It’s time to take stock on Tuesday, December 1, the annual day in the fight against AIDS. The targets set by the international community for 2020 will not be achieved, but at the same time, progress is significant on the epidemic front.
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The goals were summarized as 90-90-90: that 90% of people living with HIV know their status, that 90% of them are on treatment, and that of these, 90% have an undetectable viral load . In fact, an estimated 38 million people around the world are currently living with HIV and 26 million of them have access to treatment. It is not enough.
Patient compliance and international solidarity
At the same time, at the end of the world, HIV-positive people now come to seek their free treatment in dispensaries, based on a daily pill of generic medicine produced by laboratories, particularly in India. It took funds from international solidarity and logistics to achieve this success. It is also based on the compliance of the patients treated. They may have a blood test once a year to check that the treatment continues to make their viral load undetectable.
As a result, these 26 million patients, located for their majority in sub-Saharan Africa, have an activity and health comparable to those of people not affected by the epidemic.
A treated patient can be non-contaminating
With an undetectable viral load, the seropositive is no longer a contaminant. Detection and treatment have thus become the main means of preventing the spread of the disease. In 2016, the Kenyan Ministry of Health adopted the recommendation of the World Health Organization (WHO): “Test and treat” systematically. As an example, Médecins sans frontières (MSF) has just released a study carried out in the region of Ndiwa, Kenya, where the prevalence rate was 24% in 2014.
Doctor Mohammed Musoke, MSF medical coordinator in Kenya, talks about this experience: “We have worked to make major improvements around the three main pillars of HIV care: raising awareness of the need to know their HIV status, maximizing the number of HIV-positive people on antiretroviral therapy, and increasing the number people on treatment with an undetectable viral load. We thus aimed to reduce the rate of new infections and, ultimately, the presence of the virus in the population ”.
Testing to reduce the prevalence rate
A massive effort has been made to offer the population of Ndiwa to be tested and to provide HIV-positive access to treatment if necessary. Four years later, 93% of the population of this Kenyan region knew their HIV status – compared to 59% previously – and 97% of HIV-positive people were receiving antiretroviral treatment, compared to 68% in 2012. 95% of people receiving treatment had HIV. undetectable viral load, 11% more than in 2012. In 2018, MSF established that the prevalence rate in the region had increased to 17%.