Just the term AIDS can inspire very evocative imagery. For the past 30 years it’s been a terrifying specter that’s hung over the world, killing an estimated 39 million people. and has greatly hindered the fight against poverty. All that is changing. Infection with HIV, the virus that causes AIDS, does not mean a death sentence anymore. In fact, most HIV positive people today who have access to modern medication are expected to live a normal lifespan.
To understand how much the situation has changed, take a look at these 9 ways the fight against AIDS has changed over the past 30 years:
1. AIDS is no longer a “Gay Disease”
Flickr: torbak hopper
Part and parcel with stigma is the idea that HIV/AIDS was a “gay disease.” This has been a particularly difficult misconception to shake. AIDS was first discovered in gay men in the late 1970’s and early 1980’s. During these early years it was often referred to as the “gay cancer,” because it seemed to primarily affect men who had sex with men. By late 1982 however, the more accurate term “Acquired Immune Deficiency Syndrome” or AIDS was coined. While most now know that anyone can catch HIV and not all gay men have the virus, the idea of blaming homosexual men continues to be a barrier to treatment.
2. We’ve had 1 person who has been functionally cured of HIV
Flickr: Daniel Mennerich
One of the most striking developments in research was the functional curing of HIV in the “Berlin Patient.” Born in Seattle, Washington, Timothy Ray Brown was diagnosed with HIV in 1995 and immediately began taking antiretroviral medication to suppress the virus. In 2006, he was diagnosed with Leukemia and underwent 2 bone marrow transplants in a Berlin hospital. His stem cell donors were known to have a resistance to HIV and after his treatment, he stopped antiretroviral therapy. Since then, his condition has remained stable and shows no sign of the virus in his system.
3. HIV is no longer a death sentence
Flickr: SIM Central and South East Asia
At the start of the epidemic, HIV, the virus that causes AIDS, was a truly terrifying and terminal specter. Between 1988–1995, 78 percent of people infected with the virus died from causes directly attributable to AIDS. That number is staggering and was largely responsible for the idea that an infection was a death sentence. However, By the time we get to the period between 2005 and 2009 that number dropped to 5%. Today, if a person with HIV begins antiretroviral medication early, they are expected to have normal life span.
4. People infected with HIV can reach a point in treatment where it is very difficult for them to transmit the virus to others
Flickr: Australian Department of Foreign Affairs
When an HIV positive individual takes medication as prescribed, they can reach a point when they have an “undetectable viral load.” This means that there is no active virus in their blood and if an HIV test was administered, their infection would be undetectable. This has contributed to changing HIV from a death sentence to a manageable condition, and drastically reduces the risk of transmission. Several studies have shown that the risk of passing on the virus when a person’s viral load is undetectable is near zero.
5. There is a once a day pill that is very effective at preventing HIV infection
Flickr: Lukas Braun
This year, the CDC/WHO released new guidelines for a treatment called “Pre-Exposure Prophylaxis.” This involved people who are negative taking medication in order to reduce their risk of contracting the virus. The two health agencies recommended that at-risk populations consider starting a drug regime in addition to other preventative measure such as regular condom usage. The regime involves taking a pill called Truvada once daily. Research has shown this is between 90% and 99% effective at preventing infection if taken everyday. Right now the biggest barrier to this prevention method is cost: for those without insurance, it can cost up to $1500 a month.
6. We’ve made huge progress against one of the biggest killers of people living with AIDS
Flickr: Gates Foundation
For many years, Tuberculosis (TB) was an enormous threat to people with AIDS because the way the syndrome wreaks havoc on the immune system. It’s estimated that 1/5 people with AIDS who contracted TB eventually lost their lives. This year, at the International AIDS conference in Melbourne, a breakthrough was announced. Results of a study showed that the amount of time to clear a patient of drug-resistant TB can be decreased from 2 years, to as little as four months.
7. We have begun to find ways to coax hidden HIV out to where it can be treated
Dino H
One of the biggest challenges in fighting HIV has been the way it can “hide” in hard-to-reach reservoirs in the body. Using antiretroviral drugs, today the virus can be cleared almost completely from the bloodstream to where the virus is undetectable in the bloodstream (as outlined above). Again, at this year’s International AIDS conference, there was some amazing news. Using a drug that’s been routinely used in chemotherapy for many years, some of the latent HIV can be coaxed out of its reservoirs and therefore open itself to attack by medication. While this is not yet a cure, it is an important step on the road to the end of AIDS.
8. We’ve come miles in fighting stigma, but there is still far to go
Flickr: Len Matthews
The stigma associated with HIV has needlessly hindered the fight to eradicate the virus since it first appeared. The virus’ association with sex and drug use made it taboo to discuss in many circles. These factors, among others, have made widespread testing persistently difficult. However, this too is improving. As knowledge about treatment options increases and people around the world begin to realize that anyone can catch HIV, more and more people are getting regularly tested. That said, stigma will continue to be one of the biggest hurdles in the fight against AID.
9. An AIDS free generation is “within reach”
Flickr: April Moore-Harris
This point is truly breathtaking. The myriad of treatment advances, as well as widespread knowledge of the virus and how it’s transmitted has made the phrase “the end of AIDS” a realistic goal. This was considered unthinkable even a decade ago. UNAIDs, the UN agency in charge of coordinating the fight against the disease, has released a report on what will be needed to end the epidemic by 2030. You can read it in full here, and it’s well worth a read. In short however, it reiterates that complacency will be the biggest barrier to overcome.
On this World AIDS Day, let’s take a moment the celebrate the progress we’ve made so far and educate ourselves on what still needs to be done. Lifesaving medication is still far too expensive to be accessible to the vast majority of the world population. We need to do a lot more to make sure that such treatments are available to all, if we are going to see the end of this epidemic.
We could live to see an AIDS free generation if we stand together and push hard over the next 15 years. Let’s not let the moment slip through our fingertips.
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Tom Blake