HIV IN NUMBERS; LET’S STOP THE COUNTING

1. HIV status at Global level

Incidence: In 2020, 1.5 million (with 50% being males) new cases of HIV infections were reported worldwide. Of these new infection, 1.3 million were individuals at least 15 years old while about 160?000 were children from 0-14 years of age.

Prevalence: Globally, at least 37.7 million people were existing cases of HIV as of 2020. Since the start of the epidemic 79.3 million people were infected with HIV. Of the 37.7 million cases, 1.7 million were children (0-14 years) and 36.0 million were adults. 53% of PLHIV were females. About 6.1 million (16%) people in 2020 did not know that they were living with HIV. This implies that the 16% needed access to HIV testing services. Global HIV prevalence among adults was 0.7%. In 2020, Eswatini had the highest HIV prevalence world-wide.

Mortality:?

Since the start of the epidemic, 36.3 million people have died from HIV related illness. In 2020 alone, 680?000 HIV related deaths were reported compared to the 1.3 million who succumbed to the pandemic in 2010.?

On ART: ?

As of June 2021, 28.2 million people living with HIV (PLHIV) were on antiretroviral therapy, an improvement from 7.8 million PLHIV who were on treatment in 2010. This means that 9.5 million (25%) people are still waiting to be put on treatment. Of the 28.2 million about 17.9 million were from sub-Saharan Africa. Almost 59% of PLHIV, in 2019 globally, had viral load suppression (number of PLHIV with < 200 copies/ml of blood).

Regional impact: Majority of PLHIV are in developing nations aka low- and- middle- income countries (LMIC). In 2020, 20,6 million (55%) existing cases of HIV were in Eastern and Southern Africa,?5.7 million (15%) in Asia and the Pacific, 4.7 million (13%) in western and central Africa, and 2.2 million (6%) in Western and Central Europe and North America.

2. Place of innovation

Awareness:? People in developing nations still have limited access to information. For example, most people in developing nations are not aware of the existence of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). In the remote areas in developing nations, where mothers give birth at home, they are not aware of antenatal care services to reduce mother-to-child transmission.?This is the first area that calls for improvement. Without information, more people will perish due to HIV pandemic. Awareness campaigns should be rolled out to remote areas on frequent basis. This should be a continuous process. Mobile technology is helping PLHIV to access information about HIV, adhere to treatment and appointments through text messages. This must be rolled in LMIC especially in their rural ares.

Accessibility:?

Walking long distances to access a nearest health facility is one of the problems faced by PLHIV in LMIC. Mobile clinics can be used, for example monthly, to improve access to HIV healthcare services by those patients who can not walk to nearest hospital. In the long run, more healthcare facilities should be constructed to reduce long distances as well as congestion at the few existing facilities.?

Cost: It is currently, beyond the reach of many in 3rd world nations to afford treatment and other HIV care services. The dilapidated state of health care facilities, which include HIV testing, at public hospitals is leaving client with cheaper option but the expensive private hospitals. Clients in developing nations do not afford these exorbitant charges hence adherence to treatment and appointments is negatively affected. The public hospital should be well funded as well as well-resourced. It takes, mostly, the political will to prioritise such a human right?

Stigma:?

There is reluctance and anxiety to disclose HIV-positive status, fearing of rejection and discrimination especially in rural areas in developing nations. Being HIV position does not imply that someone was/is sleeping around. Some PLHIV are not prepared to visit hospitals for testing and/or art hence there is need to train health care workers not to be judgemental and create conducive environment at health care facilities where client’s privacy is a priority.

Technology:?

Technology has greatly helped in managing HIV. However, little, or insignificant strides have been done for the developing nations in this aspect. Most health centres in developing nations are still relying on hard copy health records which are exposed to destruction, vandalism, or manipulation. Electronic health records have assisted in giving accurate and timely patient information. To improve in this aspect, health facilities should be electrified, given computers and internet. Social media technologies can also be used to study and address HIV among at risk communities. The social media platforms include social networking sides for example Facebook and microblogs of real-time communication for example twitter. These platforms can bring together researchers, clinicians and technologists based in different countries to collaborate on innovative way to improve HIV prevention. Hence there is need to empower researchers in developing nations so that they can have access to social media platforms and also link them with researchers in developed nations.

Author: MEDx eHealthCenter B.V. Team