LivingDebate on HIV and AIDS: how to combat stigma...

Debate on HIV and AIDS: how to combat stigma and improve prevention

Since it was isolated for the first time in 1984 (work that we owe to the scientists Françoise Barré-Sinoussi and Luc Montagnier), HIV, which ultimately causes the Acquired Immune Deficiency Syndrome (AIDS for its acronym in English), is one of the most popular viruses worldwide. However, decades after its discovery, it continues to star in serious misinformation and the stigma falls on the people who suffer from it.

To begin with, HIV (refers to the virus itself, which affects the cells of the immune system) and AIDS (when HIV infection is in its most advanced stage) are often identified as synonyms, although in fact there are many differences among them. Although the incidence of AIDS has decreased in the last two decades, the same does not happen with the incidence of people with HIV, which presents a flat but constant curve, which indicates that there is still much to do in terms of prevention and disclosure.

On the occasion of World Day to Fight AIDS, and keeping all these data in mind, Muy Interesante together with Gaceta Médica, El Global and Marie Claire has contributed to the celebration of the current debate on HIV , in which we have had the privilege to chat with health professionals and patient representatives, to bring a realistic and committed vision of this virus, and address possible courses of action for the coming years.

The debate, (moderated by Santiago de Quiroga, CEO of WeCare-U Comunicación SL. And Enrique Coperías, director of Muy Interesante magazine) used as the main slogan the formula that results in the objective to be achieved regarding this virus: + Prevention , + Awareness and –Stigma.

In order to understand the current situation regarding AIDS and HIV, we must provide some facts. In 2015, 500 people died of AIDS in Spain, a low rate. However, there are 4,000 people diagnosed with HIV annually each year , as revealed by José María Gatell Artiagas, Professor of Medicine at the University of Barcelona, at the beginning of the session.

The incidence data has hardly changed in years, that is, the trend is slightly flat, indicating that there is still much to do. In this sense, we must focus on prevention, and experts recall that Spain still has to learn from other European countries, which are already implementing some cutting-edge measures. Experts say that to achieve 0 contagion, pre-exposure prophylaxis must be implemented as soon as possible in our country.

However, the work carried out in Primary Care is already a lot, such as health facilities, trained professionals and the important work of mediation. “Thanks to the mediators, we can approach patients who are not going to come to perform the test themselves, but we can reach them,” recalled Pedro Medina, from Primary Care of the Madrid Health Service. Only in Madrid there are around 800-1,000 new cases of HIV per year.

For this reason, given that universal health can offer it, the infectologist Juan Carlos López, from the Gregorio Marañón Hospital, recalls where efforts must be focused: “We must add HIV screening and take advantage of the opportunity that the patient is in the Health System”.

For his part, Dr. Juan Carlos L. Bernaldo de Quirós, warned the following: “We must act especially on people who are infected and are not diagnosed. 70% of the new infections come from this group ”.

In this sense, a data is worrying: around 18-20% of people who are infected with HIV do not know it.

The role of the HIV patient is critical. Therefore, it is important to be close to them. “We work together with NGOs to be close to patients, reveal their emotions and know their needs to improve prevention,” acknowledged Pedro Soriano, from the Madrid School of Health.

The voice of the patients, of course, was also present in the debate. Very important was the voice of Ramón Espacio, president of CESIDA (State Coordinator of HIV and AIDS): “Sexually active people should be screened every 3 months; that would be the ideal ”.

We also talk about stigma, since only 10% of people who have the virus communicate it. To combat stigma, Ramón Espacio recognizes that administrations have a key role. “For example, still today by law a person is forced to leave certain jobs, such as that of a security guard, if they have HIV. This must be eliminated ”.

Although there are fewer and fewer deaths from AIDS, because therapies ensure a long life expectancy for patients, HIV brings with it other not inconsiderable complications, which we must not overlook. What is worrying, as was discussed in the debate, is that there is a perception of risk or contagion, especially among the youngest.

The experts also set out what is the ideal goal in the fight against AIDS and HIV for 2020: the 90-90-90 goal. That is, to achieve that 90% of patients with HIV are diagnosed; that of them, 90% are treated; and that of the latter, 90% have achieved viral suspension.

And with these perspectives, the current debate on HIV was closed, waiting to improve prevention and disseminate about this disease, unfortunately, still highly stigmatized.

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