of countries with more resources than others, which gives them better access to vaccines and treatments.
For his part, Dr. José Luis Sebastián, AHF Peru Country Program Director, recalled that the 90-90-90 goals (90% of people with HIV diagnosed, 90% of them in treatment and 90% of them with undetectable levels of the virus) had been raised for 2020, however, the appearance of COVID-19 caused efforts to be interrupted and the goals to be left unmet.
At this point, Miriam Ruiz contributes that after the beginning of the coronavirus pandemic, the cases of diagnosis in the stage of AIDS (that is, the latest and most serious stage of HIV infection) increased, and a significant effort will be required to push them back.
Based on the new reality that COVID-19 has posed, and the significant interruption in HIV services that took place due to the great demand for health services that the new coronavirus implied, for Leonardo Arenas the main challenge is that people with HIV begin to return to hospital visits for treatment, follow-up exams, and return to care.
“The advantage of the pandemic was that people were given medication for 2 or 3 months, when in the past, they used to go month by month to the hospital, even if it was only to receive medicine,” he said.
Latin America and its complex scenario
For Miriam, the problem of discrimination and stigma associated to living with HIV is still very concerning. For this reason, she mentions that one of the greatest challenges is for a person with HIV to be seen the same way as a person with gastritis, that is, that the infection loses its moral burden and that a positive diagnosis “does not put your personal, family and work relationships at risk”.
In addition, it must be taken into account that biomedical interventions (that is, seeking to address HIV from medical treatments) are limited in the region due to the migratory phenomenon being experienced, since it is difficult to access treatment while migrating.
The case of Chile is privileged, both in terms of HIV and COVID-19, Leonardo Arenas acknowledges. With over 90% of the population vaccinated against the new coronavirus and with an initial figure of more than 90% of people with HIV diagnosed, the next step to take is the reincorporation of all people with HIV who were taking antiretroviral treatment before their care was interrupted by the pandemic.
Young people, inhabitants of the digital world
Generations have changed a lot over 40 years, and so has the world. Today the digital space is one of the main scenarios in which young people lead their lives, an especially large audience that AHF Latin America and the Caribbean wants to reach.
Because of this, offices like the one in Chile are active on social networks and create communication products such as webseries and podcasts. And on this topic, Arenas points out: “yes, we have to create strategies to reach the community, but we have to develop them together with the community.”
And Miriam says she is excited about the opportunity to create more strategies, either online or offline, so that the message of “use a condom” is on people’s minds just as much as the “eat fruits and vegetables” message, this is, to promote a behavior mainly based on health and self-care.
Dr. Sebastián is also aware that it is in the digital space where they will find young people. You have to work with them, but using their codes and channels, because that will be the only way they will accept the messages.
And just as any good doctor, Dr. Sebastián speaks out for emphasizing prevention, but without neglecting treatment, as well as advocating for comprehensive HIV care which takes into account all aspects of health, meaning, that also involves mental health.
HIV is a pandemic that has been around for four decades now. Efforts must be redoubled so that by 2030, AIDS is no longer a threat to global health.
At AHF Latin America and the Caribbean we work for quality and affordable HIV services for everyone. If you want a free HIV test or need advice, contact us at the closest office in your country or write to us on WhatsApp.