World AIDS Day takes place on the 1st December each year. It’s an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV, and to commemorate those who have died from an AIDS-related illness. Founded in 1988, World AIDS Day was the first ever global health day.
Acquired Immune Deficiency Syndrome (AIDS) was first observed by doctors in the United States in 1981. The initial cases were a cluster of injecting drug users and homosexual men with no known cause of impaired immunity, who showed symptoms of ‘Pneumocystis carinii pneumonia’ (PCP), a rare opportunistic infection that was known to occur in people with very compromised immune systems. Soon thereafter, an unexpected number of homosexual men developed a previously rare skin cancer, ‘Kaposi's sarcoma’ (KS). Many more cases of PCP and KS emerged, which alerted the U.S. Centers for Disease Control and Prevention (CDC), and a CDC task force was formed to monitor the outbreak.
In these early days, the CDC did not have an official name for the disease, often referring to it by way of the diseases that were associated with it (e.g. lymphadenopathy). It was realised that these terms were misleading, and the term ‘AIDS’ was introduced at a meeting in July 1982. In 1983, two separate research groups found that a novel retrovirus may have been infecting people and causing AIDS. Further research isolated this virus, and, in 1986, the term ‘Human Immunodeficiency Virus’ (HIV) was first used.
In the early years, the treatment provided for people living with HIV consisted of a cocktail of drugs, which needed to be taken at specific times every day and often had uncomfortable side effects. Over the years, treatment has developed and is unrecognisable when compared to early treatments. Treatment now consists of highly active antiretroviral therapy, which slows the progression of HIV / AIDS. These medications contain a combination of drugs, which work on different parts of the virus’s replication cycle. This means that - for the majority of people living with HIV - patients only need to take 1 tablet a day.
Today, people living with HIV can lead normal lives with a next to normal life expectancy, provided that they are taking their medication. They are also able to protect others from HIV. Once they achieve an undetectable viral load, a state where no HIV is detected in their blood, they are unable to transmit the disease to others. Although treatment is highly effective, there is currently no cure for HIV. It is important to regularly test for HIV if you are sexually active; the earlier it is detected, the sooner treatment can begin, protecting yourself and others.
Testing is available across Berkshire in a variety of settings. The two main providers of HIV tests in Berkshire are my clinic, The Florey, based at the Royal Berkshire Hospital, is open 6 days a week Monday-Friday 7am-7pm and Saturday's 9.30am-12pm. The other clinic is run by Thames Valley Positive Support, who provide testing at various locations. You can also order a test which can be completed in the privacy of your home.
In 2014, the United Nations set an ambitious target that, by 2020, 90% of all people living with HIV will know their status, 90% of all people diagnosed with HIV with be receiving treatment, and 90% of all people receiving treatment will have achieved viral suppression (having an undetectable viral load). For the first time in London, this 90:90:90 target has been met. England is just short of the 90% target of diagnosis at 88%, but targets have been exceeded for treatment (96%) and viral suppression (97%).
There are many misconceptions about HIV and AIDS. Two of the most common are that AIDS can spread through casual contact, and that HIV can infect only gay men and drug users. In 2014, some among the British public wrongly thought one could get HIV from kissing (16%), sharing a glass (5%), spitting (16%), a public toilet seat (4%), and coughing or sneezing (5%). Other misconceptions are that any act of anal intercourse between two uninfected gay men can lead to HIV infection.
HIV / AIDS stigma continues to exist around the world in a variety of ways, including ostracism, rejection, discrimination violence and avoidance of HIV infected people. Stigma-related violence, or the fear of violence, often prevents many people from seeking HIV testing, returning for their results, or securing treatment, possibly turning what could be a manageable chronic illness into a death sentence, whilst also perpetuating the spread of HIV.
If you are worried about testing for HIV, please remember that you will always be treated with compassion, and that we are here to help you. By testing, you are not only protecting yourself, but also those you love.
Article by Dan Ellis
Lead Nurse at the Florey Clinic and Reading Pride Ambassador