30 years after the commemoration of World AIDS Day "Diario La Capitale de Mar del Plata

December 1st marks the 30th anniversary of the commemoration of World AIDS Day. UN-SIDA has proposed for the occasion the motto "Know Your State", inviting all people to be tested for HIV.

In 2017, there were nearly 37 million people living with HIV worldwide. That same year, 1.8 million people contracted the infection and 940,000 people died. The motive behind this motto is that the World Health Organization recently approved the global prevention strategy called "90-90-90", originally designed by our compatriot, Professor Julio Montaner. which aims essentially for the year 2020:
-90% of people living with HIV know their HIV status
about HIV.
-90% of HIV-positive people receive antiviral treatment
keep on going
-90% of people receiving antiviral treatment have viral suppression.

To emphasize the importance of the role of treatment as a preventive measure, recent research categorically indicates that when HIV-positive patients are detected and treated correctly, the possibility of transmitting it to their heterobadual or homobadual partners is literally "nil". But for patients to be treated and their virus undetectable, you must first diagnose them (1 st 90 of the strategy).

In Argentina, 122,000 people are living with HIV, but only 70% know it. that is why the slogan "know your state" is also suitable for our country and our city.

Unfortunately, many barriers continue to hinder HIV testing. Stigma and discrimination also persist and do not encourage people to undergo tests. Thus, patients are diagnosed late when they are already suffering from the symptoms of the disease (AIDS) and, unfortunately, they have infected others; In our city, the percentage of patients who are late reaches 30%.

HIV testing programs should be expanded and all badually active people should be tested for HIV in the same way that they control cholesterol or blood glucose; but not to alarm, the vast majority
these tests will be negative (about 99.6%) since HIV prevalence in our country is low and those who are positive will be offered very simple treatments that will remain clinically asymptomatic and will not infect others.

Unfortunately, we can not forget that the usefulness of condom use has recently been questioned. To this we must respond strictly "that the condom is very useful for preventing badually transmitted diseases, including HIV." In addition and in another order, the use of the prophylactic agent is a proven measure of effectiveness for the prevention of unwanted pregnancies.

With regard to prevention, new data have been published indicating the use of antivirals as a preventive measure for uninfected persons (pre-exposure prophylaxis or "PrEP"), whose purpose is that of a badual relationship with a patient who: if you are infected with HIV, the uninfected person will not be infected by taking one tablet every day; This strategy has proved extremely useful in certain groups at high risk of infection; it is not yet implemented in our
way

With regard to treatment for people infected with HIV, they are increasingly effective, cause fewer side effects and many of them take the same pill.

Finally, definitive control of an infectious disease is achieved by a vaccine, as has been the case for smallpox and other infectious diseases; Although several investigations are ongoing, it is expected that no HIV vaccine will be available in the near future.

HIV infection was and will be "a viral and not a moral disease"; and must therefore be subject to the basic rules of medicine such as early diagnosis (know your condition), access to treatment and community education about preventive measures.

(*) Former secretary of health of the commune.