UNAIDS Global AIDS Update | 24 Jul 2024

Source: HT 

Why in News? 

Recently, the 2024 UNAIDS Global AIDS Update, titled "The Urgency of Now: AIDS at a Crossroads", presented a critical overview of the current state of the HIV/AIDS epidemic and the global response to it.  

What are the Key Highlights of the Reports? 

• About: 
  • The report underscores the potential to end AIDS as a public health threat by 2030, emphasising the necessity of addressing inequalities, increasing access to prevention and treatment, and ensuring sustainable resources. 
• Progress and Challenges: 
  • Reduction in New HIV Infections and AIDS-Related Deaths: 
    • There has been a 39% reduction in new HIV infections globally since 2010, with sub-Saharan Africa achieving the steepest decline (56%). 
    • In 2023, fewer people acquired HIV than at any point since the late 1980s, and almost 31 million people were receiving antiretroviral therapy (ART). 
    • AIDS-related deaths have decreased to their lowest level since the peak in 2004, largely due to increased access to ART. 
  • Regional Disparities: 
    • While sub-Saharan Africa has seen significant progress, regions such as Eastern Europe, Central Asia, Latin America, and the Middle East and North Africa have experienced rising numbers of new HIV infections. 
    • For the first time, more new HIV infections occurred outside sub-Saharan Africa than within it. 
  • Key Affected Groups: 
    • Key populations, including sex workers, men who have sex with men, people who inject drugs, transgender people, and people in prisons, continue to face high risks of HIV infection due to inadequate prevention programs and persistent stigma and discrimination. 
    • Community-led interventions are critical but often underfunded and unrecognized. 
  • Prevention and Treatment Gaps: 
    • HIV prevention efforts are falling short, with notable deficiencies in access to services like pre-exposure prophylaxis (PrEP) and harm reduction for people who inject drugs. 
    • About 9.3 million people living with HIV are not receiving ART, with children and adolescents particularly affected. 

What is HIV/AIDS? 

• About: 
  • HIV/AIDS is a viral infection that attacks the immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. 
  • Left untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get infections or infection-related cancers. 
  • AIDS is the final stage of HIV infection when the immune system is severely damaged and can no longer fight off infections. 
• Causes of HIV/AIDS: 
  • HIV infection is caused by the human immunodeficiency virus (HIV). The virus is transmitted through contact with infected bodily fluids, such as blood, semen, vaginal fluids, rectal fluids, and breast milk. 
  • It can be spread through sexual contact, sharing needles or syringes, from mother to child during childbirth or breastfeeding, and rarely, through blood transfusions or organ transplants. 
• Symptoms of HIV/AIDS: 
  • Clinical Latent Infection: 
    • HIV is still active but reproduces at very low levels. People may not have any symptoms or only mild ones. 
  • Acute HIV Infection: 
    • Symptoms can resemble those of the flu, including fever, swollen lymph nodes, sore throat, rash, muscle and joint aches, and headache. 
  • AIDS: 
    • The symptoms of AIDS are severe and include rapid weight loss, recurring fever or profuse night sweats, extreme and unexplained tiredness etc. 
• Diagnosis of HIV/AIDS: 
  • HIV antibody/antigen tests: These tests detect antibodies or antigens produced by the virus and are usually done on blood or oral fluid. 
  • Nucleic acid tests (NATs): These tests look for the virus itself and can detect HIV infection earlier than antibody tests. 
• Treatment and Management: 
  • Antiretroviral therapy (ART): ART involves taking a combination of HIV medicines every day. ART can't cure HIV, but it can control the virus, allowing people with HIV to live longer, healthier lives and reducing the risk of transmitting the virus to others. 
  • Pre-exposure prophylaxis (PrEP): PrEP is a daily pill for people who don't have HIV but are at risk of getting it. When taken consistently, PrEP can reduce the risk of HIV infection. 
  • A revolutionary HIV drug that reduces the need for a daily cocktail of drugs to half a dozen injections a year has recently been approved in the UK. 

What are the Key Suggestions From the Report? 

• Accelerating HIV Prevention: 
  • The report emphasises the need to expand access to HIV prevention services, particularly for key populations including sex workers, men who have sex with men, people who inject drugs, transgender people, and people in prisons. 
  • Reinstate and fund condom programs for safe sex, especially in regions where their use has declined. 
  • Scale up the availability and use of PrEP, aiming to reach the global target of 21.2 million people using PrEP by 2025. 
• Enhancing Treatment and Care: 
  • Ensure that 95% of people living with HIV are on ART by 2025. Currently, only 77% of people living with HIV are receiving ART. 
  • Improve the diagnosis and treatment of children with HIV. Only 48% of children living with HIV are receiving ART, compared to 78% of adults. 
  • Integrate HIV services with broader health services to improve outcomes and address comorbidities such as tuberculosis, hepatitis, and non-communicable diseases. 

• Addressing Inequalities and Stigma: 
  • Remove harmful laws that criminalise HIV transmission, exposure, and non-disclosure, as well as those targeting key populations. Currently, punitive laws are prevalent in most countries. 
  • Implement programs to reduce stigma and discrimination in health care and community settings. Ensure legal protection and support for people living with HIV and key populations. 

• Community-Led Responses: 
  • Strengthen the role of community-led organisations in delivering HIV services.  
    • The goal is for these organizations to deliver 30% of testing and treatment services and 80% of HIV prevention services for high-risk populations. 
• Sustainable Financing: 
  • Address the significant shortfall in funding for HIV programs. An estimated additional USD 9.5 billion is needed by 2025 to meet the targets. 
  • Explore new funding sources and mechanisms to sustain the HIV response, especially in low- and middle-income countries.