Re-energizing HIV Prevention

Re-posted with permission by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Read the original.

By Mark Dybul, Executive Director (November, 29, 2016)

An indispensable element of our efforts to end HIV as an epidemic — prevention — is lagging too far behind, and allowing too many people to be infected with the virus.

An estimated 2.1 million people were newly infected with HIV in 2015. That includes 1.9 million adults — a number that has remained steady from 2010 to 2015 — as well as more than 150,000 children. These are all people who now have to live with a disease we can prevent.

The number of people on HIV treatment is growing steadily — now more than 18 million — and that’s the results of really impressive work by many countries, work that has to continue and expand.

At the same time, to end HIV as an epidemic, we must re-energize the HIV movement with a comprehensive approach that includes medical prevention methods and also goes beyond them to address cultural and structural factors that put people at risk and undermine access to services. We must renew our commitment to people that have been left behind.

Adolescent girls and young women in eastern and southern Africa are disproportionately affected by HIV. In 2015, approximately 7,500 young women were newly diagnosed with HIV every week. To succeed in HIV prevention, we must work faster and more closely with this group and others such as sex workers, men who have sex with men, transgender communities, people who use drugs, migrants and prisoners.

At the Global Fund, we are committed to doing more to boost HIV prevention efforts among all the people who have been left behind in HIV prevention. We will work to accelerate access to comprehensive HIV services — including provision of combination prevention interventions — among key and vulnerable populations, and investing in people-centered and community-led responses.

We will seek to invest vigorously to address structural and human rights-related barriers to health services. Inequality, poverty and discrimination put most affected people at even greater risk of HIV. We will pay increased attention to social determinants that make adolescent girls and young women in high burden settings more vulnerable to HIV. We will seek broad partnerships that promote social justice by building more just and equal societies.

We recognize that to bend the curve of HIV infections, we must continue to build stronger alliances in support of prevention. The commitment by UN member states to the 2016 political declaration to invest at least one quarter of global HIV resources in effective primary prevention programs is a great step in the right direction.

WHO is supporting an increased focus on effective prevention alongside an expansion of antiretroviral therapy. It is also supporting innovations in HIV testing to reach the 14 million people with HIV who remain unaware of their HIV status. We are committed to supporting countries to expand innovative HIV interventions that help us push forward towards ending HIV as a public health threat. In this regard, we welcome WHO’s launch of new recommendations on HIV self-testing and assisted HIV partner notification, which will coincide with World AIDS Day 2016.

Self-testing is a great way to reach people who do not know their HIV status. It is an innovative strategy that will help accelerate access to and uptake of HIV testing. HIV testing is especially pivotal among people who are exposed to higher risk of HIV and who live in areas with low coverage of testing services. The service will be a great way to reach people with HIV who remain unaware of their status.

For it to succeed, global health partners will need to support this initiative to ensure linkages to confirmatory testing, treatment and care for those who test positive. Additionally, further comprehensive prevention efforts should be put in place for people who test HIV-negative.

Self-testing will be a key tool in helping us bend the curve of HIV infections. It is why we support it unequivocally.

Global health partners should all pull together to support this initiative and all other efforts that seek to reduce new HIV infections. Accelerated HIV prevention is not only essential in its own right; it is also the surest way to make treatment sustainable. It is only by tipping the balance against HIV infections that we can truly end HIV as an epidemic.