Introduction
The objective of eliminating the Human Immune-deficient Virus and Human Acquired Immune Deficient Syndrome HIV/AIDS epidemic is conceivably attainable. It would need addressing this catastrophe on both global and individual levels. HIV is the virus that fights the body’s immune system and can cause AIDS if left untreated. The virus is transmitted via vaginal secretions, blood products, and semen, and hence sexual contact is the most common way that the disease is spread. This goal of ending the epidemiologic public health issue is attainable if optimal prevention and treatment strategies are provided to all people at risk or already infected with the virus. In the 1990s, nearly every person with HIV/AIDS died prematurely, and the illness was the first-killer disease. Following a decade of tireless efforts, scientists invented high active antiretroviral therapy (HAART) cocktails. The greatest disincentive against HIV, which currently stands at an incidence of 38 million globally, is the mastery produced from systematic research till a cure or vaccine is discovered. A significant number of nations do not have fundamental data sources to assist in this research. This essay aims to explore the epidemiology of HIV/AIDS, emphasizing treatment, care continuum, mother-to-child transmission, and the impact of the COVID-19 Pandemic on the disease.
HIV Treatment Access
Access to HIV treatment is crucial to ending the global Pandemic of AIDS, a major threat to public health. At the end of 2020, more than 27 million people living with HIV could access antiretroviral therapy across the world. This data shows that more than 10 million people living with the diseases do not have access to these drugs, and hence the access rate is approximately 73% (HIV.gov, 2021). Persons diagnosed with HIV are conscious of their status, take antiretroviral therapy as prescribed, and maintain their undetectable viral, increasing their quality of life.
Studies show that a person under antiretroviral treatment has an equal life expectancy with a person who is HIV negative and of the same age. Immediate use of antiretroviral treatment gives better health outcomes as compared to a delayed start of treatment. Antiretroviral therapy plays a great role in preventing HIV-related diseases and therefore saving many lives. This treatment has seen HIV-related deaths reduce significantly since 2003 (HIV.gov, 2021). HIV treatment also helps to minimize the probability of infecting another individual who is HIV negative by approximately 96%.
HIV Care Continuum
As a public health model, the HIV care continuum delineates how a person living with HIV follows from diagnosis until viral suppression. These steps include diagnosis of the infection, connection to HIV medical care, receiving maintaining medical care, and finally attaining and retaining vial suppression. Each of these steps is characterized by evaluating the number of patients in each particular stage. Tracing UNAIDS’s 90-90-90 goals, 84% acknowledged that they are positive status, 66% were under treatment, and 73% had attained the viral suppression stage by 2020. HIV care continuum is essential as it indicates the prevalence of the disease, regardless of the time they got infected or if they know that they are infected.
Data on HIV prevalence is critical for resource allocation and planning since it shows the number of individuals requiring treatment and care. Prevalence is also essential as it compares the disease among different populations to track trends with time. According to the Centre for Disease Control, 1.2 million people aged 13 years and above were diagnosed with HIV in 2021 (Lyons et al., 2021). Out of this population, 87% were diagnosed, 66% received care, 50% retained to care for the disease. 57% of the population achieved the viral suppression stage.
Mother-to-Child Transmission
Discoveries in HIV treatment, research, and prevention have helped women diagnosed with HIV to sire HIV-negative children. In most countries, including the United States (US), HIV mother-to-child transmission has significantly reduced. Prevention of Mother-To-Child Transmission (PMTC) programs are essential. They aim to reduce the infection rate, especially in females of child-bearing age, and unplanned pregnancies among females who have the virus (Centers for Disease Control and Prevention, 2019). These programs also offer relevant infant feeding and testing of children who are highly likely to contract the disease. Approximately 84% of expectant mothers in the (US) in 2020 received treatment to reduce the probability of passing the virus to their children (UNICEF, 2020). Among the UNICEF HIV priority nations, approximately 120,000 new infections with confidence bounds of 80,000 and 200,00 among children below five years in 2020, indicating a 57% decrease from 290,000 in 20100 (UNICEF, 2020). High HIV testing coverage in developing countries has seen a rising number of expectant mothers know their status as the testing has been mandatory in antenatal care.
More than 85% of expectant mothers globally were getting antiretroviral care in 2020 to prevent transmitting the virus to the child, a tremendous increase from 17% in 2010 (UNICEF, 2020). Receiving treatment among HIV pregnant women reduces the probability of mother-to-child transmission to 5%. Prevention of Mother-to-Child HIV is among the essential health issues whose effects are felt across the globe. Over 0.5 million children have contracted the disease, especially in Sub-Saharan Africa.
Different studies have assessed the prevalence of the disease and its risk factors, especially among infants in East Africa who are exposed to the virus. The studies extracted data with different software like Microsoft Excel, and analysis was done using Stata software (Belachew et al., 2020). The study applied the random effect model to approximate the pooled prevalence of vertical HIV infection in the East Africa region. The difference between studies was computed with an I2 statistic test. In addition, meta-regression and subgroup analyses were conducted to ascertain the origin of heterogeneity in the studies. The meta-analysis and systematic review incorporated 33 research articles, and the pooled prevalence of vertical HIV infection in the region was 7.68%, with a p-value of < 0.001 and a 95% confidence interval (CI) (Belachew et al., 2020). The study results indicated that the pooled prevalence of transmitting HIV from the mother to the child is higher than the World Health Organization recommends.
Challenges and Progress
Tremendous achievements have so far been made in the most recent research for HIV treatment and research. Effective and safe types of lasting HIV prevention are likely to offer substitutes to presently available pre-exposure prophylaxis daily oral pills that patients may fail to adhere to. Different alternatives are already available for use, such as implants,
monthly vaginal rings, and injections that remain useful for six months. In cases where the current regime treatment fails to work, there is an alternative of a lenacapavir subcutaneous injection that can be administered every six months.
Even with then promising discoveries and advancements in HIV treatment, testing, and prevention, there is still a significant population (either HIV positive or is at great risk of contracting the disease) that is unable to access or enjoy these benefits. The disease affects various aspects of individual health and wellness, economic development, communities, and households. Most of the nations with high HIV prevalence also endure other infectious diseases and food insecurity. In the last decade, new international attempts have been initiated to address the epidemic. These advancements have significantly influenced the reduction in HIV incidence. Nevertheless, regardless of the access to efficient HIV prevention techniques and tools, the progress is still asymmetrical in terms of access to treatment, ensuring zero HIV-related deaths, and lowering the rate of new infections. People living with HIV are still discriminated against and stigmatized and endure social inequalities, which are key barriers to successful treatment.
HIV and the COVID-19 Pandemic
The most recent COVID-19 Pandemic has led to widespread interference with health services across the globe, with limitations in movements and delays in health services. HIV services disruption is no exception, as most countries have recorded a 75% disruption rate(HIV.gov, 2021). HIV-positive people have more comorbidities from COVID-19 as compared to HIV-negative people. Many HIV people are yet to get the COVID-19 vaccine, which is a threat to their well-being. Recent surveys from England and other countries in Africa have discovered that the probability of succumbing to COVID-19 complications is double in persons living with the disease.
Sub-Saharan Africa shelters more than half of all the patients living with the disease across the globe (HIV.gov, 2021). Nevertheless, this region is receiving COVID-19 vaccines at a slow rate compared to other regions in the world. For instance, Africa had vaccinated only 3% of its population by July 2021. Lockdowns and other restrictions associated with the Pandemic also interfered with HIV testing in most nations, hence a decrease in diagnosis and treatment. Global funds to fight diseases like Malaria, HIV/AIDS, and tuberculosis have also reduced significantly following the Pandemic. Lack of sufficient funding reduced HIV testing by more than 41% and linkage to treatment by approximately 37% when countries first introduced lockdowns in 2020.
Conclusion
As seen in the discussion, HIV remains one of the essential health issues whose effects are felt across the globe. However, recent discoveries in the disease’s treatment, research, and prevention have helped people living the virus enjoy a healthy life. Today women living with HIV can give birth to HIV-negative children, reducing the infection rate significantly. The most recent COVID-19 Pandemic has dramatically affected the HIV care continuum, causing low testing rates.
The reports show that HIV-positive individuals are more likely to succumb to COVID-19 complications than healthy individuals. Therefore, this population should be given priority to receive the COVID-19 vaccine to prevent more deaths. It is of great importance that HIV-positive people and those at a high chance of getting the virus access treatment since antiretroviral therapy helps in reducing the transmission rate by approximately 96%. As highlighted above, the most significant disincentive against HIV is the mastery produced from systematic research till a cure or vaccine is discovered. Further, considering tremendous advancements made in treating and preventing the spread of the disease, the vision of eradicating the epidemic in the year 2030 is still valid.
References
Belachew, A., Tewabe, T., & Malede, G. A. (2020). Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: A systematic review and meta-analysis. Tropical Medicine and Health, 48(1), 1-11.
Centers for Disease Control and Prevention. (2019). Diagnoses of HIV infection in the United States and dependent areas, 2018. HIV surveillance report, 31.
HIV.gov. (2021). The global HIV/AIDS epidemic. HIV Global Statistics.
Lyons, S. J., Gant, Z., Johnson, A. S., Hu, X., Yu, C., Jin, C.,… & Peruski, A. (2021). Monitoring selected national HIV prevention and care objectives using HIV surveillance data: The United States and six dependent areas, 2018.
UNICEF. (2020). Elimination of mother-to-child transmission. Web.
