Around 37 million people worldwide have contracted the Human Immunodeficiency Virus (HIV). HIV weakens the immune system by attacking CD4 cells, also known as T-helper cells, which are a type of white blood cell. There is no cure for HIV/AIDS; someone who contracts HIV will have it for the rest of their life. It is estimated that only about 70% of people living with HIV know that they have it – the virus can remain asymptomatic for many years. The most common routes of HIV transmission are the following: sexual intercourse, sharing needles or injection equipment, blood transfusions, and mother-to-child transmission through pregnancy, childbirth, or breastfeeding. If allowed to progress, HIV will eventually cause Acquired Immunodeficiency Syndrome (AIDS), the most advanced and severe stage of HIV. With the immune system depleted, the body is unable to prevent and manage infections and health problems which would otherwise be insignificant.
Great strides have been made in the treatment and prevention of HIV. The incidence of HIV transmission during medical procedures has been greatly reduced by the screening of blood, sterilization of medical equipment, and other precautions. Outside of the medical context, needle and syringe programs are an effective method of reducing the spread of HIV among people who inject drugs. However, these programs remain rare, in part due to the criminalization of drug use. For HIV-negative people at high risk of contracting the virus, pre-exposure prophylaxis (PrEP) is a medicine which can prevent infection even if one is exposed to the virus. For people living with HIV, treatment with antiretroviral therapy (ART) can lead to a long and healthy life. Moreover, a person whose HIV has been suppressed through effective ART cannot transmit HIV sexually or to their infant through mother-to-child transmission. Still, people on ART need regular medical supervision and support to take their medication as prescribed. Missing doses of medication not only harms the individual’s health but also can contribute to the evolution of drug-resistant strains of HIV.
Medical research has also expanded the availability and accuracy of HIV testing. Rapid diagnostic tests can give results quickly, even in less than an hour. HIV self-test kits allow an individual to test themselves in private, though follow up with a healthcare professional may be needed to confirm a positive diagnosis. In accordance with standards for medical ethics, HIV testing ought to be voluntary and confidential. The World Health Organization recommends that HIV testing be paired with counseling and referral to resources, including voluntary assisted partner notification services.
Even with the existence of effective treatment and prevention options, HIV remains a great public health challenge. Though often overlooked, children and adolescents make up a significant portion of the world’s HIV-positive population, and the virus remains a contributor to infant mortality. For this reason, infants exposed to HIV need testing and treatment just as much as their adult counterparts. Adolescents are also a vulnerable population. Teens often lack accurate information about sexual and reproductive health, and HIV-specific services may be less accessible to youth. Both children and adults can experience discrimination based on HIV status, whether in areas of employment, education, or social services. Finally, while effective antiretroviral therapies exist, they can often be prohibitively expensive for people who lack health insurance or a substantial income. Any adequate solution must both work to reduce the spread of HIV and work to ensure the quality of life for people living with HIV.