Global HIV/AIDS Fight at Crossroads After COVID-19 Setbacks

HThe hard-won HIV progress has stalled and put millions at risk. This alarming Wednesday report outlines how the COVID-19 Pandemic and other global crises threaten efforts to eradicate AIDS.

The decades-long global decline in HIV infection rates is finally slowing down. According to UN agency, leading global AIDS battle, the United Nations, the cases have started rising in Asia and the Pacific, where previously they had fallen.

Last year, the number of HIV-positive people grew slower than in any decade. These inequalities are increasing. Every two minutes last year, a teen girl or young woman was newly infected — and in sub-Saharan Africa, they’re three times as likely to get HIV as boys and men the same age. According to the report, 650,000 HIV-related deaths occurred last year.

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“This is an alarm to the world to say that COVID-19 has blown the AIDS response significantly off track,” said Matthew Kavanagh, deputy executive director of UNAIDS.

U.N. set the goal to reduce HIV infection by 370,000 per year by 2025. Last year, there were about 1.5 million — meaning it would take a major turnaround to get anywhere near that target. However, $8 billion remains to be spent on funding for countries of low or middle income, and international aid has also dropped.

It is possible that things could get worse as HIV testing was stopped or slowed in some places after COVID-19 struck, possibly allowing for even greater virus spread.

“People are exhausted with epidemics and pandemics,” said Dr. Anthony Fauci, the U.S. government’s leading AIDS expert. “We have to fight twice as hard to get HIV back on the radar screen where it belongs.”

The sobering news comes as the International AIDS Conference begins this week in Montreal — where some promising science is being reported. Here are some highlights

— A man who had lived with HIV for about 30 years is in long-term remission and just might be one of only a handful of people worldwide ever considered cured, thanks to a special bone marrow-like transplant.

Patients with HIV who have leukemia or need stem cell transplants to combat the disease, cannot receive this kind of rigorous treatment. This man’s donor happened to carry a rare gene mutation that makes the newly transplanted cells resistant to HIV.

Continue reading: What Researchers Have Learned About Whether it’s Possible to ‘Cure’ HIV

In 2019, the man (now 66) underwent the transplant. He was 66 years old when the COVID-19 epidemic began. Soon thereafter, he decided that he would continue to take HIV medication until he could be vaccinated. He’s now been off anti-AIDS medication for 17 months with no signs of HIV, Dr. Jana Dickter of City of Hope, a California cancer research center, said Wednesday.

This makes him the longest living person infected with HIV and is eligible for a potentially curative transplant. Scientists are hopeful that these unusual cases will provide insight into better treatment options for other people.

Also Wednesday, University of Barcelona researchers reported that a woman’s own immune system seems to have kept her HIV tamped down to an undetectable level for 15 years. The woman was part of a research study in 2006 that included some immune-boosting treatments but it’s not clear why she’s faring so well.

— Another study presented Wednesday found that taking an antibiotic after unprotected sex could reduce the chances of getting gonorrhea, chlamydia or syphilis.

Different bacteria types can be responsible for sexually transmitted infections. They are a rising threat, especially among people who also have — or are at high risk for — HIV.

Continue reading: For HIV/AIDS Survivors, COVID-19 Reawakened Old Trauma—And Renewed Calls for Change

In Seattle and San Francisco, researchers gave study participants — gay men, bisexual men and transgender women — the antibiotic doxycycline with instructions to take a single dose within 72 hours whenever they had sex without using a condom. The risk of getting infected fell by more than 60% among those who received it, according to Annie Luetkemeyer from the University of California San Francisco.

Before experts recommend that strategy, they’ll need to know if it could worsen antibiotic resistance, making either the STDs themselves or other bacteria people encounter harder to treat. While the Centers for Disease Control and Prevention indicated that it would carefully review this, they posted on-line some precautions for people considering using doxycycline.

— The UNAIDS report showed the public health fight against HIV is getting harder, but there are a few bright spots. Scientists reported Wednesday that Botswana has already achieved key goals for 2025: More than 95% know their HIV status and 95% are being treated. Signs that their virus is suppressed include more than 95% receiving treatment.

Kavanagh praised Botswana for strong policy changes that “helped more and more people into care,” including free HIV medications, pushing home HIV testing and decriminalizing same-sex relationships.

UNAIDS executive director Winnie Byanyima said it’s not too late to get back on track despite the continued COVID-19 and economic crises.

“Ending AIDS would cost much less money than not ending AIDS,” she said. “The actions needed to end AIDS are also key for overcoming other pandemics.”

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