Since the 1980s, when HIV and AIDS first became widely-known, detection and treatment has come on leaps and bounds – although much of the stigma remains.
People diagnosed with HIV, which is the virus that can trigger the immune deficiency syndrome AIDS, can now take a daily pill which makes it undetectable and untransmissible to others. However, many people don’t realise this, and still worry that coming into contact with someone who has the virus means they’ll catch it themselves.
Richard Angell, campaigns director at the HIV charity the Terrence Higgins Trust (THT, tht.org.uk) says:
“In the Eighties when AIDS first hit, there was very little you could do for people other than care for them at end of life. Treatment for the virus became available in 1996, but the issue with HIV is that while you can now take a daily pill to control the virus, there’s no pill you can take to control the stigma.
“Regrettably, half of British people wouldn’t kiss someone with living HIV, so the stigma is real and really impacts people living with HIV.”
There are many people affected by that unnecessary stigma – around 107,000 people live with HIV in the UK and Ireland, and while many may be gay or bisexual men, they’re by no means the only group of people who have the virus.
The THT says that of the 4,139 people diagnosed with HIV in the UK in 2019, 41% were gay or bisexual men, but 1,559 heterosexual people were diagnosed with it too. Of these, 37% were from the other high risk group of black African men and women. In addition, women accounted for 28% of new diagnoses.
Angell stresses that because of the huge advances in treatment, those diagnosed with HIV can lead happy, healthy lives and have a normal life expectancy if they’re taking effective medication.
Here, the THT outlines the advances in HIV testing and treatment…
Angell says that while there’s still no cure and no vaccine against HIV, “Treatment has come on in leaps and bounds.” Usually it’s a daily pill which reduces the virus in people’s blood.
“You can get what’s known as an undetectable viral load,” explains Angell, “and that means there’s so little HIV in your system that it can’t attack your immune system any longer, so it can recover. It means you can have a happy, healthy life where you’re not susceptible to other illnesses in the way people were with the virus. That really is a huge step forward.”
When treatment has made the virus undetectable, it can’t be passed on to others, including pregnant women living with HIV who won’t pass it on to their unborn baby.
“Another huge step forward is that when you’ve got an undetectable viral load, you can’t pass on the virus to a sexual partner or if you’re pregnant,” explains Angell. “We call this U=U, which means undetectable equals untransmissible. So if you’re on effective treatment, you can’t pass on the virus.”
A new long-lasting injectable HIV treatment, where injections are given every two months instead of a daily pill, was approved for use in England and Wales last month, bringing them in line with Scotland, which approved the new treatment in October. The National AIDS Trust (nat.org.uk) says it’s usual for Northern Ireland to follow the recommendations made in England and Wales.
Angell says: “Every other month you’d get an injection in your bum which lasts for two months – so you’d have it six times a year. That’s a huge step forward – it’s been approved, and will be available to patients in the new year.”
The Government’s new HIV Action Plan includes £20m over three years to fund opt-out HIV testing, where HIV testing is offered routinely, in accident emergency departments in areas with the highest HIV prevalence.
Treatment to prevent transmission
A new treatment called PrEP (pre-exposure prophylaxis) can be taken before being exposed to HIV, providing enough of the drug inside a person to block HIV. It is taken by HIV-negative people before and after sex, and the tablet is available on the NHS from sexual health clinics.
“Another thing that’s changed is that we now use PrEP,” says Angell. “It means if HIV is in your system, it can’t take hold. That’s huge.”
He adds: “Essentially, we want a world where there’s no new transmissions of HIV, aiming for a 2030 goal where there will be no new cases. The UK is a good news story – we’re taking action, and it’s working, broadly.”
To find out more visit the Terrance Higgins Trust.