HIV Cases and Deaths Are Declining Globally, Lancet HIV Research Says

In a new study published in The Lancet HIV, the new HIV infections and related deaths has seen a sharp decline.

However,  the epidemic still has miles to go before it is completely eradicated.

What’s the research says?

The research indicated that global HIV infections reduced approximately by 22% between 2010 and 2021, while deaths due to the virus has seen a sharp decline by some 40% to less than one million annually.

How? Most of the success is due to advancement in antiretroviral therapy and prevention tools such as Pre-Exposure Prophylaxis, or PrEP.

Dr. Hmwe Kyu, the lead author of the study and an associate professor at the Institute for Health Metrics and Evaluation, explained that the world has made global progress in reducing the number of new HIV infections and deaths from the disease, but there is still work to be done.

“One in every four new infections occurs in Asia, and every other new infection occurs in Africa. More than a million people contract a new HIV infection annually, and a quarter of the 40 million people living with HIV are not being treated.”

Why is there Uneven Progress?

The study reported that the HIV cases were primarily caused by improvements in the sub-Saharan region, most severely affected by the epidemic. Countries like Botswana, Eswatini, Rwanda, Tanzania, and Zimbabwe have made crucial milestones since the mid-1990s in diagnosing and treating HIV.

Other regions, Eastern Europe, Central Asia and the Middle East, recorded an increasing trend in the rate of infection. Here, the proportion of individuals infected with HIV who have viral suppression decreased by more than half from 2003 to 2021.

Globally, 1.3 million new infections were reported in 2023, a figure that is significantly more than the UN’s interim target of 370,000 infections by 2025. In 2023, 630,000 people died from AIDS-related illnesses- the lowest level since 2004 but still more than double the target levels.

The ‘Accessibility’ Issue of the Available Treatments

Highly effective preventative treatments, such as PrEP, which reduces the risk of HIV transmission by 99%, have shown to be very effective in countries with very high access to healthcare. However, only 15% of people needing PrEP received it in 2023; this lack is further exacerbated by discriminatory laws-like anti-gay legislation in Uganda-that inhibit access.

Antiretroviral therapy is still an essential instrument in managing the virus. If well administered, it reduces the virus in the blood to undetectable levels. Nonetheless, almost 9.3 million people, a quarter of the individuals living with HIV globally, are not getting this life-saving treatment.

Hope for more accessible HIV treatment has emerged in the form of a new antiretroviral drug, lenacapavir, administered as a twice-yearly injection and easier to use than current daily pill regimens, showing 100% efficacy in preventing infection in early trials.

However, the high cost of the drug—about $40,000 per person per year—has limited access in low-income countries. The manufacturer of the drug, Gilead, recently made a deal with six generic drugmakers to produce cheaper versions, but millions in affected regions are currently excluded from the agreement.

The development of an HIV vaccine is still not a success, so the treatment-focused approach continues to be the primary solution. “Lenacapavir’s potential was described as ” tremendous” by Dr. Andrew Hill of the UK’s Liverpool University, (The lenacapavir shot is like having a vaccine basically)

Until new potential treatment becomes more accessible, experts stress the need for sustained global investment in prevention, treatment, and education to ensure continued progress.

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