We must reflect on HIV journey that we have travelled so far

It has been more than three decades since HIV was first discovered. Since then, it has claimed the lives of so many people, especially before the advent of anti-retroviral therapy (ART).

We have lost more than half of the more than 78 million people who have ever been infected with HIV. As a single disease, HIV has had serious consequences, but has also provided valuable lessons for dealing with global health problems.

With the many advances that have been realised over the years, new HIV infections and HIV related deaths are on the decline. The horizon is indeed getting clearer. It is reassuring that there are 17 million people now on treatment. However, this represents just about 50 per cent of the people living with HIV globally.

In Kenya, we estimate that there are 1.5 million infected people, of whom over 900,000 are on treatment. This scale-up of treatment has contributed to the prevention of many HIV-related deaths, from a high of about 170,000 deaths a year in the year 2000 to a low of about 36,000 deaths a year in 2015 representing about 100 deaths per day (about four deaths every hour).

Treatment has tremendous health benefits not only to those living with HIV but also in preventing HIV transmission. The use of ART for prevention of mother to child transmission of HIV has, for instance contributed to about 75 per cent, reduction of new HIV infections among children, from 27,000 in 2009 to about 7,000 in 2015.

As Kenya launches the new test and treat guidelines, we must reflect on the journey that we have travelled so far.

DEATH SENTENCE

In the 1980s, if one was diagnosed with HIV, it was equivalent to a death sentence. The coming of anti-retroviral drugs in the late 1990s and early 2000s brought about hope and now those infected can lead normal lives while on treatment.

We have moved from offering ART to those who had advanced HIV to a more recent approach of offering treatment to those whose CD4 cell count is below 500. Today, there is compelling scientific evidence that treating everyone who is HIV-infected irrespective of CD4 count, has significant benefits, including preventing early deaths, keeping away opportunistic infections and preventing transmission.

There is no need to wait now, start treatment today at your nearest health facility of choice. This is what is called “Test and Start”.

It’s also good news that, the Ministry of Health, through the National Aids and STI Control Programme and partners has put in place a strategy to tailor clinic visits to client’s needs.

Even as ART is now being considered a virtual vaccine against HIV, to defeat the virus, we must invest in combination interventions involving prevention and treatment aspects.

Some of the proven prevention strategies include consistent and correct use of condoms, voluntary medical male circumcision, strategies for preventing mother to child transmission of HIV, harm reduction programmes for key populations and prevention of HIV transmission in healthcare settings such as through safe blood transfusion services. Supportive services for vulnerable populations like cash transfers programmes are critical in removing vulnerabilities to HIV infection, especially among orphans.

It is our hope that the ongoing efforts to find a vaccine for HIV will bear fruit so that this scourge can be brought to rest once and for all.

Meanwhile, let’s all be responsible in our life choices and sexual lives and say no to stigma and discrimination to those infected and affected. To get to zero, all of us have a role to play and it starts with you. And so, take a HIV test today and take control of your life.

Dr Martin Sirengo is the head of the National Aids and STI Control Programme, deputy director of medical services at the Ministry of Health, and technical team leader for the Beyond Zero Campaign.