This month’s world news is appropriately focused on containing the COVID-19 pandemic once the first vaccines are available. But we can also celebrate great successes in the fight against another global virus scourge: HIV.
During my medical training in the 1980s, the hospital wards were often filled with people dying of HIV. Since then, antiviral treatments have dramatically changed the diagnosis of HIV infection or AIDS from a death sentence to a chronic illness. A normal lifespan is no longer uncommon for people with HIV. And the preventive measures outlined below have reduced the number of people infected. Since the peak of new HIV infections in the 1980s, the number of people newly diagnosed with HIV in the United States has fallen by more than two-thirds.
Deaths from HIV infection continue to decline
A study published in November 2020 Weekly report on mortality and morbidity notable progress noted:
- Between 2010 and 2018, deaths among people diagnosed with HIV fell by more than a third, from 19.4 to 12.3 per 1,000 people.
- From 2010 to 2017, HIV-related deaths fell by almost half, falling from 9.1 to 4.7 per 1,000 people.
- The highest rates of HIV-related deaths were found among black people, people who identified themselves as mixed race, and people living in the south.
- Men with HIV had slightly lower death rates than women.
The study’s authors attribute the falling mortality rate to early diagnosis and improved treatment.
There is still a lot of room for improvement
While the number of new cases of HIV infection in the US has dropped dramatically over the past decade, the latest data from 2014 to 2018 suggest that this may be slowing. And not everyone has access to HIV testing or the most effective treatments. This is especially true for those without health insurance, good nutrition, or other resources.
As with so many diseases, there are significant differences in health care levels for people with HIV. All over the world, gender, race, and geography play a role in who gets sick and who gets timely and effective treatment. The burden of suffering and death is borne by some groups much more than others.
Advances in HIV prevention and treatment are to be celebrated, but we still have a long way to go before we declare victory.
What can you do now?
If you don’t have HIV: Take action to keep it that way.
- Limit your sexual activity to a partner who is also committed to only having sex with you
- Always use a condom
- Never share needles
- If you are at high risk (such as from sexual contact or a needle stick), contact your doctor or contact an emergency clinic to consider taking a drug to prevent HIV infection.
- HIV spreads through high-risk activities like sharing needles or unprotected sex with a partner who has HIV or whose HIV status is unclear. Medicines known as PrEP (pre-exposure prophylaxis) can prevent infection if taken regularly. Discuss this with your doctor.
If you already have HIV: Contact your doctor for monitoring and treatment. A number of powerful drugs are available to reduce the amount of virus in your body. This can prevent complications from HIV infection and reduce the risk of infecting others.
If you are not sure about your HIV status but may have been exposed: Get tested. It is estimated that one in seven people infected with HIV does not know.
The final result
We have made tremendous strides since the HIV epidemic began: researchers identified the cause and understood how it spread; highly accurate tests became available; Public health measures have been taken to prevent spread; and effective drugs were developed. However, this advance lasted for many years. And we still don’t have a vaccine against HIV infection. New infections and related deaths remain far too common, and healthcare disparities persist in the fight against HIV.
The experience of HIV has shown how dangerous a new and contagious infectious disease can be, even in places with highly developed medical care – a truth more recently highlighted by the COVID-19 pandemic. There are undoubtedly many lessons to be learned from previous infectious diseases including HIV, SARS, MERS, and Ebola as we address COVID-19. But the class could go either way. Perhaps the ways we fight COVID-19 – including creating new vaccines – can be applied to HIV.
Hopefully progress in the fight against HIV / AIDS will continue, perhaps even until it is eradicated. And what we have learned from the HIV infection over several decades and from COVID-19 in the past year should make us better equipped to tackle the next pandemic.
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