World AIDS Day: Progress, Challenges, and Hope
December 1st marks World AIDS Day, an international day dedicated to raising awareness of the AIDS pandemic and commemorating those who have died of AIDS-related illnesses. First observed in 1988, World AIDS Day was the first ever global health day, and has since become one of the most widely-observed health campaign days in the world.
What is AIDS?
AIDS stands for acquired immunodeficiency syndrome. It is caused by the human immunodeficiency virus, or HIV, which attacks and destroys the body’s immune system over time[1]. Unlike some other viruses, the human body cannot get rid of HIV, meaning that once a person has HIV, they have it for life.
HIV is transmitted through bodily fluids, most commonly through unprotected sex, contaminated needles or syringes, and from mother to child during pregnancy, childbirth, or breastfeeding[1]. Anyone can contract HIV, regardless of gender, ethnicity, sexual orientation, or other factors.
When left untreated, HIV infection leads to AIDS. This occurs when the immune system becomes so severely damaged it can no longer fight off certain types of infections and diseases[1]. These “opportunistic infections” can be extremely serious or even fatal. There is currently no cure for AIDS, but with proper treatment and care, the effects of HIV can be controlled and HIV can be slowed from progressing to AIDS[1].
Early History of the AIDS Pandemic
The world first became aware of AIDS in the early 1980s, although retrospective research suggests the disease first originated decades earlier[2]. Doctors began seeing a pattern of rare opportunistic infections and cancers in groups of young gay men in New York and California in 1981[2][3]. The disease seemed to spread through sexual contact and was fatal in most cases.
By 1983, the virus causing the disease was identified as HIV[3]. Shortly after, HIV was detected outside of the gay male population, showing it could spread through heterosexual sex and other means too. It soon became clear AIDS was turning into a global pandemic that could affect anyone[2].
In the earliest years, AIDS was met largely with fear, stigma, and misinformation. HIV/AIDS was sometimes referred to as “gay-related immune deficiency” or GRID, incorrectly suggesting it only affected homosexual men. Baseless fears of “catching” HIV from everyday contact further drove discrimination against those living with the virus. Tragically, many people with AIDS were shunned by family, medical providers, or communities[2][3].
The Global Scope of the Pandemic
Since the beginning of the HIV/AIDS epidemic, an estimated 85.6 million to 113.0 million people have been infected with the HIV virus, and about 40.4 million to 51.3 million people have died of HIV-related illnesses globally[4][5].
As of 2022, there were 39 million people living with HIV worldwide, and approximately 630,000 people died from AIDS-related illnesses in that year[4][5].
The WHO African Region remains the most severely affected, with nearly 1 in every 25 adults living with HIV and accounting for more than two-thirds of the people living with HIV worldwide[4][5].
The global death rates from HIV/AIDS have halved over the past decade, and significant progress has been made in addressing the epidemic, although challenges remain in ensuring access to prevention, treatment, and care for all those in need.
Today, HIV has spread to every region of the world. However sub-Saharan Africa remains disproportionately impacted, with nearly 70% of people living with HIV globally coming from this region[5]. Access to prevention and treatment continues to be a challenge here.
While Africa still shoulders an unequal share of the global HIV burden, the epidemic continues evolving in different regions[5]. Parts of Asia and Eastern Europe have recently seen surging rates of new infections.
Areas, where HIV was previously confined mainly to certain populations, are now experiencing more generalized epidemics crossing into the broader population.
Marginalized groups remain at elevated risk virtually everywhere, including people who use drugs, sex workers, transgender people, and men who have sex with men. Stigma and discrimination continue to block access to vital HIV services among these groups.
Modern HIV Treatment and Prevention
In 1996, antiretroviral therapy (ART) first became available to effectively manage HIV by stopping the replication of the virus in the body[6]. This transformed HIV from a fatal disease to a manageable chronic condition for those with access to treatment. Starting treatment early allows people with HIV to live long, healthy lives[7].
Today around 28 million people have access to ART globally, a major victory in the HIV response[8]. However, treatment coverage remains well below the goal of getting therapy to all who need it. Expanding access to HIV testing and treatment continues to be a core focus of advocacy and funding efforts.
Beyond treatment, great strides have also been made in HIV prevention. Proven interventions like condoms, sterile needles, routine testing, and pre-exposure prophylaxis (PrEP) medication when taken consistently have made it possible to nearly eliminate transmission risks[6][7].
Unfortunately, stigma and marginalization create barriers that stop many vulnerable people from accessing these prevention tools and getting tested or treated[6]. Ending stigma is now considered just as critical as developing new medications in order to control HIV.
Progress Towards Ending AIDS
According to the World Health Organization, an estimated 630,000 people died from HIV-related illnesses worldwide in 2022, which is 69% fewer than in 2004 (the peak) and 51% fewer than in 2010[5][9].
The Centers for Disease Control and Prevention reports that death rates among people with HIV decreased by about 37% from 2010 to 2018[10].
These numbers indicate a significant reduction in mortality rates and underscore the progress made in the fight against HIV/AIDS. However, there is still much work to be done to eliminate AIDS as a public health threat. In 2022, around 1.5 million people acquired HIV globally[5].
To decrease HIV-related deaths, people need to know their HIV status so they can take medicine to treat HIV and get the virus under control.
Major global efforts have driven progress. The Joint United Nations Programme on HIV and AIDS (UNAIDS) was established in 1996 to coordinate the global response. In 2000, governments adopted the Millennium Development Goals (MDGs) which included goals to halt and begin reversing the HIV pandemic – goals which were successfully achieved. In 2016, control of the HIV epidemic was included as a target in the new Sustainable Development Goals (SDGs)[12].
The most ambitious roadmap to date is the UNAIDS 2030 target of ending AIDS as a public health threat globally. Their plan calls for 95% of people living with HIV to know their status, 95% of diagnosed people to be on treatment, and 95% of those on treatment to have suppressed viral loads[11][12].
A new report from UNAIDS highlights that some countries have already achieved these “95-95-95” targets, demonstrating that ending AIDS is a political and financial choice. The report emphasizes that the path to ending AIDS is clear but requires continued action and commitment from leaders and communities[11].
If these 2025 milestones are met, modeling suggests AIDS-related deaths could fall below 200,000 globally by 2030 effectively ending the disease[11].
Achieving such a vision will demand accelerating efforts to make lifesaving HIV services radically more accessible, affordable, and equitable everywhere especially for marginalized groups. It will also require new medical innovations like more durable treatments and potentially an HIV cure or vaccine one day.
But for the first time, ending one of humanity’s deadliest pandemics is within reach through global solidarity and evidence-based action[11][12].
The Significance of World AIDS Day
Every year on December 1st, World AIDS Day serves as a moment for people across the globe to unite in the fight against HIV. Events, campaigns, and commemorations help raise vital awareness, stand in solidarity with those affected, demand political action, and reinvigorate efforts to ultimately end AIDS as a public health threat[13].
The red ribbon is the universal symbol of AIDS awareness worn and displayed each World AIDS Day, reminding people that HIV has not gone away. World AIDS Day events spotlight the remaining barriers to ending AIDS so they can inspire deeper commitments toward solutions[13]. And solemn commemorations ensure those we’ve lost to AIDS are not forgotten – that their memories can ignite the work still required to save lives.
AIDS Online Resources & Help
Here are six online resources that offer comprehensive information and support for individuals, caregivers, and healthcare providers:
AIDS.gov: The official website of the U.S. Department of Health and Human Services (HHS) provides a wealth of information on HIV/AIDS prevention, treatment, and research. It offers resources in multiple languages, including Spanish, Chinese, and Korean.
Phone: 1-800-442-2437
URL: https://www.hiv.gov/
AIDSmed: AIDSmed is a website that provides information about HIV/AIDS medications, including side effects, drug interactions, and dosage.
URL: https://www.aidsmeds.com/
AIDSInfo: Operated by the National Library of Medicine (NLM), AIDSInfo is a comprehensive resource for HIV/AIDS information. It includes scientific research articles, patient education materials, and news updates.
URL: https://hivinfo.nih.gov/home-page
Ryan White HIV/AIDS Program: Offers the Ryan White HIV/AIDS Program (RWHAP) Medical Provider tool to search for HIV care and support services. This program provides a comprehensive system of HIV primary medical care, medications, and essential support services for low-income people with HIV.
Phone: 301-443-1993
URL: https://ryanwhite.hrsa.gov/
The AIDS Institute: This non-profit organization provides research, education, and advocacy for HIV/AIDS prevention and treatment. Their website offers a variety of resources, including infographics, videos, and blog posts.
URL: https://www.theaidsinstitute.org/
HIV and AIDS Information from CDC: The Centers for Disease Control and Prevention (CDC) provides up-to-date information on HIV/AIDS prevention, treatment, and research. Their website includes fact sheets, statistics, and reports.
URL: https://www.cdc.gov/hiv/default.html
These six online resources offer valuable information and support for individuals affected by HIV/AIDS. They can help people understand their risk factors, learn about prevention strategies, and access treatment and support services.
In Essence
World AIDS Day matters because it provides hope in the face of an enduring crisis. It is proof that ordinary people can come together to achieve truly remarkable change against all odds. Every life saved and infection prevented moves the world closer to the end of AIDS.
After four unforgiving decades of loss, there is now a path to the last chapter in the history of humanity’s deadliest pandemic. A day to unite against AIDS may soon no longer be needed – the ultimate goal of this World AIDS Day.
References:
[1] “What Are HIV and AIDS?” HIV.gov, 2023,
www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids/.
[2] Sharp, Paul M, and Beatrice H Hahn. “Origins of HIV and the AIDS pandemic.” Cold Spring Harbor perspectives in medicine vol. 1,1 (2011): a006841. doi:10.1101/cshperspect.a006841
[3] “Timeline of the HIV and AIDS Epidemic.” HIV.gov, 2023,
www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline/.
[4] “HIV.” Who.int, 2022, www.who.int/data/gho/data/themes/hiv-aids.
[5] “Global HIV & AIDS Statistics — Fact Sheet.” Unaids.org, 2021,
www.unaids.org/en/resources/fact-sheet.
[6] Lehmann, C et al. “Moderne HIV-Therapie” [Modern HIV treatment]. Der Internist vol. 60,4 (2019): 411-419. doi:10.1007/s00108-019-0564-0
[7] Kemnic, Tyler R., and Peter G. Gulick. “HIV Antiretroviral Therapy.” Nih.gov, StatPearls Publishing, 20 Sept. 2022, www.ncbi.nlm.nih.gov/books/NBK513308/.
[8] “HIV and AIDS Epidemic Global Statistics.” HIV.gov, 2023,
www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics/.
[9] “HIV – Number of People Dying from HIV-Related Causes.” Who.int, 2021, www.who.int/data/gho/data/indicators/indicator-details/GHO/number-of-deaths-due-to-hiv-aids.
[10] Diagnose and Treat to Save Lives: Decreasing Deaths among People with HIV. 2023, www.cdc.gov/hiv/statistics/deaths/index.html.
[11] “New Report from UNAIDS Shows That AIDS Can Be Ended by 2030 and Outlines the Path to Get There.” Unaids.org, 2021,
www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2023/july/unaids-gl obal-aids-update.
[12] “The Path That Ends AIDS by 2030 Will Boost Progress towards Achieving Many Other Sustainable Development Goals.” Unaids.org, 2021,
www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2023/september/2 0230920_unga-hiv-progress.
[13] “World AIDS Day.” HIV.gov, 2023, www.hiv.gov/events/awareness-days/world-aids-day/.
