Note: This article was originally published on "Talk", an independent and non-profit source of news, analysis and comments from academic experts. Discovery information is available on the original page.
More than 60,000 Canadians and 37 million people worldwide live with HIV. In the early days of HIV and AIDS, there was enormous fear and discrimination – to the extent that politicians in British Columbia debated the quarantine of people with HIV.
Since then, the arc of scientific progress in HIV has been rapid. But HIV-related stigma and discrimination has not disappeared and the global epidemic is far from over.
Each year there are 2,000 new cases of HIV in Canada. The increase in funding for AIDS services organizations has slowed and global funding for HIV research and development has been reduced.
This World AIDS Day requires recognition that negative assessments and feelings about HIV are intertwined and intertwined with racism, transphobia and homophobia.
You can have HIV and become "portable"
Because of access to modern antiretroviral treatments, HIV has become the most manageable condition. Studies by the Center for Excellence in HIV / AIDS (BC-CfE) have shown that people with HIV who are taking treatment now have a similar lifespan for those who are HIV-negative.
Julio Montaner, director of BC-CfE, was a pioneer in the concept of "treatment as prevention" (TasP). The medical and scientific community has come to the consensus that an individual living with HIV can become "untranslatable" – meaning that there is no risk of their sexual transmission to the virus – if they achieve an invisible viral load through treatment with HIV. People living with HIV have made the "invisible, invincible" movement to share this message of hope and fight against the stigma of HIV.
According to our own research on the study to study the momentum, the number of HIV-negative homosexuals in Vancouver who knew that this concept almost doubled from 2012 to 2015. The good news is that this was not associated with any reductions in the use of condoms.
Bad news: key messages about HIV prevention and testing may not cover all audiences. For example, we found that bisexual men, older men and men living outside the city were significantly less likely to have been tested for HIV in the past two years.
Unfortunately, efforts to prevent the spread of HIV are hampered by fear and stigma. For example, some gay and bisexual men have never been tested for HIV because they care about the impact they have on their relationships and sex life and that they can face discrimination.
Men are still afraid to be tested
In Canada, it remains a crime to not reveal the status of HIV positive status in consensual sex if a condom is not used.
This discriminatory law remains despite the now strongly established scientific consensus that an individual with an invisible viral load can not transmit the virus. This was demonstrated through a study in which nearly 60,000 acts of condom-less relationship between seropositive couples (where one partner is HIV negative and the other HIV-positive) did not result in transmission of HIV.
These fears also make it difficult for men to tell their doctor about sex with other men. At least a quarter of participants in the momentum did not tell their doctor about sex with men, and those men were half of the probability that they were recently tested for HIV.
Stigma also affects access to services and mental health. Men who have experienced multiple mental challenges (depression and the use of more illicit drugs) were more likely to engage in sex that could transmit HIV.
Feelings of disassociation from the disease can be intertwined with discrimination. For example, the risk for HIV in transients in the Study on Momentum was shaped by difficulties in the safe finding of sexual partners, challenges with the use of condoms and barriers to access to health care, including the services related to the transition.
An effective drug for HIV prevention
We now have more tools in the HIV prevention tool than at the top of the epidemic. The safe sex, which once referred to condoms, now looks at issues such as undetectable status and prophylaxis of pre-exposure, or PrEP.
Preventive HIV prevention drug PrEP is very effective when taken continuously and is available at no cost to eligible HIV-negative individuals in British Columbia who are at high risk of HIV.
Before BCP was covered by BC, only 2.3 per cent of homosexuals in the Vancouver study of the momentum used the PrP. However, the API awareness more than quadrupled to 80 percent of the 18 percent in this period.
Though access challenges remain, thousands of gay men and others at risk of HIV through B.C. now get PrEP free.
HIV has changed. And our perceptions need to be leveled. Now is the time for policymakers, service providers and the country as a whole to accept a better understanding of HIV.
Complexity, ignorance and the continuation of HIV to be viewed as something embarrassing, will prevent us from progressing in our efforts to support people living with HIV and to reduce new infections.
Authors: Nathan Lachovski, docent, Faculty of Public Health and Social Policy, University of Victoria; Gbolahan Olarevayu, Coordinator for the study of the momentum of the Center for Excellence in HIV / AIDS at the University of British Columbia, and Heather Armstrong, Associate Professor for Postgraduate Beginners, Center for Excellence in HIV / AIDS, University of British Columbia
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