World AIDS Day 2022

Professor David T Evans, OBE NTF QN, Professor in Sexualities and Genders: health and well-being, shares about stopping the stigma and continuing to educate, show support, and raise awareness about HIV and AIDS.

1 December 2022

Are you someone who says: “I can’t believe how time flies so quickly!”? Well, it hardly seems 12 months since I wrote the last blog on HIV, nor presented my belated Professorial Lecture, specifically timed as a World AIDS Day event.

So, what’s happened in the past twelve months, in relation to HIV, in the UK and around the world? Of course, there are mixed pictures everywhere. There are some great successes, with some countries overachieving on UNAIDS’ aim for 90/90/90 (90% of people living with HIV: tested; 90% testing positive for HIV: on treatment; 90% of those on treatment with viral load undetectable (U=U: Undetectable = Uninfectious). Of course, there’s another 90%: to reduce stigmas relating to both HIV and AIDS by at least 90%. The learning we provide to our students in the School of Health Sciences looks at how we can help achieve on all these UNAIDS targets.

Other success stories embrace the continued emphasis on methods of prevention of HIV transmission and disease progression: these resources include effective condom use; early and increased opportunities for HIV testing; Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) medications, and antiretroviral treatments (ART, or HAART) for people living with HIV.

Effective medication brings their blood viral load so low that the virus is no longer a threat to their long-term health and living, and also doubles up for ‘Treatment as Prevention’ (TasP). The National AIDS Trust (NAT, 2022) even has a campaign to end the legal discrimination around fertility rights for people living with HIV. Of course, many of these initiatives are intricately linked to various UN Sustainable Development Goals.

All of these advances in prevention, treatment and care were just pipe dreams to those of us who lived through the early generations of this pandemic!

But, globally and nationally, the world is in danger of slipping on these great advances. UNAIDS (2022) warns that “during the last two years of COVID-19 and other global crises, progress against the HIV pandemic has faltered, resources have shrunk, and millions of lives are at risk as a result”.

COVID-19 has had a huge (global) impact on HIV prevention, treatment and care, through loss of funding; decrease in early testing and on-going viral load monitoring; difficulties for people accessing services and treatment. Putin’s war against Ukraine has displaced millions, potentially disrupting HIV testing, treatment and care. Then came alerts (and the usual panic, fears and stigmas) of yet another new infection: Monkey Pox.

Set all of these healthcare challenges in relation to the Government’s commitment in England, (DHSC, 2021), to “Prevent, test, treat and retain” (i.e., “retain in services”): that sounds great! Well, until you read the report only just out, by the Local Government Association (LGA, 2022) which warns: “Councils are facing a perfect storm of increased demand for services whilst at the same time continued cuts to their funding. This is unsustainable and risks a reversal in the encouraging fall in some STIs [including HIV] and potential increases in unwanted pregnancies.”

So, if you are interested in sexual and reproductive health, including HIV, now is not the time to rest on your laurels and think we are doing as well as we could be. Carry on!