The Year in HIV: Top 5 Resolutions to Make for 2017

A Year Marked by Breakthroughs and Game Changers

Couple holding sparkler to celebrate the new year
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2016 was a year marked by a number of scientific breakthroughs, all of which provided further evidence that—with sustained global funding—we could very well reverse the tide on HIV infections by 2030. There were not only advances on the cure front, including the development of antibody-based vaccine candidates, but changes in domestic and global policy to better achieve an end to the pandemic as we know it.

From an individual perspective, the same research suggests that we have now better ways to protect ourselves and others from infection, as well as the means to ensure a long, healthy life for those living with the disease.

 All it takes is a few key resolutions.

1. Get Tested Today

Currently in the United States, 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 200,000 Americans still undiagnosed for the disease, the call for universal screening has never been stronger.

The options for testing include next-generation combination antigen/antibody tests endorsed by the CDC. This simple, finger-prick assay can effectively cut the window period 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 less accurate than standard, point-of-care tests, they can provide a person at risk with a greater sense of autonomy and confidentiality, while providing direct hotline support should a positive test be returned.

2. Start HIV Therapy Today

2016 was the year when many global health authorities enacted a universal test and treat policy.

No longer is it recommended that treatment be delayed until a person "needs" it. Today, treatment on diagnosis not only ensures a healthier, longer life but greatly reduces the risk of onward exposure.

The change in policy was largely the result of the 2015 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 percent 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 therapy correlates to greater longevity in people with HIV, 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 percent less likely to transmit the virus to an uninfected partner.

Start by committing yourself to uninterrupted drug adherence, working with your doctor or healthcare provider to find ways 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 percent of Americans on HIV therapy are able to achieve undetectable viral loads. The consequence of continued failure can be enormous, both from a population and individual perspective. Research from the U.K. Collaborative HIV Cohort (CHIC) Study, in fact, suggests that the failure to achieve viral suppression can shorten life expectancy by as much as 11 years.

4. Take PrEP If You're at Risk of Getting HIV

HIV pre-exposure prophylaxis (PrEP) is a preventive strategy wherein a daily antiretroviral pill can reduce a person's risk of getting HIV by as much as 92 percent.

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.

Better still, when the HIV-positive partner is concurrently placed on antiretroviral therapy, the risk of infection drops to near-negligible levels.

While the uptake of PrEP had been slow since the recommendations were first made in 2014, consumer acceptance has been on the upswing. By mid-2016, over 79,000 had been prescribed PrEP, according to a public survey by the drug manufacturer.

Co-pay assistance programs are available to those who qualify, making access to PrEP far easier for those denied treatment by their insurance.

5. Get Linked (or Re-Linked) to Medical Care

HIV is a chronic, lifelong condition, one that can be effectively treated but demands consistent medical oversight. Treatment failure is largely a by-product of inconsistent care, wherein persons who fall in and out of the system tend to fare poorer than those who remain consistently in care.

A recent Canadian study showed that 68 percent of individuals retained in care were able to achieve and sustain an undetectable viral load versus only 43 percent of those who voluntarily dropped out of the system.

The barriers to HIV care are often complex, particularly for those unable to afford the high cost of HIV treatment. But there are solutions, not only for lower income individuals but for any persons struggling to pay for their drugs or insurance.

Start by learning what assistance programs you may be qualified for and explore new strategies for finding low-cost insurance coverage whatever your income bracket.

Sources:

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 December 26, 2017.

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.

Krentz, H. and Gill, M. "The effect of Churn on ‘Community Viral Load’ (CVL) in a well defined regional population." Journal of Acquired Deficiency Syndromes. October 1, 2013; 64(2):190-196.

U.S. Preventive Services Task Force. "Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement." Rockville, Maryland; April 2013.

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