The future of HIV

People all over the world are receiving effective HIV treatments and more treatment options are in the pipeline. Now, global health organisations want to end the AIDS epidemic

IN 2015, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched an ambitious target: to end the AIDS epidemic by 2030. The aim is that no child will be born with HIV and anybody already infected will be treated with medicines that give the best opportunity for healthy living.

This goal is in stark contrast to the early days of the epidemic, when the virus wreaked havoc. In the 1980s and 90s, an HIV infection was almost always fatal. But treatment has come a long way since then.

Today, nearly 21 million people around the world receive life-saving antiretroviral therapies, which can reduce the amount of the virus in the blood to undetectable levels. And scientists have even greater ambitions: some are developing vaccines, others are formulating long-acting treatments and still more are working on a cure. “HIV has changed from a deadly disease to a manageable disease,” says Jens Lundgren at the University of Copenhagen in Denmark, who has been working on HIV care and research for the past 30 years.

Until recently, HIV’s spread was rapid because it is easily transmitted via contact with infected blood and other body fluids. The most common routes of infection are through sex and shared needles.

But the risk of transmission can now be substantially reduced with antiretroviral medicines. Bruce Richman, who was diagnosed with HIV in 2003, says the treatments have changed his life. “For much of the time I had HIV, I isolated myself and had a sense of fear and shame,” he says. “Because I had a fear of transmitting HIV, I feared getting close to romantic partners.”

But that changed in 2012, when Richman’s doctor informed him that his antiretroviral treatment had reduced the amount of HIV in his blood to undetectable levels. The news was a revelation and Richman realised he no longer needed to hide.

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