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The chance to beat HIV is in sight

The largest drop in HIV rates ever seen shows that through action we have a chance of beating HIV in the UK.

Dorcas - The Chance to Beat HIV

In October 2017, Public Health England reported an 18% drop in the numbers of people diagnosed with HIV in 2016 – this includes 18% fewer diagnoses among people of black African ethnicity compared to 2015.

This was the first time that we’ve had such a significant drop and it is was all down to a combination of things we can all do to make a difference.

New ways to stop the spread of HIV

The HIV epidemic started more than 30 years ago but recently there have been some big changes which we want to share with you and make sure everyone knows about. The number of HIV infections is starting to come down in some areas and this is down to a combined approach to stopping HIV. It’s no longer JUST about condoms, HIV treatment is now a part of our armoury against HIV – and part of protected sex.

Here’s how:

1) Treatment as Prevention (TasP)

If someone is on effective HIV treatment and has an ‘undetectable viral load’ they cannot pass on HIV. (The viral load is the amount of HIV measured in a blood test – most clinics in the UK classify undetectable as being below 20 copies/ml.)

We are saying this based on findings from the PARTNER study which looked at 888 gay and straight couples (and 58,000 sex acts) where one partner was HIV positive and on effective treatment and one was HIV negative. Results found that where the HIV positive partner had an undetectable viral load, there were no cases of HIV transmission whether they had anal or vaginal sex without a condom. It can take up to six months from starting treatment to become undetectable.

What this means: This is exciting news as it means treatment is a new way to stop the spread of HIV. Don’t forget though that sex without a condom still means you can get or pass on another sexually transmitted infection (STI) and can result in a pregnancy.

2) Pre-exposure prophylaxis (PrEP)

PrEP is a course of HIV drugs taken by an HIV negative person who is at risk of getting HIV to lower their chance of becoming infected. When taken correctly, PrEP significantly reduces the chances of becoming HIV positive.

In England PrEP is not currently available on the NHS routinely, although 10,000 people will be taking it as part of the IMPACT trial, which started this autumn. In Scotland and Wales PrEP is available on the NHS.

What this means: If you are likely to be exposed to HIV, PrEP is another way to protect yourself.

3) Post-exposure prophylaxis (PEP)

PEP is a month-long course of HIV medication taken by an HIV negative person after possible exposure to reduce the chance of getting HIV. When started in time (within 72 hours, but within 24 hours is best) PEP can stop HIV infection after sex without a condom (or other exposure) with someone who is infectious – but it does not work every time.

What this means: PEP is the third way HIV treatment can be used to protect yourself, a doctor will assess whether you will be eligible or not depending on the risk taken.

Jones - The Chance to Beat HIV

Testing and treatment saves lives

In terms of stopping HIV this new information is monumental and the facts show that people power can dramatically reduce HIV transmissions. Regular testing means more people with HIV will be diagnosed and taking treatment – so they will be less likely to become ill and less likely to pass on HIV.

Despite the good news of a drop in HIV rates, 54% of newly diagnosed black African people were diagnosed late in 2016, which means they will have an increased risk of developing an AIDS-defining illness. The British HIV Association (BHIVA) recommends everyone with HIV starts treatment when they are diagnosed. This is because a study called START found that starting straight away significantly reduced people’s chances of developing AIDS-related illnesses.

So the problem we have is that although lots of us are being diagnosed and getting onto treatment in time, an even bigger proportion are finding out they have HIV at a point where their immune systems have been damaged. Regular testing is the linchpin of reducing late diagnoses and keeping people well.

Additionally, people are extremely infectious when they are first infected with HIV which is why early diagnosis is so important – if you are on effective treatment and have an undetectable viral load you cannot pass on HIV.

The Simple Science

HIV stands for Human Immunodeficiency Virus. It was identified in the early 1980s and belongs to a group of viruses called retroviruses.

HIV uses your CD4 cells to reproduce, destroying them in the process. These are important cells which co-ordinate your immune system to fight off illnesses and infections. As the number declines, you may not have enough to keep your immune system working properly. At the same time the amount of HIV in your body (the ‘viral load’) will usually increase.

Without treatment your immune system will not be able to work properly and protect you from ‘opportunistic infections’.

Effective treatment will mean your CD4 count increases and your viral load decreases – hopefully to ‘undetectable’ levels.

The viral load test shows how much HIV is in your body by measuring how many particles of HIV are in a blood sample. The results are given as the number of ‘copies’ of HIV per millilitre of blood – for example 200 copies/ml.

An ‘undetectable’ viral load does not mean there is no HIV present – HIV is still there but in levels too low for the laboratory test to pick up. Different laboratories may have different cut off points when classifying an undetectable viral load, however most clinics in the UK classify undetectable as being below 20 copies/ml.

Modern HIV treatment means that many people with HIV are living long, healthy lives and if you’re taking HIV medication and have an undetectable viral load you cannot pass on HIV.

Getting tested

Testing is for HIV is free, confidential and simple – you can even do it at home. If you are diagnosed with HIV you will be able to start treatment straight away. This will keep you healthy and by joining forces to get everyone tested and onto treatment, the rates of people being diagnosed with HIV should continue to drop.

Find out how and where to get tested

To talk to someone about HIV, testing and diagnosis call THT Direct on 080 8802 1221 from 10am-8pm Monday-Friday.

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Kerri has worked as a Health Trainer at Terrence Higgins Trust and is now their editor. She is particularly interested in the advances being made in HIV treatment and prevention. She also loves football, knitting and baking.

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