Each year on 1 December, the world comes together to mark World AIDS Day. This event serves as a reminder of the global struggle to end HIV-related stigma, an opportunity to remember those who have died and a rallying call to continue working towards a day when HIV will no longer be a public health threat. This year marks the 35th commemoration of this important day with the theme ‘World AIDS Day 35: remember and commit’.
Over the years, the landscape of HIV/AIDS has undergone significant transformations. From the initial days when the virus was shrouded in fear and misinformation, to the present era where scientific advances have brought about substantial improvements in treatment and prevention, with nurses at the forefront of this evolving journey.
There are more than 107 000 people living with HIV in the UK (Balogun et al, 2023). Worldwide, it is estimated that 38 million people are living with the virus. Over the past 40 years, more than 35 million people have died of HIV- or AIDS-related illnesses (National AIDS Trust, 2023).
HIV testing is a key element of prevention. A negative HIV test result provides a person with access to pre-exposure prophylaxis (PrEP) along with health advice. An HIV-positive test result can lead to the provision of care and life-saving treatment. People living with HIV who receive treatment and have an undetectable level of virus cannot pass the infection on to sexual partners even without the use of condoms or PrEP. PrEP involves the use of antiretroviral medicines by HIV-negative people to reduce the risk of HIV acquisition.
The number of HIV diagnoses in England rose by 22% from 3118 in 2021 to 3805 in 2022. Most of this increase is attributable to people who were diagnosed abroad, a 69% increase from 805 in 2021 to 1361 in 2022 (UK Health Security Agency (UKHSA), 2023). These infections were likely acquired abroad and so do not reflect a rise in transmission in England. Of those people previously diagnosed abroad and having a later diagnosis in England during 2022, 67% (911 of 1361) arrived in England in 2022. Most were linked to care shortly after their arrival (UKHSA, 2023).
People with HIV in the UK can live a long and healthy life. The end of AIDS is possible; it is within our grasp. Community-led approaches are the backbone of the HIV response (UNAIDS, 2023). Organisations of communities who are living with, at risk of, or affected by HIV are at the frontline of progress in the world's response to HIV. It is communities that connect people with person-centred public health services, they build trust, they collectively innovate, monitor implementation of policies and services and they also hold providers accountable.
However, inequalities still persist. HIV testing numbers among gay and bisexual men and men who have sex with men in 2022 were the highest ever reported. However, for heterosexual men and women, data remained lower than those observed in 2019 and women were most likely to not be offered, and to decline, a test. A particular emphasis is needed for women and people from ethnic minority groups, both in PrEP provision and access to HIV testing.
There remain people with HIV who still experience discrimination in all aspects of their lives.
World AIDS Day exists to highlight the experiences of people living with HIV. It celebrates the strength and resilience of those communities most affected. It is an opportunity to inspire the leadership that is required to create a future where HIV will not stand in the way of anyone's life.