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Science: Global HIV epidemic is on the decline

UNITED STATES, WASHINGTON (OBSERVATORY) — Experts analyzed data on the incidence and mortality from HIV from 1990 to 2017. The conclusions were moderately optimistic for the world as a whole, but frightening for our country.

The results of a study in which scientists from 195 countries participated were published in the journal Lancet HIV.

The HIV epidemic was gaining momentum worldwide in the 1980s and 1990s. In the mid-1980s, 1.5 million people became infected annually. By 1992, the number of people sick every year exceeded two million, and the total number of infected people exceeded 10 million.

The deadly infection reached its peak in the second half of the 90s. Then in a year more than three million people fell ill, and the total number of infected exceeded 20 million.

A few years after the peak incidence, naturally, a peak in mortality followed. In the mid-2000s, the epidemic claimed the lives of almost two million people a year.

Today, despite the general population growth, the global incidence of HIV morbidity and mortality is declining. Less than two million people a year are infected, and less than a million die. At the same time, the total number of infected people is estimated at 35 million people.

HIV affects mainly people of working age. Most women who died from HIV were 30–39 years old, while men were 35–44 years old. In 2007, about 17% of newly infected became infected in infancy, but over the decade this percentage has almost tripled.

Antiretroviral therapy (ART) plays a key role in the fight against the HIV epidemic. Timely administration of drugs allows the patient to live a long and happy life, preventing the virus from getting out of control.

“An example is the famous basketball player Irwin“ Magic ”Johnson, who exchanged the seventh dozen a couple of weeks ago,” says co-author of the study Stanislav Otstanov from the Moscow Institute of Physics and Technology. “He was diagnosed with HIV back in 1992. Of course, the financial capabilities of a talented athlete are unattainable for most of those infected with HIV, however, as a result of initiatives to combat the HIV epidemic, more than half of the total number of infected has become available to date.”

The traditionally least favorable HIV prevalence is in Africa. However, the greatest progress was also made there over the past decade: a record decline in HIV mortality was recorded in Zimbabwe (by 20.8%) and Tanzania (17.7%), and a decrease in incidence – in Esvatini (Swaziland): by 21.8% .

“Unfortunately, there is an exception to the general trend. There is an area on the planet where the HIV epidemic is gaining momentum,” comments Otstanov. “This is a number of states of the former USSR.”

Over the past decade, the largest increase in mortality is observed in Georgia (by 17.6%), and the incidence rate – in Russia (13.2%) and Kazakhstan (12.1%).

“The numbers speak eloquently about the scale of the problem: the number of people infected in a year in Russia is estimated at 139 thousand people. For comparison, in neighboring China, an order of magnitude more numerous, only about 33 thousand people were infected,” says Oststanov.

The expert names several possible reasons for this situation. This includes limited access to ART and a high level of drug addiction with the legislative prohibition of substitution therapy. In addition, groups with a high risk of HIV infection (injecting drug addicts, “priestesses of love” and their clients) do not seek medical examination and help on time and do not receive them in the required amount.

The taboo theme of HIV (and sex) in society plays a detrimental role. People often do not know about the real extent of the problem, or about the modern prospects of treatment, or even about the ways of spreading HIV and ways to prevent infection.

Recall that HIV is transmitted through sexual contact without a condom, through a syringe recently used by an infected person, and from mother to child during gestation. However, the timely administration of ART drugs can help a woman not transmit the infection to the fetus.

At the same time, touching, hugging and kissing an HIV-infected person, as well as sharing household appliances, towels and utensils are not dangerous.

The authors of the study also found out how realistic the goals in the field of HIV declared by the UN and the corresponding sustainable development goals until 2030 are.

According to experts, indicators of the availability of antiretroviral therapy for patients (81% infected by 2020, 90% by 2030) look quite real for most countries of the world.

But to achieve the stated figures for reducing the incidence and mortality from HIV will not be possible without coordinated work on a global scale. Not only drug developers, doctors and healthcare providers should make their contribution, but also legislators, the media, and every citizen who knows the ways of spreading HIV and takes steps to prevent getting infected.

By the way, earlier Vesti.Nauka (nauka.vesti.ru) talked about myths and real facts about HIV and AIDS. We also wrote about testing a vaccine against this disease.

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