Health workers and NGOs rewrite the meaning of HIV

Survival and quality of life for a person diagnosed and treated with HIV are already achievable goals thanks to therapeutic innovations. In fact, the tasks are different now. Today, one of the most pressing challenges is to provide information adapted to current needs in order to stop the transmission of the virus where questions still exist.

The reality of HIV today is very different from three decades ago, and the needs of people with HIV have changed. In this sense, certain aspects, such as the diagnosis and treatment of comorbid neuropsychiatric diseases such as anxiety, depression or insomnia, the emergence of resistance and the practice of chemsex, are becoming increasingly important to further improve the quality of life of those affected. .

Additionally, adding to these new challenges is the lack of still existing knowledge about the correlation and implications of undetectable = undetectable. Maintaining an undetectable viral load through antiretroviral treatment is critical not only for the individual health of the person with HIV, but also for its significant impact at the community level by reducing viral transmission.

In order to further advance these goals, specialists and members of NGOs focused on this cause took part in the symposium “The Changing Meaning of HIV. Life is undetectable today,” organized by Gilead as part of the XXI National Congress on AIDS and HIV Infection. STI of the Spanish Interdisciplinary Society for AIDS (SEISIDA), which takes place these days in Toledo.

“We know that with drugs alone we will not be able to solve the public health problem that transmission of the virus poses.”

On the part of the HIV community, they insist on fighting the ignorance of people with HIV and society as a whole. To achieve this, they strive to spread awareness on every issue. In this sense, it becomes increasingly important to develop a communication process between the patient and their medical team to ensure a comprehensive approach and provide answers to all the questions they face.

In line with this roadmap, Pau Arbos, Gilead’s Director of HIV, stated that “at Gilead, we have been focused on innovations that will change the meaning of this concept for more than 35 years. However, we know that we cannot solve this problem with drugs alone. Does virus transmission have public health implications? It takes the commitment of every individual to raise public awareness about how to stop HIV infection. “Information is as valuable a tool as treatment in the face of this problem that affects the entire community.”

Conversation about HIV today

For decades, pharmacological treatments have been able to extend the life expectancy of patients, and today one in two people with HIV is over 50 years of age. This new reality creates a veteran patient profile that asks HIV specialists questions with which they have no prior experience.

One of these is the impact of new clinical indicators that should be considered when assessing the success of long-term treatment that is not virologically controlled. This applies to cardiovascular diseases and related neuropsychiatric diseases such as anxiety, depression and insomnia. These conditions are more common and occur earlier in people with HIV than in the general population and are also responsible for the premature aging process.

“Today we see older people with HIV who usually have an undetectable viral load and raise other questions.”

In this sense, Dr. Maria Jesús Pérez Elias, head of the infectious diseases service at the Ramón y Cajal Hospital in Madrid and moderator of the symposium, notes that this is a significant challenge. “Today we see older people with HIV, who typically have an undetectable viral load, raising other questions. For example, we need to assess their cardiovascular risk because they have higher cholesterol levels or blood pressure problems. As doctors, we need to be aware of this. your overall health,” he adds.

Another problem characterizing the current situation with HIV is the practice of chemsex (the intentional use of psychoactive substances before or during sexual relations to increase desire, arousal and their duration) as a risk factor. This practice has been shown to increase the likelihood of vulnerability to HIV1.

Viral replication and the emergence of resistance to some treatments are also adding a new dimension to the conversation about HIV, as they may jeopardize the therapeutic success of treatment. Thus, symposium participants agreed on the need to address these issues holistically, not only by providing access to treatment, but also by offering social, emotional, and educational support to ensure good long-term treatment outcomes.