People living with HIV

GENEVA, 27 May 2015— UNAIDS welcomes additional evidence that starting antiretroviral therapy at a higher CD4 (a measure of immune system health) level has a positive effect on the health and well-being of people living with HIV.

“Every person living with HIV should have immediate access to life-saving antiretroviral therapy,” said Michel Sidibé, Executive Director of UNAIDS. “Delaying access to HIV treatment under any pretext is denying the right to health.”

The NIH-funded international randomized clinical trial START (Strategic Timing of Antiretroviral Treatment) has found compelling evidence that the benefits of immediately starting antiretroviral therapy outweigh the risks. Data from the study showed that the risk of AIDS, other serious illnesses or death was reduced by 53% among people who started treatment when their CD4 levels were 500 or above, compared to the group whose treatment was deferred to when their CD4 levels dropped to 350.

The START announcement follows a series of research findings over the past several years indicating the health benefits of starting HIV treatment earlier. The findings from these studies will play an important role in shaping the new treatment guidance from the World Health Organization due to be released later in 2015.

“This is a further demonstration of the importance of science and research that enables an evidence-based, people-centred response to HIV that leaves no one behind,” said Michel Sidibé, Executive Director of UNAIDS. “The findings strongly support the UNAIDS Fast-Track approach to achieving the 90-90-90 HIV treatment targets and ending the AIDS epidemic by 2030.”

UNAIDS reaffirms the importance of respecting a person’s right to know their HIV status and to decide whether and when to begin antiretroviral therapy. HIV treatment decisions must be well-informed and voluntary. Wider and more equitable delivery of antiretroviral therapy will require increased efforts to address the social and legal barriers that inhibit access to health services for people living with HIV, especially marginalized populations.

Evidence of the health benefits of earlier initiation of treatment, combined with previous findings on the impact of antiretroviral medicines on reducing HIV transmission, confirms that antiretroviral therapy is a cornerstone of efforts to save and improve lives as well as to prevent new HIV infections together with all other HIV prevention options currently available.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

More than 540 people living with HIV in the capital of the Central African Republic, Bangui, have been able to resume taking antiretroviral therapy owing to a joint project run by UNAIDS and the government of the Republic of Korea.

The recent instability in the country forced many people away from their homes and into camps for internally displaced people, where health services are limited. In addition, many health facilities were destroyed, inaccessible or unstaffed during the crisis. Around a third of people on antiretroviral therapy across the country were unable to continue their treatment.

Social services and community volunteers have located 544 of 1500 people who left treatment programmes in Bangui, enabling them to resume access to the life-saving medication. UNAIDS and the government of the Republic of Korea aim to extend the project to other provinces and to start rebuilding some of the country’s shattered health infrastructure.

A total of 120 000 people were living with HIV in the Central African Republic in 2013, with about 16 500 on antiretroviral therapy.

At an event held to mark World Social Work Day on 17 March, participants representing schools of social work, nongovernmental organizations, the United Nations and countries explored ways in which social workers can join efforts to end the AIDS epidemic by 2030.

The meeting, which was organized by the International Association of Schools of Social Work and the International Federation of Social Workers, with support from UNAIDS, celebrated the contributions social workers make in providing social and health services to vulnerable populations and looked at how best to collaborate on the AIDS response.

During the meeting, held at UNAIDS headquarters in Geneva, Switzerland, the participants called for dignity and respect for all, including poor and marginalized people that social workers often work with. Since HIV does not exist in isolation or relate solely to health, an integrated approach was recommended to address psychological, physical and social needs.

The participants acknowledged that gaps exist in the AIDS response, and noted that social workers can contribute significantly to ensuring that no one is left behind.

Social workers can make a difference by scaling up proven social policies and social protection programmes that focus on key populations and by extending their services to locations where there is the greatest need for them.

The International Association of Schools of Social Work and the International Federation of Social Workers pledged to expand their partnership with UNAIDS and to apply the principles of social work to the AIDS response by protecting the rights and dignity of people accessing HIV services. 

In the lead up to International Women’s Day, UNAIDS Deputy Executive Director Jan Beagle joined a group of women living with HIV in Auckland, New Zealand, to hear about their experiences. The meeting was one of the regular meetings of Positive Women, a support organization for women living with HIV and their families. The group works on raising awareness of HIV in the community through educational and anti-stigma programmes.

Jane Bruning, National Coordinator of Positive Women Inc. said, “Living with HIV can be very isolating as many women don’t want to tell anyone about their status. So it’s extremely important to have a safe space where women can gather and speak openly without fearing they will be judged.”

Ms Beagle, who is originally from Auckland, said she was touched by the women’s stories. “I’ve visited women living with HIV in many countries, but it is special to hear from women living with HIV in my own country. I am moved by their stories and I am committed to work with them to address the stigma and discrimination that is so much a part of their daily lives.”

The women told Ms Beagle about their fear of disclosing their status publicly. Their reasons were often different. For some, there was concern over losing their employment, while others were worried their children would be ostracized because their mother is living with HIV.

Judith Mukakayange, who is now open about her status, said she came to New Zealand 15 years ago as a refugee, fleeing civil war in Rwanda. When she arrived she was overjoyed to start a new life. However, that dream quickly crumbled when as part of her application process to emigrate she took an HIV test and learned that she was HIV-positive. “When you hear you have HIV you feel so isolated, so it’s important to connect to other people who understand you,” said Ms Mukakayange.

“I have this story that I don’t tell anybody. Even my close friends don’t know. I just can’t say I have AIDS. It’s awkward, awkward, awkward. Coming here to Positive Women is great. I can’t imagine life without Positive Women,” another woman at the meeting said.

From the early days of the AIDS epidemic, New Zealand has taken a lead in the response. The country implemented evidence-informed programmes to ensure that key populations at higher risk of acquiring HIV received priority attention. In 1987, New Zealand was among the first countries to introduce needle exchange programmes for people who use drugs. It was also a regional pioneer in decriminalizing sex work and sex between men.

These initiatives are widely credited with having curbed the epidemic in the country. New Zealand has a very low HIV prevalence, with the Ministry of Health reporting around 0.1% of adults aged 15 to 49 living with HIV. In 2013, around 180 people were newly diagnosed with the virus.  

However, despite this progress, people living with HIV still face stigma and discrimination. A recent survey conducted by local AIDS organizations found that 50% of people surveyed would be uncomfortable having food prepared by someone living with HIV.

Of Positive Women Ms Bruning said, “We may be a small organization but we punch well above our weight. I am proud of what we do.”

Vera Brezhneva, UNAIDS Goodwill Ambassador for Eastern Europe and Central Asia, has called for zero discrimination during a visit to a centre providing services for people living with HIV in Saint Petersburg, Russian Federation.

Ms Brezhneva visited the Centre for Social Services for Families and Children in the Krasnoselsky district of the city on the eve of Zero Discrimination Day on 1 March. One of the centre’s main goals is to provide social support for women living with HIV, as well as for their children and other family members.

The centre is part of a pilot project launched by the city of Saint Petersburg that aims to broaden support for people living with HIV. More than 260 people, including pregnant women, former prisoners and drug users, are benefiting from the centre’s services, which include peer-to-peer counselling, care and support. 

The President of Nigeria, Goodluck Jonathan, has signed a new antidiscrimination bill into law that protects the rights and dignity of people living with HIV.

The HIV/AIDS Anti-Discrimination Act 2014 makes it illegal to discriminate against people based on their HIV status. It also prohibits any employer, individual or organization from requiring a person to take an HIV test as a precondition for employment or access to services.

It is hoped that the new law will create a more supportive environment, allowing people living with HIV to carry on their lives as normally as possible. More than three million people are living with HIV in Nigeria.

Adolescents are being left behind in the global AIDS response. HIV is the number one contributor to adolescent mortality in sub-Saharan African and number two globally. Adolescents often lack access to proven, life-saving services, such as HIV treatment. To address this situation, a meeting was held in Geneva, Switzerland, from 3 to 5 December to design a strategy to address the challenges that adolescents face.

The global strategy consultation brought together around 50 activists from youth networks, governments, implementers, donors and UNAIDS cosponsors, all committed to making real progress through improving programmes, driving innovation and amplifying advocacy.

The participants took stock of ongoing efforts and reviewed a results framework to create accountability towards, and track progress for, the often neglected population. They looked at establishing milestones to measure progress and at what can be done to accelerate change for adolescents using innovative approaches and improved data. Critically, there was consensus among all partners that much more needs to be done to tap the inherent potential of adolescents and young people for progressive social change.

An action plan was developed outlining catalytic efforts in which partners could join to deliver results. Partners will now work together to finalize the All In agenda, which will be launched in February 2015.

The consultation was convened by UNAIDS and the United Nations Children’s Fund. The United Nations Population Fund and the World Health Organization were co-convenors, in collaboration with youth networks and other core members of the All In Leadership Group: the Global Fund to Fight AIDS, Tuberculosis and Malaria, the United States President’s Emergency Plan for AIDS Relief and the MTV Staying Alive Foundation.

Around 100 representatives of populations at higher risk of HIV infection from 18 countries in eastern and southern Africa are convening in Johannesburg, South Africa, from 17 to 19 November to discuss ways to improve access to HIV services.

Under the theme Close the Gap—Leave No One Behind, sex workers, gay men and other men who have sex with men, transgender people and people who inject drugs will engage in the first regional consultation for key populations in the region. During the meeting, the participants will share experiences and take stock of the remaining challenges.

During the 30 years of the AIDS epidemic, it has become evident that better and faster health outcomes are achieved through smart investment and community-centred systems that leave no one behind, noted UNAIDS Deputy Executive Director Luiz Loures.

People at higher risk of HIV infection contribute to substantial proportions of new HIV infections in some countries in the region. According to the latest Modes of Transmission study conducted between 2008 and 2010, sex workers and their clients, gay men and other men who have sex with men and people who inject drugs accounted for an estimated 33% of the total number of new HIV infections in Kenya, 26% in South Africa and 18% in Mozambique.

Daughtie Ogutu, Africa Coordinator for the African Sex Workers Alliance and a sex worker from Kenya, noted that countries can control the HIV epidemic only when all of its citizens, including people vulnerable to HIV infection, are guaranteed access to comprehensive HIV prevention, treatment and care services.

In the three days of the meeting, communities and development partners will focus their discussion around access to HIV prevention and treatment services, HIV-related stigma and discrimination and strategic information for people at higher risk of HIV infection.