It has been a momentous week in terms of HIV activism, with the International AIDS Conference (AIDS 2018) taking place in Amsterdam from 23 to 27 July.
This has seen a number of important announcements around HIV, as well as speeches from advocates such as Prince Harry and Elton John.
For me, as a gay man living with HIV, I was really excited by the PARTNER 2 study. The phrase “Undetectable equals Untransmittable” (U=U) is increasingly known throughout the world.
HIV treatment works by reducing the amount of virus in the blood to undetectable levels. The PARTNER study monitored serodifferent couples, where one partner is HIV negative and the other positive. It looked at instances of condomless sex between them, drawing on the experiences of both straight and LGBTQ couples from across 14 European countries.
PARTNER 1 confirmed that an HIV positive person on effective treatment cannot pass the virus on. PARTNER 2 focused exclusively on same-sex male couples, further strengthening the U=U argument for the LGBTQ community.
Image: Philip Baldwin
U=U has the potential to draw a line under the lingering fears of those less informed about HIV. HIV stigma remains rife, even within the LGBTQ community. I have encountered this first hand. Some guys have reacted very badly to my HIV status. On one occasion, upon finding out that I was diagnosed with HIV at the age of 24, then hepatitis C a week later, my date told me that I was a “dirty slut.” He added that I must have slept around a lot to become HIV positive at that age and he wanted to stay “clean”. U=U goes straight to the core of the stigma surrounding HIV.
Other countries might say that we are extremely fortunate in the UK, having seen a dramatic decline in HIV diagnoses. The last full set of data showed an 18% drop in diagnoses across the UK, with this figure increasing to 21% amongst gay and bisexual men.
The UK is a world leader, although many issues remain. We are seeing a generation ageing with HIV. As an HIV positive person ages, they become increasingly susceptible to comorbities, where an individual has more than one long term condition.
Pre-Exposure Prophylaxis (PrEP) also needs to be available to all who are at risk. It is great that the Terrence Higgins Trust are launching a PrEP Access Fund for those who cannot afford the drugs in England and Northern Ireland, but frustrating that a charity is having to step in to achieve this.
We will get to a point in the UK where HIV transmissions are rarer, but it cannot be ignored that, in 2016, there were still 2,810 new HIV diagnoses amongst gay and bisexual men.
It has been reiterated multiple times at AIDS 2018 that we cannot afford to be complacent. Globally, since the beginning of the epidemic, it is estimated that 76 million people have become HIV positive. Half of them have died. There were 1.6 million new HIV diagnoses in 2016, which is roughly the same number as in 2017. Deaths from HIV did decline between 2016 and 2017, but from just below one million to 940,000. Globally we may be seeing more people than ever accessing HIV treatment, but new infections and deaths remain high.
It is possible to quote statistic after statistic, but as one speaker poignantly reminded me last week, behind these figures are real people. Friends, siblings, parents and children are being lost to AIDS. Global conferences are an opportunity for UK health professionals and campaigners to learn what is taking place in other countries, as well as sharing our own expertise. I am continually inspired by the stories of other HIV positive people and by the campaigning which is taking place in the UK and further afield.
AIDS 2018 has brought people together in all their glorious diversity. Positive news, such as the findings of PARTNER 2 provide great hope, but if we are truly to defeat the killer that is HIV/AIDS we must work together and advocate relentlessly, on treatment, prevention and against stigma.