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April 19, 2023

From Awareness to Action: How the World Continues to Fight HIV and AIDS

HIV testing is an important part in ending the HIV/AIDS epidemic. Knowledge of HIV status helps prevent HIV infections for you and your sexual partner(s).

What is the HIV/AIDS epidemic?

Human immunodeficiency virus (HIV) is a virus that weakens the body’s immune system and if left untreated, eventually progresses into a more advanced form of the infection known as acquired immune deficiency syndrome or, more commonly, AIDS. [1]

Scientific advancements in HIV treatment and prevention have helped reduce transmission and HIV-related deaths, but social and economic barriers to implementing HIV services continue to plague efforts to bring an end to the HIV epidemic. [2]

Current state of the HIV/AIDS epidemic

Information from the HIV.gov website shows that in 2021:

There were ~38.4 million people with HIV infections worldwide. [3]
~5.9 million people with HIV were not aware of their HIV status. [3]
~650,000 people died from AIDS-related illnesses worldwide. [3]

While the current state of the epidemic might feel overwhelming, major innovations in testing, treatment, and prevention of HIV have seen these numbers steadily decline over the years. [3] Barriers such as accessibility, stigma, and criminalization perpetuate the spread of the infection throughout vulnerable communities worldwide.

Governments and organizations like the Elton John AIDS Foundation (EJAF), community-based organizations, plus individuals around the globe are actively working toward expanding access to sexual health services for vulnerable communities and advocating for those currently impacted by the HIV/AIDS epidemic. Here is a snapshot of some of the systematic changes that need your support:

Expand Access to HIV testing

The Centers for Disease Control and Prevention (CDC) reports that, as of 2019, less than 40% of people in the U.S. have ever been tested for HIV, HIV status. [4][5]

Understanding your HIV status plays two crucial roles in helping to end the HIV/AIDS epidemic: prevents ongoing disease transmission and allows those living with HIV to engage with treatment to slow the progression of the infection and lead long, healthy lives.

But many in the U.S. lack convenient access to HIV testing, facing barriers to care like transportation, geographic location, and stigma. In fact, about one-third of people receive a diagnosis less than one year before the infection has progressed into AIDS. [6]

Advocating for more convenient testing options that meet people where they’re at can help to slow the spread of infection and protect more people from immune system damage that occurs when the HIV infection remains unchecked. It’s also important that if you have access to testing you follow the latest CDC recommendations around HIV testing to play your part in the effort to end the HIV/AIDS epidemic. Knowing your own HIV status not only protects you but also your sexual partner(s).

Improve HIV-related health outcomes

The first antiretroviral therapy (ART) medication was approved by the U.S. Food & Drug Administration (FDA) in 1987 and was promising in the short term for inhibiting the replication of the HIV virus, but it wasn’t long before multiple resistance mutations occurred and led to long term treatment consequences. [7]

Innovation pressed on and by the mid-’90s, the U.S. Centers for Disease Control and Prevention (CDC) reported the first substantial decline in HIV/AIDS-related deaths in the United States, due largely to the use of highly active antiretroviral therapy (HAART). [8]

Today, antiretroviral therapy drugs are highly effective in suppressing HIV viral load, restoring immune function, and improving the overall quality of life for those living with HIV infection. [9]

Social and logistical barriers like stigma, transportation, and lack of medical insurance coverage continue to make it difficult for people to access ART. [10]

Prevent New HIV Infections

Antiretroviral therapies have also been developed to protect those who are currently HIV-negative and may be exposed to the virus. Two of the most prominent HIV prevention options include:

Pre-Exposure Prophylaxis (PrEP) Oral PrEP is typically taken daily by those who do not currently have HIV, but who are at risk of getting HIV to help reduce the risk of HIV infection. [11] This highly effective medication plays a key role in helping to prevent new infections, lowering the risk of HIV by about 99% when taken as prescribed. [12]

And while this medication shows promise for ending the epidemic, there are still a multitude of social and clinical barriers that prevent eligible people from accessing it in the U.S. [12]

CDC data reveals:

In 2020, 1.2 million people in the U.S. were recommended for PrEP, but only ~25% were prescribed it. [13]
Black and Hispanic/Latino populations are recommended PrEP at the highest rates and yet only 9% of Black people and 16% of Hispanic/Latino people eligible were prescribed the medication. [13]
Young people aged 16-24 are also receiving PrEP prescriptions at a low rate with only 16% of eligible people in this age bracket accessing PrEP medication. [13]
Studies also show high levels of awareness about PrEP medication amongst transgender women, but very low uptake even though this demographic is at high risk for HIV infection due to social and economic factors. [13]

PrEP stigma is a major social barrier to PrEP uptake and adherence. [14]

While PrEP is specifically designed to prevent HIV infection, PrEP stigma and HIV stigma are inextricably linked. Studies reveal that potential and current PrEP users are concerned that people will think they are HIV-positive if they are seen taking PrEP medication for prevention. [14] And surveys designed to evaluate PrEP-related attitudes show that people believe that PrEP causes people to participate in riskier sexual behaviors and that they believe people should simply be more careful rather than rely on medication to protect them. [14]

Post-Exposure Prophylaxis (PEP)

PEP is usually reserved for those who experienced one high-risk exposure to HIV and can be taken within 72 hours and continued for 4 weeks.

Those living with HIV can play an important role in preventing transmission and protecting their sexual partners by taking HIV medicines that work to slow the replication of the virus, which helps maintain an undetectable viral load. With such a low amount of HIV, the risk of transmitting the virus to sexual partners is eliminated. [16] There is still a risk of transmitting HIV through shared needles, breastfeeding, and childbirth, although the CDC states that the risk is likely reduced. [16]

Advocating for People Living With HIV

Destigmatize

HIV stigma is largely rooted in fear and outdated misconceptions around the transmission of HIV and what it looks like to live with the infection today. [17]

Some examples of HIV stigma provided by the CDC include: [17]

Believing that only select groups can get HIV.
Morally judging those who seek out HIV testing, treatment, and/or prevention resources.
Feeling like people deserve HIV based on their lifestyle choices, including injecting drugs and the number of sexual partners they choose to have.

These and other stigmas surrounding the HIV/AIDS epidemic are not only morally wrong, but they can be incredibly harmful to HIV-positive individuals and communities. As we work to change the narrative around HIV/AIDS, check out this helpful Stigma Language Guide from the CDC to ensure you’re not unknowingly perpetuating harmful language or beliefs.

Decriminalize

Many people around the world are denied access to healthcare due to their sexual orientation. So, while we all work to battle our own implicit biases and challenge those of our friends and family around us, it’s also important to stand with organizations and advocacy groups who support policy and law changes to ensure every individual has access to non-discriminatory sexual health services.

Demarginalize

HIV is a viral infection, not a social status. But worrying social patterns still exist today, with those who are most vulnerable to HIV infection often siloed in their communities. [18]

The CDC’s 2020 data clearly shows that both sexual minorities and racial minorities experience disproportionately higher levels of HIV infection. Men who have sexual contact with men and Black/African Americans are the two more vulnerable populations in the US. [19]

In a recent HIV/AIDS Prevention Announcement, Dr. Daskalakis, the CDC’s Director of the Division of HIV/AIDS Prevention, responded the following when asked about his “why” in life, “I still get emotional talking about the early days of the AIDS epidemic not because I’m sad, but because I can’t believe how different the story is today. We have the tools at our hands to prevent infection and to keep people living with HIV healthy. Our barrier to achieving this vision is no longer science, it is systemic racism, sexism, homophobia, and transphobia.” [20]

It’s important to not only be an ally to marginalized groups but also advocate for policies that help these marginalized groups break through barriers to sexual healthcare.

At binx health, We Are Doing Our Part

binx health is partnering with the Elton John AIDS Foundation (EJAF) to further advance each other’s efforts in providing access to testing the most hard-to-reach communities. Our program powered by binx everywhere will enable EJAF to offer convenient, remote self-collection for HIV testing at our binx partner lab network as well as convenient PrEP pickup at our partner pharmacies for individuals seeking care.

If you’re an organization looking to implement a program for your populations, visit our website to learn more about our partnership with EJAF and how a program for HIV and other sexually transmitted infections (STIs) can work.

Both binx health and EJAF are committed to doing our part in the effort to end the HIV/AIDS epidemic, and by getting tested, you can play an essential role in this initiative.

Together, we can put an end to the HIV/AIDS epidemic.

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Previous Reading

Innovations and Solutions for Sexually Transmitted Infections (STI) in the U.S.