The world is on track to eliminate AIDS by 2030.
This is according to a United Nations (UN) report, which, however, warns that this goal depends on fully funded programs to combat the disease.
Sub-Saharan Africa, home to 65% of all people living with the human immunodeficiency virus (HIV) that can cause AIDS, is making great strides in eliminating the disease.
Botswana, Esuatini, Rwanda, Tanzania and Zimbabwe have already reached the “95-95-95” target, according to UNAIDS, the United Nations agency specializing in combating the disease.
This means that 95% of people living with HIV know their HIV status, 95% of people who know their status are receiving antiretroviral treatment, and 95% of people on treatment have suppressed the virus, making it almost impossible to transmit it.
Another 16 countries, eight of them in sub-Saharan Africa, are also close to achieving this goal.
Appealing to the conscience
“The end of AIDS is an opportunity for today’s leaders to leave an exceptionally powerful legacy,” said Winnie Byanyima, executive director of UNAIDS, in a statement.
“[Leaders] could save millions of lives and protect the health of all. They could show what leadership can achieve,” she added.
But Onusida faces an $8.5 billion shortfall in its budget for low- and middle-income countries by 2025.
The agency has warned that progress could easily be wasted.
“The figures in this report show that the path is clear,” Byanyima added.
Girls at risk
But there are still hurdles to overcome. Every week, 4,000 adolescent girls and young women become infected with HIV.
And in sub-Saharan Africa, despite progress, the UN says women and girls of all ages are the most vulnerable, accounting for 63% of all new HIV infections in 2022.
In Botswana in southern Africa, girls remain vulnerable when older men take advantage of them, known as “intergenerational sex.”
Gaone is a 32-year-old woman who became infected with HIV when she was a schoolgirl.
“One of my very close relatives used to help me a lot. He was in his 30s, twice my age. I trusted him. He would take advantage of me and have sex with me,” she narrated.
Gaone has been taking antiretroviral drugs since 2012 and is a mother of two. Both of her children are HIV-negative and she now works as an activist.
According to Gaone, the community is not ready to talk openly about “rape” and “sexual exploitation.”
“Some days I get messages from up to five women who contracted HIV from an older person, mostly family members. If men don’t listen, what can we do?” he posited.
The power of prayer
All the data show that HIV-infected men are more reluctant than women to seek medical help.
Botswana is now engaging religious leaders to try to change male attitudes and prevent transmission of the virus.
“In Botswana, 95 percent of people living with HIV know their status. Most of those who do not know their status are men,” the priest said. Mmachakga Mpho Moruakgomo is a Christian leader who is part of a multi-faith group working on this issue.
He added: “Because people respect religious leaders, we use it to tell men that once their identity is confirmed, they should be tested and registered for treatment.”
Rev. Moruakgomo said Muslim, Hindu and Bahai leaders, as well as native healers, are engaged, with some even going door-to-door to spread the message.
The campaign is called “Brethren Arise,” inspired by a phrase from the country’s national anthem.
“There is a lot of stigma around HIV and we religious leaders were responsible for that,” the African Methodist Episcopal Church pastor candidly admitted.
“We were very critical and blamed those who got infected. Sex and sexuality are fundamental to our existence. We need to apologize and admit we were wrong,” he concluded.
Ontiretse Letlhare, director of Botswana’s National AIDS and Health Promotion Agency (Napha), said the country is on track to eliminate AIDS by 2030 and hopes religious leaders can provide that vital impetus.
“The critical issue is to intensify efforts to destigmatize HIV and avoid situations where people living with HIV are afraid to seek help at health facilities,” she added.
World overview
In the rest of the globe the trend is less positive, admitted the UN, which revealed that nearly a quarter of new HIV infections recorded in 2022 occurred in Asia and the Pacific.
However, the steepest increases in new infections were recorded in Eastern Europe and Central Asia (up 49% since 2010) and the Middle East and North Africa (up 61% since 2010).
The UN said these trends are due to a lack of HIV prevention services for marginalized populations and laws that criminalize the LGBTQ+ community.
But a treatment known as pre-exposure prophylaxis or PrEP is providing hope.
Cambodia, for example, is providing these tablets free of charge to vulnerable populations, including sex workers, the gay and transgender community.
The daily tablet contains the drugs used to treat HIV and also serves to prevent transmission when the person is HIV-negative.
“I have to take the tablets regularly for three months. The first few days I had headaches, but then there were no other side effects. I take one pill a day,” said Kuy Pov, a 32-year-old transgender woman who owns a beauty salon in the capital, Phnom Penh.
“I am taking PrEP because I have multiple sexual partners. I know I’m really at risk,” she said. The reason? Despite asking her partners to use condoms, they sometimes refuse.
Some 76,000 people in Cambodia are living with HIV. Eighty-six percent of this population knows their status. And of those, nearly 99% are able to access treatment.
New infections have decreased by 91% compared to 1996. But at least four people are infected every day, which remains a major concern.
“In the past, condom use was promoted, but there were many who did not use them. PrEP is an innovative way to help the community prevent HIV transmission,” said Danou Chy, who works for the non-governmental organization Men’s Health in Cambodia, in the country’s capital.
PrEP pills are showing encouraging results and there are plans to introduce an injectable version, the activist explained.
The new treatment has given Kuy control of his life and he recently took an HIV test, which came back negative.