HealthcareBold Solutions: Advancements in HIV Treatment and Prevention

By Michael Muszynski, MD, FAAP, FPIDS — Hope and Help Center of Central Florida

UNAIDS data show that the spread of HIV/AIDS has reached epidemic levels, mainly concentrated among men who have sex with men and injection drug users. Although significant strides have been made in HIV/AIDS healthcare, many patients still face obstacles that prevent them from receiving needed care.

The need for HIV/AIDS education

Unfortunately, a significant part of why the spread of sexually transmitted infections (STIs), including HIV/AIDS, has become such a pervasive problem is the stigma and lack of education surrounding these conditions. Worse yet, much of the stigma associated with these diseases is misinformed, out-of-date, discriminatory, and toxic.

Great strides in the treatment of HIV/AIDS and other STIs are such that patients can live long, healthy, happy lives after receiving proper care. However, issues come with encouraging the community to seek out said care. We have come a long way from the diagnosis of HIV infection being a death sentence. Therapeutic advancements have been remarkable, from initiating protocols in mothers infected with HIV that prevent transmission to the newborn to newer, highly effective medications for everyone diagnosed with HIV, including options that minimize the number of drugs per day to even an option of one dose per week, or even one injection per month. HIV is now, more than not, a life-long manageable condition. Nevertheless, the prevention of infection remains the most rewarding strategy.

Studies have shown that education is the best tool to curb the spread of STIs, including HIV/AIDS, especially among younger generations. It is access to education about sexual wellness. The CDC reported that 19% of new HIV diagnoses in 2021 were among young people aged 13 to 24 years. Still, only 6% of high school students had ever been tested to determine their HIV status, meaning that young people do not have the resources they need to stay informed about their sexual wellness and not hesitate to ask for guidance.

While efforts to raise awareness of the STI epidemic are essential, it is crucial to implement educational initiatives that support ways to mitigate the spread of STIs so that communities can come together to help end this epidemic. Because so many people are ashamed to step forward due to the stigma associated with an STI diagnosis, cases are being underreported, and there are even more people living with and transmitting STIs than we know about. Lack of community awareness and buy-in hampers prevention.

Preventing the spread of HIV/AIDS with preventative care

A proactive approach is one of the best ways communities can rally to address the spread of STIs, including HIV/AIDS. Thankfully, many community clinics now offer resources such as free condoms or pre-exposure prophylaxis (PrEP) prescriptions, a medicine that can be up to 99% effective at reducing the risk of sexual transmission of HIV/AIDS, and even more so when used in combination with condoms. By offering these services, clinics are helping those who are not HIV-positive keep from being HIV-positive.

Another integral part of a proactive approach to curbing the spread is to make STI testing more widely available. Knowing one’s status is the first step to prevention, and thankfully, many community clinics now offer low-cost or free STI and HIV testing. However, there are still barriers to access, especially among low-income communities. Stigma and disenfranchisement are associated with these diagnoses, which cause people to avoid seeking medical treatment or even unintentionally spread these preventable, life-altering diseases.

Resources are available to people to help curb the spread of HIV, Hepatitis C, and other STIs, regardless of whether they test reactive or not. Clinics offer treatment options for patients who test reactive for STIs to manage the medical aspects and transmissibility of their condition. , Clinics give patients who test non-reactive (negative) the resources to stay free of STIs. Treating those who are reactive and informing those who are non-reactive on prevention measures form the cornerstone of addressing this epidemic.

Overcoming the stigma around STIs

Still, compassion may be the most powerful tool to move us toward controlling STIs. We must treat those living with STIs with humanism and empathy, end the stigma surrounding their diagnosis, and allow them to receive the help, understanding, and guidance needed to stop the spread of these preventable infections.

Within the reality and inequities of our healthcare and education system, people often do not consider the risk of acquiring HIV and other STIs until they have been diagnosed. The status quo is unacceptable. New and expanded education and prevention strategies are needed.

By eliminating barriers to STI treatment and education, we can make a difference for the patients we serve and generations to come. In an era where young people are affected by HIV/AIDS more than ever before, it is paramount that we provide them with the tools and resources they need to maximize their sexual wellness and end the STI epidemic we face today. This approach to both treat and prevent the spread of HIV/AIDS, along with other STIs, is what will make a genuine difference.