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AIDS-free generation?


AIDS-free generation?

Recent advancements in our understanding of HIV transmission, treatment, prevention and testing are changing the landscape of our response to HIV and generating a significant amount of optimism.
The buzz at the International AIDS Conference this past July in Washington, DC, was that we may now be able to achieve an “AIDS-free generation” where first, no one will be born with the virus; second, that as people age, they will be at a far lower risk of becoming infected than they are today; and third, that if they do acquire HIV, they will get treatment that keeps them healthy and prevents them from transmitting the virus to others.
Similarly, the United Nations AIDS organization’s Getting to Zero campaign for World AIDS Day, Dec 1, signifies the aim of getting to zero new infections, zero AIDS-related deaths, and zero discrimination.
There are many reasons we should feel these commendable goals can be achieved. But there are also significant challenges that need to be addressed before we get there.
New understanding about HIV
First, a word about those things that give us confidence.
We now have new medications for people living with HIV that are easier to take and have fewer side effects, thereby making HIV treatment more manageable. These medications also allow people living with HIV to have a near-normal life expectancy.
We also have a much better understanding of the importance of starting treatment early in order to achieve better health outcomes.
Treatment can also help prevent the transmission of HIV. Research shows that people living with the virus who are on successful antiretroviral therapy and have a fully suppressed (undetectable) viral load are less likely to pass on HIV to others.
Due to these advancements in our understanding of the virus, treatment guidelines now recommend that people living with HIV begin antiretroviral therapy as soon as they are ready after diagnosis.
The importance of early detection
To complement the uptake of early treatment, we have also made progress in developing new testing technologies and strategies that allow us to detect HIV earlier and faster than ever before, allowing HIV-positive people to learn about their status much sooner after becoming infected.
Early diagnosis is crucial to our success in preventing HIV transmission for three major reasons. First, it may help identify people during the first few months after HIV infection when their viral load and risk of HIV transmission is highest. Second, it gives newly diagnosed individuals the option to start treatment earlier. And lastly, the majority of people diagnosed with HIV take active measures to reduce their risk of passing on HIV to others.
New prevention approaches
Although condoms and clean needles are the backbone of our prevention efforts, we are learning about additional prevention tools that can also be used. We now know that the same drugs used to treat HIV can be used by HIV-negative people to help reduce their risk of an HIV infection. These preventative approaches are known as post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP).
While PEP is the standard of care for occupational exposure to HIV, its availability for non-occupational exposures and its cost vary greatly across Canada. Although PrEP is not currently approved for use by Health Canada, some doctors may already be prescribing it to their patients (known as “off-label” use). These new prevention approaches are promising options for HIV-negative people who are at high risk of getting HIV.
HIV drugs, in combination with other strategies such as not breastfeeding, can also help eliminate the transmission of the virus from an HIV-positive mother to her newborn child.
Challenges we still face
Despite these advancements, translating them into a generation without AIDS or without new HIV infections remains challenging. The hurdles we continue to face include limited financial resources applied to HIV prevention and treatment and the barriers people living with, and at-risk of, HIV face when accessing HIV-related services.
Additionally, people living with HIV can be criminally prosecuted for not disclosing their HIV status to their sexual partners, which can discourage them from wanting to know their status and lead to their opting out of getting tested.
Stigma, discrimination and poverty can make it difficult for marginalized populations to access services, which explains why some populations are more strongly affected by the HIV epidemic. The reality is that a number of Canada’s communities have a high prevalence of HIV. According to the latest estimates (2008) by the Public Health Agency of Canada, gay men and other men who have sex with men represent a majority (51 percent) of people living with HIV. People who use injection drugs represent 20 percent, people from regions where HIV is endemic (such as Africa and the Caribbean) represent 14 percent, and aboriginal people represent eight percent of the total epidemic in Canada.
Where do we go from here?
It’s clearer than ever that HIV prevention, testing, care, support and treatment are all mutually reinforcing elements of an effective response to realizing an AIDS-free generation.
At CATIE, we feel these advancements call for an “integrated approach” to HIV treatment and prevention. Such an approach will be discussed, for example, in September 2013, when CATIE will host a forum that will explore the recent developments in HIV and determine ways to integrate HIV treatment and prevention for us to move forward in an effective way.
While we are still years away from an AIDS-free generation, we appear to be on the right path. It takes only a look back 30 years ago at the despair we once felt in the face of this unknown disease to see how far we’ve come.
Laurie Edmiston is the executive director of CATIE.  
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CATIE sponsors QuAIA events
It was interesting that Xtra published the above guest column from Laurie Edmiston, the executive director of the Canadian AIDS Treatment Information Exchange (CATIE). I lost respect for CATIE when they co-sponsored a QuAIA event that competed with the annual Toronto AIDS Vigil in 2011 (both events were held at the same time). Source: http://queersagainstapartheid.org/2011/06/15/learning-tactics-and-strategies-with-act-up/ CATIE applies for grants from government health agencies by stating that it’s mission is to provide information about HIV and HIV treatments to at-risk communities, people living with HIV and heathcare providers. On the basis of those representations, governments give taxpayer money to CATIE. For example, in 2009, CATIE received $1,865,600.00 from the Public Health Agency of Canada. Source: http://www.gcdisclosure-divulgationsc.phac-aspc.gc.ca/phac-aspc/pd-dp/gc-oc.nsf/WEBbydetails/A2A3BCE9A7FD878585257A9A004CB726?OpenDocument&lang=eng& Governments don’t provide that money so CATIE can support leftist, anti-Israel groups like QuAIA (even if it is the pet project of their poz cronies like QuAIA’s Tim McCaskill).
@Tom (the second poster)
Hey Tom (the second poster), AIDS and HIV are much more serious than the flu. Surely that’s why there are so many publicly-funded AIDS service organizations and so many AIDS activist groups, yet none for the flu. For example, either at the national level or in Toronto alone, we have the AIDS Committee of Toronto, the Toronto People With AIDS Foundation, AIDS ACTION NOW!, Casey House, Fife House, Black Coalition for AIDS Prevention, Africans in Partnership Against AIDS (APAA) of Toronto, Alliance for South Asian AIDS Prevention (ASAAP), Asian Community AIDS Services, Centre for Spanish Speaking Peoples - AIDS Prevention Program, VIVER - Portuguese-Speaking HIV/AIDS Coalition, Voices of Positive Women, Positive Youth Outreach, Mother-Risk - HIV Health Line, Prisoners' HIV/AIDS Support Action Network, HIV & AIDS Legal Clinic Ontario (HALCO), Ontario Working Group on Criminal Law and HIV Exposure, Canadian HIV/AIDS Legal Network, Canadian AIDS Treatment Information Exchange, Canadian AIDS Society, Canadian Aboriginal AIDS Network and the Canadian Foundation for AIDS Research (CANFAR). I'm sure the availablity of government grant money has nothing to do with such a plethora of organizations.
I'm sure his massive drug use of
cocaine and meth among other substances had nothing to do with his heart attack. He was HIV+ and therefore died of HIV "complications"....Hepatitis C is an increasing problem for gay men.There is no preventative vaccine for Hepatitis C infection, but some treatments can be effective in around 50% of cases. Death usually follows for the others..... If you or a loved one has HIV/AIDS, you may know how hard it is to prevent viral infections such as the FLU. FLU complications such as pneumonia can deteriorate the body's already compromised immune system. There's also a higher risk of flu-related deaths among people with HIV. Everyone should be forced to get a flu shot. If they refuse they should be criminalized.
Reality check on Toronto AIDS activists
Bareback porn actor Josh Weston has died from HIV-related complications. He was only 39 years old. Source: http://www.gay.net/news/2012/12/18/gay-adult-film-star-josh-weston-dies
This is reality check on Toronto AIDS activists who downplay the seriousness of HIV infection when opposing criminal sanctions for HIV-positive people who have unsafe sex without disclosing their HIV status.
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