World AIDS Day Offers A Chance To Celebrate Successes & Assess The Challenges Ahead

As World AIDS Day approaches on Dec. 1, it’s a good time for everyone, and those in the healthcare community in particular, to take a look at how far we have come in terms of HIV and AIDS awareness and prevention—and renew our collective focus on all that is yet to be done.

Since its founding in 1988, World AIDS Day (which was the first-ever global health day), reminds us that there are an estimated 36.7 million people worldwide who have the virus, and that more than 35 million people have died since HIV was identified in 1984. While new ways of prevention continue to be created and fine-tuned, HIV has not gone away and still remains a global threat.

First, some quick numbers to get a sense of where we are now with HIV and AIDS. According to the U.S. Department of Health & Human Services (HHS):

• 1.1 million people in the United States ate living with HIV.
• Of those, 15 percent of them (1 in 7) are unaware they are infected.
• An estimated 38,700 Americans became newly infected with HIV in 2016. In 2017, 38,739 people received an HIV diagnosis. Overall, the annual number of new HIV diagnoses in the U.S. remained stable from 2012 to 2016.
• Gay, bisexual, and other men who have sex with men bear the greatest burden by risk group, representing an estimated 26,000 of new HIV infections per year.

Minorities, younger people see rising exposure and infection

The department further reports that HIV diagnoses are not evenly distributed across states and regions. Of the 38,739 new HIV diagnoses in the U.S in 2017, 19,968 (52%) were in the South. And the Centers for Disease Control estimates that the decline in HIV infections has plateaued because effective HIV prevention and treatment are not adequately reaching those who could most benefit from them. These gaps remain particularly troublesome in rural areas and in the South and among disproportionately affected populations such as African Americans and Latinos.

Another troubling sign is the rise of younger people becoming infection. HHS statistics show that by age group, between 2010-2016, the annual number of HIV infections decreased among persons aged 13–24 and 45–54 but increased among persons aged 25–34. The number of infections remained stable among persons aged 33-44 and those older than 55.

The ‘Ending the HIV Epidemic’ Initiative

Obviously, much still needs to be done around not only treatment but also awareness and prevention, One major new campaign, Ending the HIV Epidemic: A Plan for America, was announced in early 2019. It is built around the deployment of some specific strategies, including:

• Diagnosing all individuals with HIV as early as possible after infection.
• Treating HIV rapidly and effectively after diagnosis to achieve sustained viral suppression.
• Protecting individuals at risk for HIV using proven prevention approaches.
• Responding rapidly to detect and respond to growing HIV clusters and prevent new infections.

In its early deployment, the initiative is designed to rapidly increase use of these strategies in the 48 counties with the highest HIV burden, as well as in Washington, D.C.; San Juan, Puerto Rico; and seven states with a disproportionate rural HIV burden. Its goal is to reduce new HIV infections by 90 percent over 10 years.

Drug treatments continue to advance as well. One major breakthrough in recent years has been the introduction of Pre-exposure prophylaxis, or PrEP. This medication is a way for people who do not have HIV, but are at very high risk, to lessen that risk with a daily pill. Studies have shown that PrEP reduces the risk of getting HIV from sex by almost 99 percent when taken daily, but it’s important to note that it loses effectiveness if not ingested every day, and that it also does not protect against other sexually transmitted diseases.

HIV remains an elusive foe. Treatments, both for those living with the virus and those who are not, continue to make their way into the marketplace. Transmission rates and new cases go up in some communities down in others. From public awareness around reducing transmission risks to more in our arsenal of preventative treatments, there are an array of measures that can be started or strengthened. World AIDS Day reminds us to explore every front dedicated to ending this global pandemic.