World AIDS Day has been observed annually on Dec. 1 since 1988 to remember the more than 35 million people who have died from HIV-related illnesses, to advocate for those living with HIV and to raise awareness to prevent the spread of the virus.
World AIDS Day is the first ever global health day and a lot of progress has been made over the past three decades in treatment and slowing the spread of HIV, but the goal is to End HIV. And ending it is possible globally through testing and medication.
End HIV Oregon started five years ago. The mission is to test all Oregonians and put those who test HIV positive on antiretroviral therapy (ART).
Today, the estimated 9,100 people in Oregon living with HIV can enjoy healthy, full lives when taking ART. ART is so effective at reducing the amount of virus in blood that 77 percent of people in Oregon living with HIV do not carry enough of the virus to transmit it to others. This is an increase from 63 percent in 2012.
“In the fifth full year since beginning End HIV Oregon in December 2016, statewide partners continue to bring HIV/Sexually Transmitted Infection testing to communities in need, expand access to prevention services like PrEP, and ensure high-quality treatment for people infected with HIV,” said Rachael Banks, public health director for Oregon Health Authority.
Undetectable = Untransmittable
“The science is clear,” said Tim Menza, M.D., PhD., medical director, HIV/STD/Tuberculosis section, Public Health Division, Oregon Health Authority. “Individuals living with HIV who take ART and achieve and maintain an undetectable viral load for at least six months cannot transmit HIV to their sexual partners.”
PrEP (pre-exposure prophylaxis) is a preventative daily pill that reduces the risk of HIV infection before it happens by more than 99 percent in sexual transmissions and at least 74 percent in transmission via needles. PrEP is available for free from most insurance providers, including the Oregon Health Plan.
Raising awareness that people living with HIV, once virally suppressed, cannot transmit the virus can help reduce the stigma. “It allows greater focus on relationships and personal connections, improves self-image, alleviates anxiety and guilt around potential transmission, and enables a worry-free sex life,” said Menza.
About 6 in 10 Oregonians have never been tested for HIV. This means some Oregonians have HIV and are not aware of it. People who know they are HIV positive are less likely to spread the virus and can begin life-saving treatment today.
In 2012, 15 percent of people newly diagnosed with HIV were virally suppressed within 90 days. In 2020 that number increased to 59 percent and newly diagnosed clients of Oregon’s HIV Early Intervention Services and Outreach are virally suppressed after a median of 62 days.
“That is a testament to the work of local public health agencies, community-based partners who provide case management, housing, and other critical support services, CareAssist, and Oregon’s many dedicated HIV care providers,” Menza said. “We are getting people linked to care, to insurance coverage, and on treatment as soon as possible.”
There has been progress, but more work needs to be done to prevent new infections and end HIV.
“Almost 80 percent of Oregonians diagnosed with HIV cannot transmit HIV,” said Menza. “While viral suppression is robust in Oregon, we remain short of our goal of 90% viral suppression by 2022.”
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