December 1 marks the 30th anniversary of the commemoration of World AIDS Day. UN-SIDA has proposed at the global level for this opportunity the motto "recognize your country", invite everyone to be tested for HIV.
In 2017, there are nearly 37 million people living with HIV in the world, in the same year 1.8 million people contracted the infection and 940,000 people died. The reason for this motto is based on the fact that the World Health Organization has endorsed some time ago, a worldwide prevention strategy called "90-90-90", originally designed by our compatriot, Professor Julio Montaner, which basically aims for years 2020:
-90% of people living with HIV know their HIV status
-90% of people diagnosed with HIV receive antiviral therapy
-90% of people who receive antiviral therapy have viral suppression.
To emphasize the importance of the role of care as a preventive measure, recent research categorically shows that when patients with HIV are detected and treated correctly, the possibility of transmitting this to their hetero or homosexual partners is literally "zero". But to get treated patients and with their virus undetected, you must first diagnose them (1 90 of the strategies).
In Argentina, 122,000 people suffer from HIV, but only 70% know; that's why the slogan "recognize your country" is also very suitable for our country and our city.
Unfortunately, many obstacles continue to inhibit HIV testing. Stigma and discrimination also persist and do not encourage people to undergo tests, so patients are diagnosed late when they already suffer from symptoms of disease (AIDS), and unfortunately they have infected others; In our city, the percentage of patients who are late reaches 30%.
HIV testing programs must be expanded, and all sexually active people must be tested for HIV in the same way as they control cholesterol or blood glucose; but not for alarms, mostly
of these tests will be negative (around 99.6%) given that in our country HIV prevalence is low, and those who are positive will be offered very simple treatments that will remain asymptomatic clinically and not infect others.
Unfortunately we cannot forget the fact that the usefulness of condom use has recently been questioned, for this we must answer once again and in a strict way "that condoms are very useful in preventing sexually transmitted diseases, including HIV." In addition and in other order, Prophylactic use is a proven measure of effectiveness for the prevention of unwanted pregnancies.
With regard to prevention, new data have been published showing the use of antiviral drugs in prevention methods for people who are not infected (PrEP or "PrEP"), whose goal is to deal with sexual relations with patients who have HIV infection, people who do not HIV infection is not infected by taking pills every day; This strategy has proved very useful in some groups at high risk of infection; it has not been implemented in us
In terms of care for people infected with HIV the more efficient, with fewer side effects and many of them in one pill.
Finally, definitive control of infectious diseases is achieved through vaccines, such as those that occur with smallpox and other infectious diseases; Although there are several ongoing investigations, it can be anticipated that there will be no vaccine for HIV in the near future.
HIV infection is and will become a "virus and not a moral disease"; and therefore must abide by the basic rules of medicine such as early diagnosis (recognize your condition), access to care and education to the public about what precautions are taken.
(*) Former Health Secretary of the municipality.