Stephen Lewis: World AIDS Day–AIDS Isn’t Over
Celebrated humanitarian, former UN Special Envoy for HIV/AIDS in Africa, and the co-founder and co-director of the organization AIDS-Free World, Stephen Lewis is a leader in the global fight against HIV/AIDS. In recognition of World AIDS Day yesterday, he put together the above message to let people know that HIV/AIDS isn’t over and that there is still much to be done.
Facts about HIV/AIDS:
1. Half of all people with HIV don’t know it.
Half of all people living with HIV worldwide don’t know they have the virus.
2. 35.3 million people are living with HIV.
Globally, 35.3 million people are living with HIV today, a number the size of the population of Canada. The vast majority—25 million—are in sub-Saharan Africa, where 1 in 20 people is living with the virus.
3. There is still an orphan crisis.
There is still a huge orphan crisis in sub-Saharan Africa. Although orphans have largely faded from the headlines, there are currently 16 million children who have lost a parent to AIDS—a number equivalent to every man, woman, and child in Norway, Finland, and Denmark. Research in South Africa shows that AIDS orphans and those with AIDS-sick caregivers experience cumulative trauma that makes them even more vulnerable to food insecurity, psychological distress, and stigma than impoverished children orphaned by other causes
4. AIDS deaths have decreased overall, but have increased in many countries.
Deaths caused by AIDS have increased in at least 40 countries. In 2012, 1.6 million people died of AIDS-related causes—nearly three times the number of all cancer deaths in the United States during the same period.
5. Most people who need treatment to prolong their lives aren’t getting it.
Recent changes to World Health Organization guidelines mean that people diagnosed with HIV should be started on anti-retroviral drugs sooner after diagnosis. In low- and middle-income countries, which include all sub-Saharan African countries, 28.6 million people need the life-prolonging drugs now. Only one-third are receiving them.
6. Most children living with HIV aren’t getting the life-saving treatment they need.
In 2012, only a third of the children living with HIV who should have been on anti-retroviral drugs to prolong their lives received them. The World Health Organization recently expanded its criteria for those who should receive treatment, and so the number of children on pediatric drugs is now an even smaller fraction of those who need them to survive.
7. Adolescents are falling through the cracks.
Too old for pediatric HIV treatment programs and too young for adult prevention programs, adolescents aged 10 to 19 are falling through the cracks. Over 2 million are now living with HIV. AIDS-related deaths in this age group have risen by 50% since 2006. Far too many of the young people who do get tested are only started on treatment once they are very ill.
8. New HIV infections are actually rising in many parts of the world.
HIV epidemics have finally peaked in the hardest-hit regions—but they’re still rising elsewhere. In Eastern Europe and Central Asia, new infections have risen 13% since 2006. East Asia’s rates have gone up 19% since 2001, and 50% more people in the Middle East and North Africa became infected last year than in 2001.
9. Breast is best after all—but no one is telling mothers living with HIV.
Global programs aimed at “zero new infections” in children are using old science. We now know that: (1) a protein discovered in breastmilk this year actually blocks HIV; (2) HIV-positive mothers protect their babies by breastfeeding exclusively for 6 months; and (3) anti-retroviral drugs taken throughout breastfeeding make it safe even when it’s not exclusive. But global programs to prevent HIV in children still: (1) focus on pregnancy and childbirth and all but ignore breastfeeding; (2) give half the women enrolled no drug treatment during breastfeeding; and (3) provide mothers almost no comprehensive, correct infant feeding information or support to exclusively breastfeed. The preventable, tragic result: half of the children who acquired HIV last year became infected during breastfeeding.
10. Bad laws keep HIV alive.
In spite of overwhelming evidence that punitive laws prevent people from accessing HIV testing, care and treatment, 60% of countries have laws and policies in place that prevent people from seeking support. One of the most glaring examples: 76 countries still criminalize same-sex relations, even though men who have sex with men are 22 times more likely to be living with HIV than the general population.
11. Providing clean needles and drug injection equipment saves lives and money.
The rare governments that run needle and injection equipment exchange programs have kept HIV rates as well as public health expenditures low among people who inject drugs. But most countries opt for punishment instead—resulting in negligible improvement in HIV rates for a population at very high risk.
12. Young women are more likely to be infected and less likely to have the knowledge they need to protect them from acquiring HIV.
Among sub-Saharan Africa’s 15-24-year-olds, the rate of HIV for females is 2 ½ times the rate for males. Because pregnant women are tested, a slightly larger percentage of women than men know their status, but after all these decades, information about how HIV spreads is still reaching only 28% of young women.
13. There’s a link between HIV and violence—and not just sexual violence.
It’s common knowledge that an HIV-positive rapist can transmit the virus. But rape by someone who is HIV-negative can also increase a victim’s future HIV risk by causing STIs, post-traumatic stress, or depression. And victims of intimate partner violence are 50% more likely than others to acquire HIV.
14. New, aggressive strains of HIV are still being discovered.
Swedish researchers have discovered a new, more aggressive strain of HIV in Guinea-Bissau, West Africa. The ‘recombinant’ form, a fusion of two existing strains of HIV, progresses to AIDS within five years—2-2 1/2 years faster than the original strains. The researchers warn that many other aggressive recombinant forms, as yet undiscovered, may now be spreading in Europe, the US, and other parts of the world.