Today, December 1st, is World AIDS Day, and in commemoration, today’s post will be about issues related to HIV/AIDS that make me a bit unhappy. We have come a very long way over the past three and a half decades, since the first cases of AIDS were reported. There have been vast improvements in diagnosis, treatment, and prevention of HIV and it’s related conditions. As such, there has been an overall decline in the total number of new cases of HIV worldwide. And, of those persons with HIV infection, more of them are on effective antiviral treatment, and less are dying.
However, even though there has been overall improvement in the status of HIV and AIDS worldwide, there are still pockets where infection rates have not declined as desired, and also pockets where access to effective medical care, is suboptimal. As an Infectious Diseases physician working in the south of the United States, and also having recently worked in Caribbean, which is classified as a developing region, I have witnessed first hand some of these deficiencies.
Related post: HIV – Everybody’s Business
I was not completely surprised at the deficiencies in the Caribbean. In fact, I was pleasantly surprised at the overall availability and accessibility of HIV services (at least in the OECS [Organization of Eastern Caribbean States] islands). However, I have been unpleasantly surprised at some of the deficiencies in the American south, particularly the level of poverty among some groups, the shortage of specialist medical providers for HIV care, with patients sometimes having to travel for 100 miles and more to see the doctor, the severe stigma associated with HIV, and the lack of awareness in young people, of their risk for HIV.
Approaching World AIDS Day this year, I have been mulling over the things I wish for, regarding HIV. Here are my wishes…
I wish everyone would go and get tested, at least once, for HIV.
The knowledge of one’s HIV status brings power. Power to take the necessary precautions to maintain a negative HIV status forever. Power to take the necessary precautions, if HIV positive, to get treated so that death from AIDS never happens.
I wish everyone knew that HIV testing kits were available in pharmacies for purchase over the counter.
Even stores like Walmart in the US carry these kits on their shelves. This allows self testing for HIV in the comfort of one’s own home. Then, one can choose the medical facility or doctor they wish to take care of them.
This year, for world AIDS day, the WHO (World Health Organization) is promoting HIV self testing in developing countries. Too many HIV positive persons are unaware of their infected status. Undiagnosed HIV positive persons promote the continued spread of the virus.
I wish everyone with HIV infection got diagnosed in the very early stage, before onset of AIDS.
Far too often, we get patients diagnosed for the first time with HIV infection, when they already have advanced AIDS and are sometimes on the brink of death. This pains my heart, especially since a lot of these cases are very young people, in their 20s, many black.
I wish everyone with HIV infection knew how easy it is to treat the infection.
HIV infection is so much easier to treat than conditions such as diabetes. One tablet, once per day, is often all that is needed to completely suppress the infection, enabling infected persons to lead completely normal lives.
I wish there was no stigma against HIV.
People need to realize that stigmatizing persons with HIV is totally pointless. You stigmatize the 1 person you know for sure has HIV, but what about the countless others with whom you come into contact with from time to time? The waiter in the fancy restaurant, the doctor taking care of you in the emergency room, the nurse coming to take care of your mother at home, the attendant at the car dealership, the mailman. HIV infected people work in all these capacities and you will never know, because they look no different from you and I. So being mean to the 1 person who you happen to know has HIV, causes some amount of suffering to that person, and in turn results in absolutely no benefit to you.
I wish all persons with HIV took their medicines religiously every single day.
Yes, HIV infection is a condition for which there is no cure (at least, not yet). The only way to avoid progression to AIDS and eventual death, is to take specific medication every day for the rest of one’s life.
It makes me really sad when people who have access to excellent life saving medication simply choose not to take it. It makes me very sad when these same people come into hospital time after time, with various infections related to the weakened immune system from AIDS. All this can be totally prevented by the readily available treatment.
I wish we no longer had new HIV infections.
Who would have thought that 30 plus years since the emergence of HIV, with all the knowledge and awareness gained, that we would still be having people infected every day around the world? Sadly, complexed social issues including stigma, contribute to the continued spread of HIV infection.
I wish people with HIV infection would never act irresponsibly, and knowingly spread the virus.
Unfortunately, there are some very mean people in the world. For that reason each and everyone of us has a personal responsibility to protect ourselves from this infection. We cannot relinquish this control to others. That, unfortunately, is easier said than done sometimes, especially for women in relationships where they are completely dependent on a man. But, we can continue trying to empower women, and other disempowered members of society, with education and support.
I wish there were no longer babies being born with HIV.
For me, this is one of the saddest situations related to HIV medicine. Sometimes women get infected with HIV while pregnant, and do not get diagnosed in time. In other situations, women who know they have HIV, simply choose not to take the required medication, often because of the effect of illicit drug use, or mental illness. But the worst, for me, is when the medical system falls short for pregnant women, failing to diagnose and appropriately treat their HIV infection to prevent transmission to the unborn child. Mother to child transmission of HIV has decreased significantly over the years, but is not yet where it should be – at ZERO.
I wish we had a cure for HIV.
Unfortunately this virus has shown us how smart it is, and to date has eluded complete eradication from the body. Prevention of infection is possible of course, however there are multiple, mostly social and cultural factors, that makes this a challenge, resulting in continued new infections every, single, day.
There is however, an HIV vaccine trial that is just getting underway in South Africa, one of the largest such trials to date. Everyone is hoping that this trial results in the first licensed vaccine against HIV. Then, we would definitely be on our way to completely eradicating HIV/AIDS from our world.
Lets all put our hands up for #HIVprevention on this World AIDS Day 2016.