HIV and AIDS has been with us for 4 decades or so. Some 40 million people have tragically died. For a long time, HIV was perhaps THE dominant healthcare issue but in recent years this has perhaps changed somewhat so let’s take a look at HIV in 2022…
Human Immunodeficiency Virus was first identified in the 1980s. Probably originating in primates, HIV was first seen in men having sex with men, giving rise to the initial misconception that HIV was a “lifestyle disease” that infected and affected gay people only. It soon emerged that heterosexual transmission was the most common mode of transmission and so HIV became a worldwide pandemic where all sexually active adults were at risk. Africa, especially eastern and Southern Africa, has borne the brunt of this pandemic throughout. Today, of the 40 million or so people living with HIV worldwide, more than half are African.
South Africa has been seen as “ground zero” wrt to the HIV pandemic: some 7-8 million people – close to 20% of SA adults – are HIV positive in South Africa.
HIV has ever been a disease associated with stigma and prejudice. There are many and complex reasons for this, many of which are controversial and or beyond the scope of this article. Societal, economic, cultural, religious, political, and other factors are at play here. Each of us should guard against any form of prejudice or discrimination, with good knowledge of the real facts probably the best way to ensure we are part of the solution, not the problem.
HIV is spread through sexual intimacy (oral sex, vaginal sex, anal sex), blood transfusion, and from mother to child in pregnancy. Of these, sexual spread is by far the most common and most important – in most cases the other two are either avoidable (e.g. testing of blood pre-transfusion) and or manageable (e.g. special procedures and medications during pregnancy and childbirth).
There is no cure for HIV (as at mid-2022 we are starting to see a handful of named patients who appear to have maintained zero-detected-virus status for some time, and this may equate to “cure” but it is too soon to say definitively). Modern antiretroviral drugs (ARVs) do however suppress HIV very effectively. They are also quite well tolerated and fairly affordable. This is a good-news story and most people with HIV can live a long and good life.
The advent of the coronavirus pandemic of 2020 has dominated healthcare (and other) thinking worldwide for some time. This is obviously both understandable and appropriate. But HIV certainly remains a major concern worldwide, most especially in Africa. More happily, good proven effective treatments are available and so the current strategy around HIV is and should remain avoiding stigma while always encouraging testing and early treatment for all in need.
Written by Dr Colin Burns
