HIV In 2021: Where Are We Now?

Photo by Pawel Czerwinski on Unsplash

Since the beginning of the epidemic, HIV has infected 79.3 million people so far. Almost four decades after the HIV identification, how do people live with the virus nowadays? What progress has science made in recent years, and what's missing to move the cause further?

How many people were infected by HIV in 2020?

According to WHO & UNAIDS, in 2020:

• An estimated 37.7 million people were living with HIV, of which over two-thirds are in Africa

• 1.5 million people got infected with HIV

• 680 000 people died from HIV-related causes 

• 27.5 million people were accessing antiretroviral therapy

Read: The History Of Condoms 

Read: How Are Condoms Really Made

Education comes first: HIV basics

Where does HIV come from?

The origins of the AIDS pandemic were traced to the 1920s in Congo, thanks to viral archeology. It came from a mutated version of the chimpanzee virus - known as simian immunodeficiency virus - passed on to humans through meat consumption in Central Africa in the late 1800s.

What's the difference between HIV and AIDS?

HIV (human immunodeficiency virus) attacks the CD4 cells of the immune system, in charge of protecting the body against illnesses and infections. HIV incorporates its DNA in the DNA of every cell it infects, and over time, the body is likely to get various conditions and cancers. If left untreated, HIV leads to AIDS (acquired immunodeficiency syndrome), the last stage of infection.

More information about the three stages of HIV.

How do you get HIV?

• Unprotected sex (that is, any type of penetration, oral sex, contact with vaginal secretions and sperm) without a condom, medicine to prevent or treat HIV. 

• From the mother to the child

• Blood contamination

How to protect yourself against HIV?

Use a condom, get regularly tested, never share needles.

How do you know if you have HIV?

The only way to find out is to get tested: a simple blood analysis will detect HIV infection. Still, keep in mind that HIV can be detected only three weeks after contamination.  

Ask your healthcare provider or proceed to HIV self-testing.

Are there any symptoms? 

HIV can be asymptomatic, but you still can transmit the virus to other people! Some experience flu-like symptoms within 2 to 4 weeks after infection, including fever, rash, night sweats, chills, muscle aches, sore throat, fatigue, swollen lymph nodes, mouth ulcers.

What about HIV treatment?

While there isn't any cure for HIV - which is a long-life condition - it can be controlled with antiretroviral therapy that prevents the virus from infecting more cells and your sexual partners. 

Read: What Are The Best Contraception Methods?

Read: Truth About Condoms

What is the latest news about HIV research?

Scientists are now working on diversifying methods to stop the virus from spreading in the body. By providing more choices to patients, the idea is to stress prevention and treatment to avoid severe outbreaks. 

Tests on alternative treatments

• A vaccine that would activate an immune response to a wide range of HIV strains. The early results show 97% efficiency.

• A vaginal ring to replace monthly. For now, results show a reduction of 30% of the risk of getting HIV.

• An injection that would require a shot every eight weeks to protect for 1 to 6 months.

• An implant that could protect people for one year.

• An oral pill that would last 30 days.

HIV treatment, what's next?

So far, the only treatment that exists has to be taken on a daily basis. And so, scientists are focusing on long-lasting treatments. In 2021, the FDA approved the first long-lasting injectable treatments for HIV: cabenuva & lenacapavir.

Hope for a cure!

A new 2021 study published in eBioMedicine shows that about 4% of the population in Congo is able to suppress HIV without any medication. HIV infects cells by attaching a protein to their surface, called CCR5. People resistant to the virus have a genetic mutation that changes the shape of this protein, so HIV is unable to attach to the cells.

Some patients were cured of HIV by receiving bone marrow transplants from those naturally resistant to HIV. Bone marrow is the spongy tissue inside some of our bones and contains stem cells. The transplant helped them replace their white blood cells with those of the donor. The first person in the world to be cured of HIV is Timothy Ray Brown in 2007, the second is "the London patient" in 2019, and rumors mention a third one, "the Düsseldorf patient".

In 2018, the Chinese researcher He Jiankui used CRISPR (a technology used to edit genes) on human embryos to introduce the CCR5 mutation, making babies naturally resistant to HIV infection.

Other scientists have investigated the possibility of using CRISPR to erase HIV DNA from cells. Promising, but it is still at an experimental stage on mice!

What are the next steps?

In the past decades, HIV has become more manageable to live a long and healthy life with the help of better treatment, diagnosis, and prevention. But it isn't enough: the tools to fight HIV already exist, but health authorities and professionals need to find the right way to use them.

Get people with HIV to actually take their medications.

There is a widespread phenomenon of treatment refusal, and health authorities still need to understand why it's happening. According to this study, people with HIV would prefer long-lasting treatments to prevent missed doses and provide more medical privacy. 

Overcome the persisting stigma surrounding HIV and AIDS.

Researchers say that removing the stigma is essential to improve the quality of life of people with HIV, who need to be treated with respect and understanding to avoid isolation. Patients find it difficult to communicate with friends and family about their infection by fear of rejection or physical abuse. One of the most harmful myths is that HIV is spread through touch, tears, sweat, or even saliva, which can reinforce social isolation. 

Unfortunately, our knowledge doesn't stop us from having regular unsafe sex. Let's admit it, we've all done it a couple of times even though we know it's taking big risks. Even if your partner doesn't want to wear a condom, it takes two to tango! Your sexual health is in your hands ♥

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