Today is World AIDS Day, and whilst we should celebrate the enormous strides that have been made in HIV testing and treatment, Dr Michael Brady tells Better2Know that there’s still more to be done.

Dr Brady is a Consultant in Sexual Health and HIV at the King’s College Hospital in London. He is also the Medical Director at the Terrence Higgins Trust.

World AIDS Day is an important time for us to both reflect and celebrate. We remember those we’ve lost to HIV and AIDS, but also mark the incredible successes that have been achieved since the beginning of the epidemic. It’s a time to not only show our support for those living with and affected by HIV, but also to highlight the work that is still to be done.

There are few medical conditions that have changed so much in such a short space of time. Effective HIV therapy now means a normal life expectancy is a reality for those living with HIV and brings confidence that they will not pass the virus on to others. Having said that, HIV remains a disease of inequalities; disproportionally affecting some groups over others. It is a disease where those affected still experience unacceptable stigma and discrimination.

In the UK we are finally beginning to see real evidence of a turning point in the HIV epidemic. A couple of weeks ago Public Health England (PHE) released their latest HIV Statistics, which showed three remarkable findings:

  1. HIV diagnoses in gay and bisexual men dropped by 21% between 2015 and 2016 – the first decline we’ve seen since the beginning of the epidemic. This is due to reductions in HIV transmission. The estimated annual number of new infections in gay and bisexual men fell from around 2,800 in 2012 to 1,700 in 2016.
  2. In 2016, London, for the first time, met the UNAIDS 90:90:90 target, with 90% of people diagnosed, 97% of those receiving treatment and 97% of those being fully virally suppressed. The rest of England is not far behind with respective figures of 88%, 96% and 97%.
  3. The mortality rate of people aged 15 – 59 who received an early diagnosis for HIV, is in line with the general population of the same age group – demonstrating for the first time that early HIV diagnosis and effective treatment brings a normal life expectancy.

 

These advances are incredible – but it’s not a time to be complacent. What we are seeing is a great start, but we need to keep working. The largest drop in HIV diagnoses has been in gay men, and we now need to ensure that everyone at risk of HIV has access to what we know is working: regular testing, early treatment for those who are positive, and PrEP for those who are negative and at continued risk. Despite our efforts, 12% of people living with HIV remain undiagnosed and we need new testing strategies, such as self-testing and more widespread testing in General Practice, to address this. We also need a concerted effort to eliminate HIV stigma once and for all.

As we reflect and remember the past, our responsibility for the future is clear. If we can scale up what we have achieved so far, we really could achieve the end of HIV in the UK.




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