The Year of No Fear – HIV today

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What does it mean to be HIV positive today?  

I was diagnosed on 12 August this year and I was lucky. I was diagnosed in what I call ‘the year of no fear’.

Thanks to the PARTNER study and the PROUD study our HIV status, be it positive or negative has less potential to polarize and divide us. The PARTNER study showed that condoms were no longer needed to prevent HIV transmission so long as the HIV positive person had an undetectable viral load on HIV treatment (ART). The PROUD study showed that HIV negative men taking daily PrEP (Pre-Exposure Prophylaxis) were protected against HIV transmission, again even without condoms. For the first time in 30 years we truly have the opportunity to live and thrive as HIV equals.

So I was diagnosed as HIV positive and publicly disclosed my status immediately because I felt empowered by this knowledge and fearless because of these studies. Sure, there would be social hurdles but that’s the amazing part – I’m not a Scientist or a Doctor. They have done their bit by affording me these comforts. Now it’s my turn to do my bit. I’m just an everyday person with no clinical background but what I can do is change people and their preconceptions. I can – we all can.

But the opportunities expand well beyond just deconstructing stigma and establishing equality. We now also have the chance to start winning the fight against HIV and AIDS. It’s time to look to San Francisco for the beacon of hope and pioneering example.

San Francisco is the only city that have stabilised their number of new HIV infections. In the last 3 years they have delivered a 30% reduction. The reasons why are simple. TasP (Treatment as Prevention) where anyone diagnosed with HIV is on effective ART (Antiretroviral Therapy) and are therefore undetectable and non-infectious, combined with PrEP for HIV negative people. 

Always seemingly a step ahead, San Francisco embarked on their RAPID initiative, involving 39 men from July 2014 to December 2014, which implemented a process of treatment at point of diagnosis. This in effect speeded up the process of beginning ART (Antiretroviral Therapy), preventing people from falling out of the system by collapsing some of the steps of the care continuum. Thus reducing the window of onward transmission from infectious newly diagnosed patients.

In the UK the clinical benefits of earlier treatment were shown in an international study called START. It is undoubtedly one of the most important HIV studies of the last decade. It was designed to look at the benefits and risks of early HIV treatment (ART). The results were both exciting and reassuring for people living with HIV today. The following is from HIV i-Base.

Main findings include:

  • HIV treatment was safe for people starting HIV meds with a high CD4 count. Many people in START had a CD4 count above 800.
  • Early treatment led to fewer serious AIDS-related illnesses, even at high CD4 counts.
  • The biggest [negative/general health] impact from early treatment was expected to be on illnesses like heart, liver and kidney disease and some non-AIDS cancers. The opposite was true in that early ART reduced HIV-related illnesses. This is big news.
  • The results were similar in both low- and high-income countries. This should result in making HIV treatment more available in all countries.

Secondly, the results show that benefits of treatment and prevention overlap. Other studies have proven that treatment dramatically reduces HIV transmission. Now people using treatment as prevention (TasP) will know there are direct benefits for their own personal health as well as that of the community.

Ultimately, it’s not about us and our generation. I have two 5 year old nephews and I would love to think that by the time they are in their 20’s that we will have managed to reduce our number of new HIV infections in the UK to such a low level that neither of them need ever worry about contracting HIV as I have. It is for them and our children that we need to take responsibility and action now!

We need to manage and reduce this country’s alarming and unacceptably high number of new HIV infections. Let us put the focus back on the AIDS crisis. There is still an AIDS crisis. Not in this country, here in the UK we have a ‘new HIV infections’ issue – not an AIDS crisis. But in sub-Saharan Africa and even as close by as Eastern Europe and Russia they still have an AIDS crisis.

Our brothers and sisters before us did not die of AIDS so that we could become complacent with HIV and allow ourselves to be immersed in AIDS apathy. It started with them, it can end with us. We have the tools to stop and end HIV and AIDS. We need to use them. 

We can’t allow our privileges to diminish our responsibilities in this global healthcare issue.

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