New HIV infections on decline but progress still slow

AS the world celebrates World Aids Day on December 1, the Pan American Health Organization (PAHO) is campaigning to put human rights at the forefront of efforts to end the HIV epidemic, with a particular emphasis on expanding access to Pre-Exposure Prophylaxis (PrEP). Under the theme Better with PrEP.

World Aids Day, first observed on December 1, 1988, was started by two public information officers from the World Health Organization (WHO) as an international day to raise awareness about HIV/Aids.

PAHO, via its website, is urging global communities to act decisively as countries work towards ending the epidemic, saying the path is clearer and more achievable when preventive measures like PrEP are made widely available. It describes PrEP as a highly effective HIV prevention strategy for individuals at risk.

Taken before potential exposure, PrEP helps prevent HIV infection, offering a critical tool in halting the spread of the disease. According to PAHO, around 2.7 million people in Latin America and the Caribbean are living with HIV, with new infections highest among key populations, such as gay men, sex workers and people who inject drugs.

PAHO says achieving an undetectable viral load (where the virus is suppressed to levels undetectable by standard tests) allows people living with HIV to live healthy, active lives and prevents transmission to others. However, it says to eliminate the virus, it is crucial to reach everyone affected by the virus.

In addition to advocating for broader access to PrEP, PAHO calls for increased HIV testing and better access to care, highlighting that testing is vital in identifying individuals at risk and linking them to preventive measures like PrEP and treatment. Expanding HIV testing and treatment coverage remains critical in the fight to end the epidemic.

According to a 2023 UNAids report, there were 39.9 million people living with HIV worldwide and 86 per cent knew their status. Also In 2023, 1.3 million people made up new infections and approximately 630,000 people died from Aids-related illnesses.

Despite advancements in antiretroviral therapy (ART), which has helped reduce Aids-related deaths by 69 per cent since 2004, the global response continues to face serious challenges.

Progress has been seen in some regions, particularly in the Caribbean, where new HIV infections have declined by 22 per cent since 2010. However, recent reports showed slow progress, with new infections remaining stable in the past five years.

In 2023, nearly 90 per cent of new infections in the Caribbean were concentrated in just four countries: Cuba, the Dominican Republic, Haiti and Jamaica, underscoring the need for targeted interventions.

The report says coverage has improved globally and 61 per cent of people have achieved viral suppression, but significant gaps remain. Viral suppression refers to HIV treatment that reduces the amount of HIV in the blood and occurs when the viral load falls below 200 copies per millilitre of blood.

In the Caribbean, paediatric treatment remains a critical gap, with only 39 per cent of children living with HIV receiving necessary care. Moreover, legal and social barriers continue to hinder effective responses.

It says many countries still criminalise behaviours associated with higher risk of transmission, such as same-sex relations and sex work, further stigmatising affected populations and complicating efforts to curb the epidemic.

Despite the progress made, funding for HIV programmes continues to fall short of what is needed. In 2023, global funding for response in low- and middle-income countries reached US$19.8 billion, well below the estimated US$29.3 billion required by 2025 to fight the epidemic.

It says countries in the Caribbean and Latin America continue to rely heavily on external funding, with over 70 per cent of HIV-related activities supported by international donors.