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The Role of Cities in the HIV Prevention Strategy




Pau Arbós

Senior Business Unit Director HIV at Gilead Spain

Interview

 

Town councils have a relevant role in making cities more inclusive spaces with the LGBTQ+ community. During myGwork’s #WorkPride, we have been able to learn about some of these projects regarding health, migration, employment, inclusive sports, culture, and the elderly members of the LGBTQ+ community. In the field of health, LGBTQ+ people are closer to the reality of living with HIV. The prevention and fight against stigma measures that municipalities can promote help the population in general, and the LGBTQ+ community in particular.

 

How can town councils stop the spread of HIV and the social stigma associated with it?

Town halls are a bulwark for the citizen as they are the closest institution to ensure their interests and needs. More and more councils are developing social health initiatives that guarantee equity and equal opportunities, ensuring the well-being of the most vulnerable populations. In the pandemic, town councils have played a fundamental role in epidemiological surveillance, building bridges with other institutions and organizations. As we have seen during #WorkPride, they support initiatives for prevention, early diagnosis, job integration and a culture of equal opportunities for people living with HIV.

 

The town councils are a key element in achieving healthy cities and their serious involvement of great added value in a variety of topics, such as bringing sexual education closer to the population, launching initiatives for the prevention of HIV and other STIs, creating safe spaces for the most vulnerable groups, working together with the various entities that exist in the cities and creating joint projects to respond to the 2030 objectives.

 

To reduce stigma, associations such as Trabajando en Positivo, Apoyo+ and local LGBTQ+ entities have greatly helped to transmit the message "Undetectable = Untransmissible”

 

How does Gilead collaborate with these associations? How can more awareness be raised about the fact that HIV cannot be passed on by a person on effective medication?

The current challenges are to offer HIV patients robust and simple treatments as soon as possible, with few side effects and with the fewest interactions. To this end, in 2020 Gilead launched the RET Movement project with which is redefining the key factors to guarantee a comprehensive approach for HIV patients. Gilead has incorporated PROs (patient-reported outcomes) into the clinical development of its latest drugs to better adapt to the needs of the patient.

 

At Gilead, we work with one purpose: to transform the lives of people with serious illnesses. To do this, we strive every day to develop innovative therapies that revolutionize the scientific landscape, paying special attention to debilitating diseases such as HIV. For Gilead, innovation goes further, and for this reason, we create and collaborate with non-governmental entities in launch initiatives that contribute to reaching the 2030 targets and reaching the four 95th targets, for which we support prevention and sexuality education, early HIV diagnosis in the most accessible community setting for users, educating about the importance of adherence or the control of viral load, the management of comorbidities, and to help people with HIV have a good quality of life and long-term health, without forgetting, how could it be otherwise, to fight racism, homophobia and transphobia.

 

Science and medicine have made great developments in recent years. What is the medical situation for people living with HIV today?

Today, patients living with HIV are mostly stable, enjoy normal lives and have a life expectancy equal to those without HIV. However, they are not exempt from age-related complications, emerging comorbidities, and even some treatment-related adverse effects. The latest studies show that progress must be made in a multidisciplinary healthcare model. In this way, different professionals in the field of HIV, coordinated by the HIV specialist doctor, can contribute their knowledge so that each patient has access to personalized care (mental health professionals, nutritionists, community teams, etc.), of course, maintaining the main objectives of sustained virological suppression, immune recovery and the absence of opportunistic diseases.

 

What is the strategy promoted by the United Nations Fast-Track Cities (FTC)?

The commitment of UNAIDS is the elimination of AIDS as a public health problem by 2030, although additional efforts are still necessary in terms of stigma and discrimination, quality of life and a reduction in the number of new HIV diagnoses, for which the municipal response in HIV prevention is key.

 

In Spain, the National Plan on AIDS, from the General Directorate of Public Health, of the Ministry of Health, promotes the FTC initiative, reinforcing its commitment to the municipal response in HIV prevention. The objective is to achieve in 2030 the “95-95-95-95 objectives” at the municipal level:

-    95% of people with HIV diagnosed

-    95% of those diagnosed follow adequate treatment on an ongoing basis

-    95% of people in treatment succeed in suppressing their viral load so that they remain healthy and reduce the risk of HIV transmission

-    95% good quality of life and zero discrimination

 

To these four, a fifth “95” was added so that people with the disease have a good quality of life and zero discrimination.

 

Today the FTC cities in Spain are Barcelona, Madrid, Murcia, Palma de Mallorca, Torremolinos, Sevilla, Valencia and Zaragoza. This strategy gives a main role to the municipalities. What actions can they develop?

Last April, the Red Española de Ciudades Saludables (the Spanish Network of Healthy Cities (RECS)) shared initiatives based primarily on facilitating prevention, early diagnosis and linking the most vulnerable populations to social and health care. Likewise, the coordination of municipal teams with regional health services was reinforced. Municipal resources were also allocated to promote equal opportunities at the labor, socio-cultural and care level for the LGBTQ+ group, thus fighting against stigma for this group.

 

What public-private actions allow achieving the 95-95-95-95 objectives?

In our experience, public-private collaboration projects with public administrations, in coordination also with NGOs, are an example of success in carrying out this type of initiative. Projects that support public awareness campaigns, training for professionals and groups, and support to generate evidence in prevention, pre-exposure or in the screening of sexually transmitted diseases. Our desire is to go further and support equal opportunities initiatives for people living with HIV in the areas of the workplace, health, culture and the social, thus supporting the fight against stigma and discrimination.

 

Gilead is one of the pharmaceutical companies that has helped the most in the development of treatments for HIV and has also transferred this commitment to society. What initiatives have you developed with public entities?

We have a scholarship program that involves NGOs and LGBTQ+ groups, we collaborate with municipal groups in screening projects for sexually transmitted diseases, together with their prevention and prophylaxis, projects for the coordination of social health care with hospitals, training patients through LGBTQ+ groups and supporting migrant populations in which women are a group that needs our help.

 

Companies are the productive fabric of cities, whilst also being a space for personal and professional development. Their LGBTQ+ networks have opened new debates regarding making companies more humane. In many of these companies, HIV awareness talks are held. What activities can companies do to ensure that the staff working there are non-judgmental and more knowledgeable about HIV?

Inclusive and diverse companies are the most productive as they contribute to a better work environment by enhancing talent and skills. Equal opportunity is written in Gilead's DNA and fighting stigma is part of our core values as a company. We are very proud of our employees' commitment to fighting stigma and working for a healthier and better world.

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