After 35 years of identifying HIV as a cause of AIDS, there is still stigmatization and ignorance.
On January 23, 1983, Luc Montagnier, of the Pasteur Institute in Paris, identified for the first time the virus that causes AIDS.
HIV: these three letters meant a death sentence 35 years ago, when Star Wars was only a trilogy, when the first personal computer was revolutionizing society as we knew it, and when the virus was first linked to AIDS.
On January 23, 1983, scientist Luc Montagnier, of the Pasteur Institute in Paris, identified for the first time the Human Immunodeficiency Virus (HIV) as the cause of AIDS, a disease then considered rare and detected in homosexual men. It would become one of the worst epidemics in human history.
However, those three letters have come to mean something very different in the last 35 years. Now, people can live with HIV, the knowledge of the disease has improved substantially and a child of an HIV-positive mother can be born free of the virus.
By 2020, the aspiration is that the world has achieved the so-called 90-90-90 goal proposed by UNAIDS, which means that 90 percent of people infected with HIV / AIDS know their status, that 90 percent of they receive antiretroviral treatment, and 90 percent of those in treatment have undetectable levels of the virus in their blood.
However, in Latin America, the Caribbean and Africa "the regions where most people with HIV live " there is still a long way to go to achieve these goals, as UNAIDS notes in its 2017 status report, 'Ending AIDS: progress towards the 90-90-90 targets'.
Only one African country, Botswana, is among the seven countries in the world that have already reached the 90-90-90 target, joining Cambodia, Denmark, Iceland, the United Kingdom, Singapore and Sweden.
In Latin America and the Caribbean, only four countries have achieved at least one of the objectives: Brazil, Chile, Ecuador and Haiti. This happens after some countries in the region made strides in their fight against the disease, especially Cuba, which in 2015 became the first country in the world to eliminate the transmission of HIV from mother to child.
According to the UNAIDS report, despite the remaining challenges, Latin America has made important progress.
For example, the number of people in treatment almost doubled in six years, going from 32 percent in 2010 to 58 percent in 2016. However, the situation is not the same throughout the region, and there are countries like Bolivia, Guatemala, Jamaica, Paraguay, the Dominican Republic and Suriname that still try to overcome the third of seropositives in treatment.
Also, between 2000 and 2016, the increase in treatment coverage also reduced mortality in Latin America by 12 percent and 45 percent in the Caribbean.
In children (0-14 years) "one of the most vulnerable groups" efforts in the region helped to lower infections by 66 percent since 2000, and increase treatment coverage from 17 to 53 percent. in that population.
The problem is that, despite progress, stigma and ignorance continue to hamper efforts to combat the disease on the two continents where the largest population with HIV resides. Many countries still need to work to reverse the stigmatization of certain segments of the population, such as homosexuals and drug users.
In Togo, for example, a survey by the National Center for the Fight against AIDS (CNLS) shows that the infection rate is almost one in five people among gay men, compared to 2.4 percent nationally.
In Rwanda, the prevalence among sex workers is estimated at 45 percent nationwide, and 51 percent in the capital, Kigali, according to a demographic and health survey led by the government in 2015.
' The discrimination that these groups often suffer prevents them from accessing antiretroviral screening and treatment, "Claver Dagnra, coordinator of CNLS in Togo, told SciDev.Net.
But it is not only in Africa where this stigma is devastating. Gracia Violeta Ross, president of the National Network of People Living with HIV and AIDS in Bolivia, believes, for example, that 'stigma is the most serious problem'. 'In Bolivia,' he told SciDev.Net, 'there is very little information about HIV. The current (prejudice) is that it is a disease that should only concern groups at risk, such as men who have sex with men or transgender women. '
Given the success of existing therapies, and as awareness has increased around the world, in recent years, the focus of management against HIV / AIDS has shifted towards the need for all patients to access medication treatment. Tailored antiretrovirals. However, as a result, many observers point out that prevention must once again be placed at the heart of the campaign against HIV / AIDS to halt its progress.
In Colombia, for example, it is estimated that the use of condoms in the general population varies between nine percent in young people in certain medium-sized cities, between 20 and 30 percent in uninfected men and women, and up to 96 percent in seropositive sex workers.
The situation is almost the same in Brazil, which has been a leader in the fight against the disease and was the first country to challenge the patent laws covering the antiretroviral drug AZT, when in 2007 the Brazilian government suspended the patent for the drug efavirenz , which allowed the country to import and manufacture a generic and reduce the cost of treatment.
The main challenge is still to fight against the spread of the disease in remote areas. There, the population is more vulnerable, with limited access to health services and information, lower income, less education and less ability of women to demand condom use, in addition to more cases of child prostitution.
"Since access to retrovirals is universal, the prevention approach has been lost and the focus is only on care," Felipe Varela Ojeda, a researcher at the Center for Analysis and Research of Fundar in Mexico, told SciDev.Net.
And especially, on this aspect of awareness, Marcelo Vila, subregional consultant on HIV, tuberculosis and hepatitis in Argentina believes that 'the biggest challenge is still diagnosis'.
