Ending HIV

Around the world, 37 million people are living with HIV, the highest number ever, yet a quarter of them do not know that they have the virus. Today (December 1), on World AIDS Day, the theme is “Live Life Positively: Know your HIV Status”. Today also marks the 30th anniversary of World AIDS Day.

Significant progress has been made in the AIDS response since 1988, and today three in four people living with HIV know their status. According to the latest data, 9.4 million people living with HIV don't know their status and 1.8 million people were newly infected with HIV in 2017 alone.

We still have miles to go, as the latest UNAIDS Report shows, that includes reaching people living with HIV who do not know their status and ensuring that they are linked to quality care and prevention services. One problem is that if a patient is infected with the HIV virus, he or she may live without any symptoms for one to 10 years. Even with the HIV virus present in the blood, the blood test results for HIV may be negative, if tested within three months from the date of infection. This is because the antibody development takes about three months from the date of infection.

HIV testing is essential for expanding treatment and ensuring that all people living with HIV can lead healthy and productive lives. It is also crucial to achieving the prevention targets and empowering people to make choices about HIV prevention so they can protect themselves and their loved ones.

Unfortunately, many barriers to HIV testing remain. Stigma and discrimination still deter people from taking an HIV test. Access to confidential HIV testing is still an issue of concern. Many people still only get tested after becoming ill.

Knowing your HIV status has many advantages. It is an essential entry point to HIV treatment, prevention, care and support services. People who test positive for HIV should be linked immediately to antiretroviral therapy to keep them alive and well and, when viral load suppression is reached, prevent transmission of the virus.

Knowing your HIV status also enables people to make informed decisions about HIV prevention options, including services to prevent children from becoming infected with HIV, male and female condoms and other preventive measures.

More than 77 million people worldwide have become infected with HIV, and more than 35 million have died of an AIDS-related illness. But huge progress has been made in diagnosis and treatment, and prevention efforts have avoided millions of new infections. But as UN Secretary General Antonio Guterres notes, the pace of progress is not matching global ambition. New HIV infections are not falling rapidly enough. Some regions are lagging behind, and financial resources are insufficient. Stigma and discrimination are still holding people back from getting tested for HIV and getting treatment. Guterres says there is still time -- to scale-up testing for HIV; to enable more people to access treatment; to increase resources needed to prevent new infections; and to end the stigma.

Here in Sri Lanka, there is wide awareness on HIV/AIDS, but more needs to be done. The highest number of HIV infections in the Sri Lankan history was reported last year (2017) and the number is 285. According to venereologists, every week around six new HIV infections are detected in Sri Lanka and the estimated number of HIV infected persons in the country is around 4,200. Compared to the population as a whole, this is a very low rate of infection. Experts say that our cultural and religious ethos may have played a part in this.

However, one-third of those infected do not know that they are HIV positive. The new HIV infected persons detected in the country are between the ages of 15 and 49. New HIV infections among youth have shown an upward trend over the last five years. Earlier, it was young adults around 30 and 35 who were susceptible to HIV infection, but now the age has gone down to 20–25. More awareness of HIV and safe sexual practices is needed to prevent more people from this age group falling victim of HIV. Sex education should be an essential part of the school curriculum.

We also need to tackle the issue of stigma and myths surrounding HIV. A few years ago there was a well-known case of a boy being excluded from his school in Kurunegala as he was suspected of having HIV. The incident also exposed the lack of knowledge in society about HIV – many parents thought that their children would also get HIV by being near the affected child, whereas HIV is not transmitted through the air like certain respiratory diseases. The media must play a bigger role in educating the public on HIV.

Scientists around the world have stepped up efforts to create an HIV/AIDS vaccine and they could succeed in 10-15 years at present rates of research and development. Several breakthroughs have been reported recently in this regard. A world free of HIV could be a possibility sooner rather than later.