The Year in HIV/AIDS: Top 5 Resolutions to Make in 2016

Five Ways to Ensure Happy Years Ahead, Whether HIV-Positive or -Negative

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Photograph © Vito Palmisano

The year 2015 was marked by a number of research breakthroughs which provide compelling evidence that, with sustained global and domestic funding, the end to the AIDS epidemic as we know it could be over in the next 15 to 20 years.

From an individual perspective, the same research suggests that we have far better ways to protect ourselves from HIV, better ways to ensure we don't pass HIV to others, and better ways to ensure a long, healthy life for those living with HIV.

 And all it takes is a few, key resolutions:

1. Get Tested Today

Currently in the U.S, it is recommended that all persons between the ages of 15 and 65 be tested for HIV as part of a routine doctor's visit. With an estimated 250,000 Americans still undiagnosed for the disease, the call for universal screening has never been greater.

The options for HIV testing include next-generation combination antigen/antibody tests endorsed by the Centers for Disease Control and Prevention (CDC) . This simple, finger-prick assay can effectively cut the window period (i.e., the time between exposure and the point where a test will give an accurate reading) from an average of four weeks to as little as 12 days.

Over-the-counter, rapid in-home tests are also available for those who might otherwise avoid public testing facilities. Although somewhat less accurate than standard, point-of-care tests, they can provide a person with a greater sense of autonomy, control and confidentiality, while affording them direct hotline support should a positive test be returned.

2. Start HIV Therapy Today

2015 was the year of the START Study. The trial, which had recruited 4,685 HIV-positive men and women in 35 countries, proved that treatment at the time of diagnosis not only reduced the likelihood of illness and death by 57% but did so irrespective of a person’s age, race, sex, region of the world, economic status or immune status (as measured by the person's CD4 count).

Moreover, the immediate initiation of HIV therapy correlates to greater longevity, with life expectancy now equaling that of the general population.

3. Get and Stay Undetectable

The benefits of early treatment even extend to those not infected with HIV. By sustaining an undetectable viral load, a person living with HIV is up to 96% less likely transmit the virus to an uninfected partner.

Start by committing yourself to uninterrupted drug adherence. working with your doctor or healthcare provider to find way to overcome any barriers that keep you from taking your pills on time, every day. This includes ensuring regular doctor visits and lab tests, as well as finding support systems if you are having personal or emotional difficulties.

Today, as few as 65% of Americans on HIV therapy are able to achieve undetectable viral loads, the consequences of which can be enormous. In fact, research from the U.K. Collaborative HIV Cohort Study suggests that the failure to achieve viral suppression can result in the loss of life-years of as much as 11 years.

4. Take PrEP, the Daily HIV Prevention Pill

HIV pre-exposure prophylaxis (PrEP) is a preventive strategy wherein a daily antiretroviral pill (Truvada) can reduce a person's risk of getting HIV by as much as 92%. PrEP is currently recommended for people at high risk of HIV infection, including men who have sex with men (MSM), injecting drug users, or mixed-status heterosexual couples with HIV.

In fact, when the HIV-positive partner is on fully suppressive therapy, the risk to the person on PrEP is believed to drop to negligible levels.

While the uptake of PrEP had been slow when the recommendations were first issued in 2014, consumer acceptance has been on the upswing. According the manufacturer, Gilead Sciences, first-time Truvada prescriptions skyrocketed by some 332% in 2015, with further growth expected into 2016.

Co-pay and patient assistance programs (PAP) are also available to those who qualify.

5. Stop Smoking

HIV cannot be treated in isolation. It requires positive changes in lifestyle, which include a healthier diet, more exercise, and a reduction in behaviors that can directly undermine HIV therapy.

So why single out smoking? The simple truth is that people with HIV today are twice as likely to be smokers than those without (42% vs 21%). Add to that the fact that smoking, as an independent factor, more than doubles the risk of death even in those on fully suppressive therapy.

To make matters even worse, smokers with HIV 

  • are twice as likely to have acute heart disease;
  • are 14 times more likely to develop lung cancer;
  • are three times more likely to transmit HIV during pregnancy, and;
  • die an average of 12.3 years earlier than non-smokers with HIV.

By contrast, smoking cessation cuts the risk of cardiovascular disease by up to 65% over three years, while reducing the risk lung cancer by as much as 50%.

With it takes an average of eight attempts to fully kick the habit, most private insurance, as well as Medicaid and Medicare, cover smoking cessation treatment under the essential health benefits (EHB) defined by the Affordable Care Act (ACA).


U.S. Preventive Services Task Force (USPSTF). "Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement." Rockville, Maryland; April 2013; accessed February 7, 2014.

U.S. Centers for Disease Control and Prevention (CDC). "HIV Surveillance Report: Diagnoses of HIV Infection and AIDS in the United States and Dependent Areas, 2010." Atlanta, Georgia; access February 7.

Branson, B.; Owen, S.; Wesolowski, M.; et al. "Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations." U.S. Centers for Disease Control and Prevention (CDC). Atlanta, Georgia; released June 27, 2014.

Hogg, R.; Althoff, K.; Samji, H.; et al. "Increases in life expectancy among treated HIV-positive individuals in the United States and Canada, 2000-2007." 7th International AIDS Society (IAS) Conference on Pathogenesis, Treatment and Prevention. Kuala Lumpur, Malaysia. June 30-July 3, 2013; Abstract TUPE260.

Gardner, E.; McLees, M.; Steiner, J.; et al. "The Spectrum of Engagement in HIV Care and its Relevance to Test-and-Treat Strategies for Prevention of HIV Infection." Clinical Infectious Diseases. March 2011; 52(6):793-800.

Laprise, C.; de Pokomandy, A.; Baril, J.; et al. "Virologic failure following persistent low-level viremia in a cohort of HIV-positive patients: results from 12 years of observation." Clinical Infectious Diseases. November 2013; 57(10):1489-96.

Hasse, B,; Ledergerber, B.; Egger, M., et al. "Aging and (Non-HIV-associated) Co-morbidity in HIV-positive Persons: The Swiss Cohort Study (SHCS)." 18th Conference on Retroviruses and Opportunistic Infections (CROI). Boston, Massachusetts; February 27-March 2, 2011; abstract 792.

Cohen, M.; Chen, Y.; McCauley, M.; et al. "Prevention of HIV-1 infection with early antiretroviral therapy." New England Journal of Medicine. August 11, 2011; 365(6):493-505.

U.S. Public Health Service (PHS). "Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2014: A Clinical Practice Guideline." Washington, D.C.; published May 14, 2014; accessed November 6, 2014.

Helleberg, M.;  et al. "Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America." AIDS. January 4, 2015; 29(2):221-229.

Mdodo, R.; Frazier, E.; Mattson, C.; et al. "Cigarette smoking among HIV+ adults in care: Medical Monitoring Project, US, 2009." 20th Conference on Retroviruses and Opportunistic Infections (CROI 2013). Atlanta, Georgia; March 3-6, 2013: Abstract 775.

Helleberg M.; Afzal, S.; Kronborg, G.; et al. "Mortality attributable to smoking among HIV-1-infected individuals: a nationwide population-based cohort study." Clinical Infectious Diseases. March 2013; 56(5): 723-734.

Clifford G.; Lise, M.; Franceschi, S.; et al. "Lung cancer in the Swiss HIV cohort study: role of smoking, immunodeficiency and pulmonary infection." British Journal of Cancer. January 12, 2012; 106(3): 447-452.

Crothers, K.; Griffith, T.; McGinnis, K.; et al. "The impact of cigarette smoking on mortality, quality of life, and comorbid illness among HIV-positive veterans." Journal of General Internal Medicine. December 2005; 20(12):1142-1145.

Grant, R. and Smith, D. "Integrating Antiretroviral Strategies for Human Immunodeficiency Virus Prevention: Post- and Pre-Exposure Prophylaxis and Early Treatment." Oxford Forum Infectious Diseases. August 24, 2015; 2(4):doi: 10.1093/ofid/ofv126.

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