World AIDS Day: Where We Are Now

This Saturday is World AIDS Day, a day to pause and reflect on the horrendous history of the virus and to look to what we can do for the future. There have been great achievements over the last few years, we’ve seen HIV rates drop across the developed world, we’ve seen the advent of PrEP and other drugs, and we’ve seen the slow erosion of the stigmatisation faced by HIV-positive people.

“New HIV diagnoses are declining in the UK. Over the past two years alone, they have dropped by an incredible 28 per cent nationally,” Prince Harry said during the National HIV Testing Week he fronted this month.

“Getting tested has helped play a major role in this shift.”

He’s right. HIV rates have dropped significantly in the UK, from 2015 to 2016, the number of people being diagnosed with HIV dropped by 18 per cent, that number goes down with every year.

“New HIV diagnoses are declining in the UK. Over the past two years alone, they have dropped by an incredible 28 per cent nationally.”

Campaigns like the National HIV Testing Week aim to continue this trend, because while diagnoses are dropping the UK still has some of the worst rates of infection in the world, especially among certain demographics.

“(The campaign is) aimed at gay men and African people, because those are the two groups of people with the highest rates of HIV here,” said Terrence Higgins Trust policy director Lisa Power.

Current estimates have it at 89,400 people living with HIV in England, with 10,400 who are undiagnosed.

“One gay man in 10 in London, and one in 20 in the country, has HIV. For people in Africa and living here, it’s about the same,” explains Power.

“That’s as high, or higher, than many of the countries which we think of as centres of the epidemic.”

“One gay man in 10 in London, and one in 20 in the country, has HIV."

While encouraging regular testing is definitely part of lowering infection rates new medical developments like PrEP have done even more. PrEP, or Pre-Exposure Prophylaxis, is a ground-breaking drug that if taken every day (or in the lead up to sexual intercourse) can prevent an uninfected person from catching HIV. The drug has been given to those deemed high risk – men who regularly have sex with men – and the results have been incredible: a recent trial in Australia found PrEP cut HIV transmissions by 25 percent.

CurrentlyPrEP is being trialled as part of the Impact Trial in England which began in September 2017 and is testing the effectiveness of the drug on 13,000 people - though the NHS has been under pressure to roll out PrEP on a wider scale.

The combination of testing and PrEP caused NAMto declare last year that the UK is moving to a complete elimination of HIV transmissionaltogether.

“The progress we have made in diagnosing, treating and preventing HIV has been astonishing,” saidMatthew Hodson of NAM aidsmap.

“Twenty-one years ago an HIV diagnosis was considered a death sentence but now life expectancy for someone promptly diagnosed and on treatment is the same as for someone who remains uninfected.

“HIV treatment is now so effective that those who are treated and have an undetectable viral load will not pass the virus on to their sexual partners,” Hodson continues.

“This knowledge strikes to the heart of much of the stigma that people like me, who are living with the virus, experience. I’m delighted that PHE acknowledge that effective treatment can prevent transmission, even for people who have sex without condoms. It’s vital that people with HIV and our sexual partners know that undetectable means untransmittable.”

“HIV diagnosis was considered a death sentence but now life expectancy for someone promptly diagnosed and on treatment is the same as for someone who remains uninfected."

Professor Chloe Orkin of the British HIV Association (BHIVA) said that while these achievements are incredible, we mustn’t slow down our efforts to continue the promotion of testing and the distribution of PrEP to those who need it: “These possibilities make it more important than ever that we normalise HIV testing and recommend it to our patients.

 "In 2017 there is no good reason why any healthcare professional should not be able to offer and recommend HIV testing to their patients, yet time and time again it doesn’t happen, with tragic consequences.”

Scientists across the world are continuing to make progress on new treatments for those living with HIV as well. Israeli-based pharmaceutical company, Zion Medical, recently made headlines with its “potential HIV cure.”

The results of their first clinical trial showed a 99% elimination of the HI virus within four weeks of treatment. While this result is incredibly encouraging, it is still a long way off from being fully developed.

“Much work remains in this mission including additional trials, publication of results and the steps required to make (this treatment) commercially available,” the company said in a statement.

"We are not there yet, but we are a step closer, hopeful – and committed to keeping you informed of our progress."

As for current HIV treatments in 2018, scientists have managed to distill the so-called "triple cocktail" of pills into a single pill, meaning it's now easier than ever to live with HIV.

Those who are undetectable cannot pass on the virus either, with treatment HIV-positive can live long and healthy lives.

By all accounts the future is bright, but it requires us to remain vigil, to continue being tested and to demand access to drugs like PrEP. Together we can reach a transmission rate of zero.

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