TCA, vol 21: An AIDS-Free world is on the horizon.
TCA, vol 21: An AIDS-Free world is on the horizon.
I'm literally in shock.
As a child of the 80’s, I vividly remember the panic of this new disease called AIDS. I was born too late for the sexual revolution…by the time I was in high school, sex was shrouded in fear and paranoia. PSAs by Madonna and Michael Jackson reminded me that safe sex was cool and you should get tested for HIV often. Everyone in Rent had AIDS and AZT-breaks were part of their daily life.
Before the first anti-HIV drug was available (AZT), getting diagnosed with HIV meant that you were likely not going to live another year. Even after medicines were available, the life expenctancy for the HIV+ 20 year old was about 19 years. You couldn’t expect to make it to your 40’s. Because of the development of better medicines, combinational therapies, testing, education and prevention, someone getting an HIV diagnosis today can expect to live a normal human life-span. This story continues to amaze me….
Buried in the bottom of this week’s JAMA was this nugget: World on Path to Eliminate AIDS as a Global Threat by 2030.
I could cry.
How is this possible?? Because of a program called PEPFAR (President’s Emergency Plan for AIDS Relief). Initiated in 2003 by President Bush Jr, this program’s goal was to address the HIV/AIDS epidemic globally and help save the lives of those infected. Since then 100 billion dollars have been invested in HIV prevention, treatment, education and care in many countries around the world: officially the single largest investment by one country to combat a disease in human history.
Here are some amazing stats from PEPFAR according to a recent CDC analysis:
The number of people receiving PEPFAR care for HIV infection has increased 300-fold since 2004: from 66,500 people to 20 million.
95% of the people receiving PEPFAR care are now virally suppressed (the virus is controlled). Full suppression means you are no longer contagious by sex or through childbirth.
PEPFAR supports 10,000 testing labs in 50 countries
25 million lives have been saved
Millions of infections have been prevented
If this trajectory continues, HIV could no longer be considered a public health threat within the next 7 years. Wow.
Continued vigilance is necessary
All of the estimated 38.4 million people currently living with HIV infection need to continue to be supported for the rest of their lives. For most, HIV cannot be cured (officially 5 people have been cured of HIV infection, but that’s another story for another day). HIV can only be managed through medication, which keeps the number of viruses in the bloodstream low or undetectable. When its undetectable, the patient is not contagious by sex or childbirth.
However, if the person stops taking the medication or their virus becomes resistant to the medication, then the virus load will increase, they will become contagious again and may progress to illness and AIDS. So, its critical to make sure all infected persons are identified and supported with medications. If we can do that though, then we can stop HIV transmission completely…. and within a generation, this disease will disappear.
Prevention is also key. Condom usage, access to a safe blood supply and clean needles/medical equipment, and preventative medications are necessary to stop new infections. It is now possible to access PrEP medications (Pre-Exposure Prophylaxis) if you are considered a high risk for infection, and taken correctly, has a 99% success rate of preventing HIV through sex and a 74% success rate of preventing HIV infection through injecting drugs.
The Hot Take: With continued funding of PEPFAR, increased access to PrEP medications, education, testing and community support… it is possible to eliminate HIV as a global health threat by the year 2030.
Stay happy, healthy and informed!
Jessica at TCA
Emily Harris. JAMA. World on Path to Eliminate AIDS as a Global Threat by 2030
The United States President’s Emergency Plan for AIDS Relief. The US Department of State.
Johnny Wood. How living with HIV and Aids has changed, more than 30 years on