Leap forward in HIV stigma fight

THE revelation that HIV-positive people who are on effective anti-retroviral therapy cannot transmit the virus when they become virally suppressed could reduce stigma, stakeholders say.

People on ART can become virally suppressed within 12 to 28 weeks.

The United States Centres for Disease Control said earlier this month that people living with HIV while taking effective medication cannot pass it on through sexual encounters.

This follows years of clinical trials showing that those using effective ART do not risk infecting their sexual partners.

Activists and researchers had long campaigned for the CDC to make the declaration. In November, CDC directors Eugene McCray and Jonathan Mermin finally signed off on this.

“Across three different studies, including thousands of couples and many thousand acts of sex without condoms or pre-exposure prophylaxis, no HIV transmissions to an HIV-negative partner were observed when the HIV-positive person was virally suppressed,” they said.

“This means that people who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.”

The director of the Health and Child Care Ministry’s AIDS and TB unit, Dr Owen Mugurungi, welcomed the announcement with a note of caution.

“ART removes actively replicating HIV, yet the virus can remain hidden in the body, meaning a patient must take the drugs continuously,” he said. “However, people still need to exercise caution and refrain from recklessly taking a cue from the latest developments.”

Among people living with HIV (15 to 64-years-old) who self-report current use of ART in Zimbabwe, 78,7 percent are virally suppressed.

Modern anti-retroviral drugs often achieve viral suppression, meaning levels of the virus are reduced to undetectable levels in the blood. Undetectable levels of HIV are below 50 copies.

“Viral suppression can be lifelong if people stay on medication,” added Dr Mugurungi.

According to statistics from a Zimbabwe Network for People Living with HIV and Aids (ZNNP+), survey, stigmatisation of people with the virus is above 65,5 percent, with different forms of discrimination prevalent at workplaces, in families and other social spaces.

Society has various forms of stigma and discrimination against PLHIV which range from exclusion, name-calling, insults, dismissal from employment and sexual rejection.

The survey established that forms of stigma range from exclusion from gatherings, discrimination by partners, exclusion from family activities, dismissal or suspension from work or educational institutions, exclusion from religious activities or places of worship and sexual rejection.

Southern African HIV and Aids Information Dissemination Service head of media, marketing and public relations Mrs Tariro Makanga-Chikumbirike said more still needed to be done to fight stigma and discrimination. “Unfortunately normalising HIV is taking longer than anticipated. People still have the fear of HIV and in some instances still equate it to the death sentence,” said Mrs Makanga-Chikumbirike.

“We still need to do more to make people understand that with the treatment advancements, HIV is now just like any other chronic illness which can be managed.”

Activist Ms Tendayi Kateketa added that stigma levels remained high because: “Many people are still afraid of getting tested for HIV to find out their HIV status. Stigma is being fuelled in our homes, some healthcare settings, the workplaces and sections of the religious communities.”

The annual incidence of HIV among adults (15 to 64-years-old) in Zimbabwe has declined from 0,85 percent in 2015 to 0,45 percent, corresponding to approximately 32 000 new cases yearly.

Government estimates that 1,4 million people are living with HIV, of which 86 percent are on ART.

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