World AIDS Day 2023

World AIDS Day is honored every year on December 1st. For the last 33 years, the World Health Organization (WHO) has acknowledged it as one of the eleven official global public health campaigns. Since its inception in 1988, people worldwide have united on this day to raise awareness about HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome). 

Various organizations conduct awareness campaigns and activities, emphasizing the significance of understanding and combating HIV, as well as addressing the stigma around HIV and AIDS. The day stands as a global moment of solidarity for those living with HIV, honoring those lost to AIDS-related diseases and rallying against the virus spread. 

World AIDS Day 2023 Theme

This year's theme, "LET COMMUNITIES LEAD!" underscores communities' influence in responding to HIV and advancing global health. It's a call to action, recognizing the collective strength of communities in making a positive impact on the ongoing fight against HIV/AIDS.

Importance Of AIDS Awareness: A Statistical Overview

• HIV is a significant global health issue, with 40.4 million lives lost so far and ongoing transmission worldwide.
• Approximately 39.0 million people were living with HIV at the end of 2022, with the number of People Living with HIV (PLHIV) estimated at around 24 lakhs in India.
• In 2022, 630,000 people died from HIV-related causes, and 1.3 million people acquired HIV.
• While there's no cure for HIV, access to effective prevention, diagnosis, and treatment has turned it into a manageable chronic condition.
• WHO, the Global Fund, and UNAIDS (Joint United Nations Programme on HIV/AIDS) have aligned strategies to end the HIV epidemic by 2030.
   

Decoding HIV and AIDS
 

HIV is a virus that strikes our immune system, leading to the most advanced stage, known as Acquired Immune Deficiency Syndrome (AIDS). It weakens white blood cells, making the body susceptible to opportunistic diseases like tuberculosis and infections. The virus spreads through infected body fluids but not through everyday contact. It can also pass from a mother to her baby.
 

Fortunately, HIV can be treated and prevented with anti-retroviral therapy (ART). If left untreated, it can develop into AIDS (advanced HIV disease) after many years. WHO identifies Advanced HIV Disease (AHD) based on CD4 cell count or WHO clinical staging. In adults and adolescents, AHD is indicated by a CD4 count below 200 cells/mm3. In addition, WHO identified WHO's clinical staging: stages 3 and 4 as AHD. For children under five, all HIV cases are considered advanced. 
 

Signs And Symptoms Of AIDS
 

•  Early Stage:

  - Spread more easily in the first months

  - Many are only aware of the later stages

  - Initial weeks may have no symptoms or flu-like signs
 

• Progressive Stage:

  - Weakening of the immune system

  - Symptoms include swollen lymph nodes, loss of weight, fever, diarrhea, and cough
 

• Advanced Stage:  

Severe Illnesses Without Treatment leads to the development of opportunistic infections like:

  - Tuberculosis (TB)

  - Cryptococcal meningitis

  - Severe bacterial infections

  - Cancers like lymphomas and Kaposi's sarcoma

  - Hepatitis C

  - Hepatitis B

  - Pox infections

Transmission Of AIDS
 

AIDS can spread through body fluids: blood, breast milk, semen, and vaginal secretions. Factors increasing the risk of HIV transmission include:

- Unprotected anal or vaginal sex (semen and vaginal secretions)

- Presence of other sexually transmitted infections (STIs)

- Sharing contaminated needles and injecting equipment

- Unsafe medical procedures, including unsterile cutting or piercing

- Accidental needle stick injuries, especially among healthcare workers

- Through breast milk from an HIV-infected mother to the baby.

- Through Organ transplantation: Organ transplant-related HIV risk is low due to donor screening but may not detect recent exposures.

AIDS Testing and Screening

Although HIV tests are highly accurate, none can detect the virus immediately after infection. The timing for HIV detection depends on the test type. There are three types of HIV tests: antibody tests, antigen/antibody tests, and nucleic acid tests (NAT). HIV testing and screening is the gateway to prevention, care, and treatment.

How can I self-test for HIV using home testing kits?

HIV home testing kits offer rapid and convenient testing from the comfort of your home. Simply follow these steps:  

1. Collect a throat swab or blood sample as per the kit instructions.  

2. Place the swab or blood sample in the provided solution or test well.  

3. Wait 20 to 30 minutes for the results, indicated by single or double lines on the kit.  

Through these are reliable, lab testing is necessary to confirm the diagnosis. 
 

Prevention Of AIDS

HIV is preventable through various measures, including the use of condoms during sex, regular testing for HIV and other infections, and considering circumcision for men. Harm reduction services are essential for individuals using drugs. Pre-exposure prophylaxis (PrEP) pills, special rings during sex, and injectable prophylactic antiretroviral drugs are recommended for prevention. Pregnant women at high risk receive antiretroviral drugs to protect their babies. If on treatment, maintaining control of HIV through regular testing and medication ensures non-transmission and overall health.

U-Test: Youth-Friendly HIV Prevention

UNICEF's U-Test uses AI (artificial intelligence) and social media to help young people learn about HIV in a friendly way. It lets them do a simple, private test at home using a kit. If needed, it connects them to support. In places like West Africa, over a million young people have used U-Test, with 10,000 testing themselves for HIV in just a year. It's spreading to more countries, making it easier for young people to get information and support about HIV.
 

Treatment For AIDS

HIV has no cure, but daily anti-retroviral drugs (ART) control the virus, improving overall health. ART lowers virus levels, preventing symptoms and transmission.  Additionally, Complementary therapies for HIV can manage stress and anxiety. Pregnant women with HIV take ART to protect themselves and their babies. Medications like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) help prevent and manage HIV. WHO supports advanced HIV care, and ongoing research seeks more convenient treatments. Overall, ART is a lifelong commitment for a normal life, and its benefits extend beyond individual health.
 

NACO's Holistic Support for HIV Patients in India

National AIDS Control Organization (NACO) addresses the care, support, and treatment needs of HIV-positive individuals tailored to the infection stage. NACO focuses on low-cost care for common opportunistic infections, enhancing ART accessibility for the poor, and strengthening family and community care, particularly for marginalized women and children. Community Care Centres, established in high-prevalence districts, offer counseling, nutritional support, treatment assistance, and legal services. 
 

Busting Myths

Myth: I can get HIV by being around HIV-positive people.

Fact: You can't catch HIV through touch, tears, sweat, saliva, or pee. It is not transmitted by inhaling the same air, using the same toilet seat or touching the door handle, drinking from a water bottle, hugging, kissing, shaking hands, sharing eating utensils, or using exercise equipment at a gym. HIV is only transmitted through infected blood, semen, vaginal fluid, or breast milk.

Myth: I believe oral sex is just as risky when it comes to HIV.

Fact: The risk from oral sex is almost negligible compared with other types of sex. In theory, it seems possible if your partner has HIV, but in reality, that is not the case.

Myth: I believe I would show symptoms if I had HIV, and I can tell if my partner is positive.

Fact: HIV can remain asymptomatic for years. Testing is the only way for you or your partner to determine positivity. Recognizing the prolonged asymptomatic phase, the CDC (Centers for Disease Control and Prevention) recommends testing for everyone between 18 and 64 as part of routine blood work.
 

Take Away

As we mark World AIDS Day, let us collectively prioritize education, dispel misconceptions, and work towards a future where HIV is no longer a global health threat. Together, we can contribute to the goal of ending the HIV epidemic by 2030.

"Anti-retroviral Anthem; Let's March in Harmony Against HIV"