December 1st is recognised as World AIDS Day. To mark this day, we are sharing some wisdom from LGBT Helpline Volunteer and member of ACT UP Cork, William Kennedy. Will has written the following article to give some insight into the realities of living with HIV in Ireland today, explain U=U and the national roll out of free access to PrEP.
When HIV/AIDS first arrived on the scene back in the 1980s, for the vast majority who got HIV, went on to develop full blown AIDS resulting in death. The life span of people living with HIV was vastly shorter than the norm.
Today, I am happy to say the story is substantially different. This is due to the enormous developments in HIV treatment and prevention. In this short piece, I will outline these developments and talk a little about what living with HIV in 2019, in Ireland is like.
Living with HIV today, the medical side of things are really good. New meds means less side effects and also the different combinations available means people can switch meds, meaning there is less and less need to put up with what can be very uncomfortable side effects. The life span of someone living with HIV is now the same as the rest of the population. Therefore, people living with HIV can look forward to a long and healthy life.
Ending the Stigma
The greatest challenge facing people living with HIV today is stigma. While the medical side of this infection has vastly improved, lack of education and knowledge about HIV among the general public, means many of them still hold very outdated ideas about HIV. Those who remember the old adds on TV with the big headstones coming up out of the ground with AIDS written across them, still think this is the situation today.
In many surveys carried out fairly recently, people were still unsure just how you could get HIV. Many still though you could get it by drinking from the same glass, from kissing and many other strange ideas. Why is this? Ask yourself, have you seen many, or any, campaigns about the developments in the whole area of HIV? I think the honest answer would have to be no.
So, while the lives, medically speaking that is, of people living with HIV today can be said to be really good, we need now to really begin a well-organised, concrete and prolonged campaign to bring about an end to HIV stigma and discrimination.
I am happy to say that there are signs that steps are been taking to bring this about. Take the PrEP program that was recently announced by the HSE. PrEP stands for pre-exposure prophylaxis. PrEP is taken by HIV negative people before having sex (pre-exposure) and after sex, to prevent HIV (this is called prophylaxis). PrEP dose not prevent you getting other STIs. It should be seen as another tool along with condoms in preventing you getting HIV.
While HIV activists are happy to see the PrEP program finally being rolled out across the country, we will be keeping a close eye on how it is working. Sad to say there already have been problems and delays in my own county Cork. Due to various reasons staffing and admin, the program is being delayed here in Cork. But the very fact that the program exists is a great development.
I will end this short piece with the greatest development for people living with HIV that is now a proven scientific fact, U=U.
Undetectable = Untransmittable
U=U means “Undetectable = Untransmittable,” indicating that if an HIV-positive person is on HIV meds (antiretroviral therapy, or ART) with a consistently undetectable HIV viral load, the HIV virus cannot be transmitted to a sex partner. As a prevention strategy, this is often referred to as Treatment as Prevention, or TasP.
U=U and TasP are based on substantial scientific data. In fact, the U.S. Centers for Disease Control and Prevention has said that, “People who take ART daily as prescribed and achieve and maintain an undetectable viral load have no risk of sexually transmitting the virus to an HIV-negative partner.”
So, for HIV-positive persons: take your HIV meds every day! Double down on this both for your personal health and, with confidence, to prevent HIV transmission.
Treatment as prevention
This has changed the lives of those people living with HIV. We are no longer infectious; we cannot pass it on, once we become undetectable. As this is now the case, there should be a real effort to get everyone who is sexually active to get tested regularly. Think about it, if everyone got tested, became aware of their HIV statues, were on meds and became undetectable, then HIV would no longer be transmitted. This is what is meant by, treatment as prevention.
To sum up then, HIV is no longer a death sentence. People living with HIV are living long and healthy lives. The goal now has to be to make these lives, not just long, but happy, productive and vibrant. Lives free from the fear of stigma and discrimination. Lives where people living with HIV no longer have to live with a secret. Secrets can lead people to live their lives in loneliness and isolation, secrets effect our physical and mental health.
HIV should be treated holistically, as it effects and impacts the whole person. Events like Worlds AIDS Day are great for casting light on HIV, but we need more than just one day’s focus on the issue of HIV. People are living with HIV 365 days of the year, so there has to be a concentrated and sustained full time campaign to raise awareness, as this is really the only way to bring about the end to HIV stigma and discrimination.