HIV; World AIDS Day;
Posted on by Jun Huang

New proposals focus on quality of life and stigma reduction amid hopes to improve health outcomes and well-being for people afflicted with HIV.

International experts have called for new initiatives to improve the quality of life of people living with HIV and to end the stigma associated with it on World AIDS Day (December 1).

The HIV Outcomes held a roundtable in Strasbourg on November 26 to discuss a new era of HIV care, ‘beyond viral suppression’, as well as launched a new Lancet HIV Series on HIV Outcomes Beyond Viral Suppression aimed at people living with HIV in the long-run.

Professor Jane Anderson, an HIV Outcomes co-chair, presented the initiative and the Call to Action at the meeting, urging policymakers to deliver on political commitments ensuring stable long-term health outcomes and well-being for people living with HIV.

According to Professor Anderson, who is also from Homerton University Hospital NHS Foundation Trust, the Call to Action emphasises the promotion of well-being values, comorbidity prevention and de-stigmatisation, and the elimination of discrimination for long-term improvement to the lives of people living with HIV.

The meeting also presented a joint statement, stating: “Europe must ensure that people living with HIV have good health-related quality of life and that stigma and discrimination are eliminated.”

The addition of a fourth 90 goal

The newly-launched Lancet HIV Series, led and guest-edited by Professor Anderson and fellow co-chair, Professor Jeffrey Lazarus, suggested that “the fourth 90” should be integrated into the extension of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 goals.

The UNAIDS 90-90-90 targets aim to achieve 90% diagnosis of HIV, 90% treatment of those diagnosed and viral suppression for 90% of those treated by 2020. The goals do not cover other HIV-related health problem, like mental health issues, stigma and discrimination of patients.

However, these goals are not enough: The Lancet HIV warns that “health systems are unprepared” to meet the needs of growing numbers of people living with HIV, especially the elderly group.

“In 2019 it is not enough that people living with HIV are alive. They should also be living well,” the Series co-editors Peter Hayward and Philippa Harris from The Lancet HIV writes in a linked editorial.

The editorial further suggests that good quality care and the elimination of discrimination should be the way forward,  as “the health-care needs of people living with HIV continue to move beyond specialist services.”

No stigma for a better life

According to the research, HIV-related stigma and discrimination are ‘major barriers for overall health-related quality of life’ and can ‘negatively affect happiness, self-esteem, sexual and social relationships, and the sense of purpose in those living with HIV.’ These have prompted experts to address these areas.

On a high note, the UK has become one of the first countries to meet the UNAIDS 90-90-90 targets, with 92% of people diagnosed with HIV, 98% of those diagnosed receiving treatment, and 97% of those on treatment having viral suppression as of 2017, according to Public Health England (PHE).

Treatment and care outcomes have rated excellent in the results of a national HIV patient survey Positive Voices, but it is also revealed that nearly 50% of people living with the disease had social and welfare needs that were largely unmet.  

Alongside 30 other organisations participating in the manifesto aimed at the next government include the UK’s leading HIV charities National Terrence Higgins Trust (THT) and AIDS Trust (NAT). 

Mirroring the Lancet HIV Series, the manifesto reads, “Tackling stigma is vital to improving the lives of people living with HIV and is integral to tackling new HIV transmissions”.

The NAT has launched this year’s Rock the Ribbon Together Campaign to celebrate World AIDS Day, calling for standing in solidarity with people living with HIV to tackle HIV-related stigma and isolation. Also, they match up action for promoting peer support during the election time.

Chief Executive of NAT, Deborah Gold, announced that 20 percent of HIV patients battled with loneliness, adding: “No one should feel isolated or alone because of their HIV status.”

She recommends high quality peer support, that can offer a range of benefits. This in turn, will reduce the pressure on health and social care services.  “Peer support can and does transform the lives of people living with HIV.”