In a world grappling with various health crises, one condition that has long endured both medical and societal challenges is HIV/AIDS. Over the past few decades, significant progress has been made in understanding and managing this complex virus. However, alongside medical advancements, the fight against HIV/AIDS demands a parallel battle against a formidable foe: stigma. This July 21st, we come together to commemorate Zero HIV Stigma Day, a day dedicated to raising awareness, breaking down barriers, and fostering a world free from discrimination and prejudice.
HIV stigma remains one of the most persistent barriers to achieving universal access to HIV prevention, treatment, care, and support. The stigma associated with HIV/AIDS not only affects the individuals living with the virus, but also their families, friends, and communities. It perpetuates fear, shame, and misinformation, preventing people from seeking necessary healthcare services, support systems, and education about prevention.
What is HIV?
Human Immunodeficiency Virus (HIV) is a viral infection that attacks the immune system, specifically targeting CD4 cells (T-helper cells), which are crucial for the body's defence against infections and diseases[i]. Left untreated, HIV can progress to Acquired Immunodeficiency Syndrome (AIDS), a condition where the immune system becomes severely compromised, making individuals vulnerable to opportunistic infections and cancers.
Acquired Immunodeficiency Syndrome (AIDS) is the advanced stage of HIV infection. It is diagnosed when the immune system becomes severely damaged, leading to the development of opportunistic infections or certain cancers. The criteria for an AIDS diagnosis include a significant decline in CD4 cell count and the presence of specific opportunistic infections or cancers[ii].
HIV is considered a sexually transmitted infection (STI)[iii], a term often used interchangeably with sexually transmitted disease (STD) to describe infections transmitted through sexual contact. However, it is important to note that not all STIs are the same as HIV. There are various STIs, such as gonorrhoea (also stylised as gonorrhea), chlamydia, syphilis, herpes, and HPV, which can have distinct symptoms and treatment options. Although HIV is considered an STI, it is important to understand all the different ways in which HIV is transmitted, including those transmitted by non-sexual means.
HIV can be transmitted through certain body fluids, including blood, semen, vaginal fluids, and breast milk[iv]. The most common modes of HIV transmission are:
- Unprotected sexual intercourse: Engaging in vaginal, anal, or oral sex without using barrier methods like condoms can put individuals at risk of contracting HIV if their partner is HIV-positive
- Sharing contaminated needles or syringes: Sharing needles or other drug injection equipment with an HIV-infected person can lead to the transmission of the virus
- Mother-to-child transmission: HIV can be passed from an HIV-positive mother to her child during pregnancy, childbirth, or breastfeeding. However, with proper medical interventions, the risk of transmission can be significantly reduced.
HIV Transmission in Australia, 2021. Image credit: Health Equity Matters
After HIV infection, some individuals may experience flu-like symptoms within a few weeks[v]. These symptoms, known as acute retroviral syndrome (ARS), can include:
- Sore throat
- Swollen lymph nodes
- Muscle aches
- HIV rash
HIV Symptoms in Men
The symptoms of HIV in men are generally similar to those in women. Some common symptoms that may occur in men include:
- Unexplained weight loss
- Night sweats
- Recurrent fevers
- Chronic diarrhea
- Oral or genital sores[vi]
It is crucial to remember that symptoms alone cannot confirm an HIV infection, as they can also be indicative of other conditions.
Understanding the basics of HIV, including its transmission routes, symptoms, and progression to AIDS, is crucial for raising awareness and promoting prevention. By educating ourselves and others about HIV and addressing the stigma associated with it, we can work towards a more inclusive and compassionate society where individuals living with HIV receive the support they need to live healthy and fulfilling lives.
What is Zero HIV Stigma Day
Zero HIV Stigma Day is an initiative that aims to challenge the deep-rooted misconceptions and stereotypes surrounding HIV/AIDS. By shedding light on the impact of stigma and discrimination, this day seeks to foster empathy, compassion, and understanding, ultimately leading to a more inclusive and supportive society[vii].
The significance of Zero HIV Stigma Day extends beyond a single day of observance. It serves as a powerful reminder that we all have a role to play in addressing the underlying social, cultural, and structural factors that perpetuate stigma. It encourages conversations, education, and collective action to dismantle the barriers that hinder progress in combating HIV/AIDS.
On this day, organisations, activists, healthcare professionals, policymakers, and individuals around the world come together to amplify their voices and advocate for change. Through awareness campaigns, educational events, and community outreach, they strive to dismantle prejudice and foster an environment of acceptance and support for those affected by HIV/AIDS.
The journey towards zero stigma surrounding HIV/AIDS may seem daunting, but it is essential in achieving global health equity. It requires us to challenge our own biases, dispel myths, and ensure that everyone receives equitable access to healthcare and support, regardless of their HIV status. By empowering individuals, fostering understanding, and cultivating an environment free from judgment, we can work collectively to create a future where people living with HIV/AIDS can lead fulfilling lives without fear of discrimination or isolation.
Why does Zero HIV Stigma Day Occur on July 21?
July 21 is the date that Prudence Nobantu Mabele was born (1971) and died (2017). A prominent HIV activist, Prudence Mabele played a crucial role in destigmatising HIV/AIDS by publicly disclosing her own HIV status in 1992, becoming the first woman in South Africa to do so. She dedicated her life to advocating for the rights of women and children living with HIV and fighting against gender-based violence[viii].
Prudence Mabele, the first woman in South Africa to publicly disclose her HIV status in 1992. Image credit: BBC
Her courage in sharing her status without shame and her commitment to seeking treatment, care, and living a fulfilling life became an inspiration for others living with HIV. Prudence Mabele set a precedent for open discussions about HIV status, encouraged individuals to seek appropriate medical care, and contributed to breaking down the barriers of stigma and discrimination surrounding HIV/AIDS.
In light of Prudence Mabele's immense contributions, the choice of July 21 for Zero HIV Stigma Day becomes even more meaningful. It serves as a day to honour her legacy, recognise her impact, and continue the work of addressing and eliminating HIV-related stigma, not only in South Africa but also globally.
To effectively address HIV stigma, it is crucial to shift the focus from the virus itself to the individuals living with HIV. HIV does not define a person's worth or character, and it is essential to recognise their inherent dignity and rights. By fostering empathy, understanding, and education, we can challenge the negative stereotypes and discrimination that contribute to HIV stigma.
Another key component to reducing the stigma associated with HIV is access to testing, preventative medicine, and post-infection treatment that is free from judgement and discrimination[ix]. Advancements in medical science have led to significant breakthroughs in HIV treatment, transforming it from a life-threatening condition to a manageable chronic illness. Access to appropriate treatment and care plays a vital role in improving the health and well-being of people living with HIV and reducing the risk of transmission. Key components of HIV treatment include:
- HIV Test: Testing for HIV is the first step towards early diagnosis and treatment. HIV tests are confidential, and various options are available, including rapid tests, laboratory-based tests, and home HIV test kits.
- HIV Medication: Antiretroviral therapy (ART) is the standard treatment for HIV. ART involves taking a combination of medications that suppress the replication of the virus, allowing the immune system to rebuild and maintain its strength[x]. Adherence to medication is crucial for its effectiveness, and regular medical follow-ups are essential to monitor the treatment's progress.
- PrEP: Pre-Exposure Prophylaxis (PrEP) is a preventive approach for individuals at high risk of contracting HIV. It involves taking a daily medication regimen to reduce the risk of acquiring the virus[xi]. PrEP has proven to be highly effective when used consistently and in combination with other prevention methods, such as condom use.
- HIV Cure: While there is no cure for HIV at present, scientists and researchers continue to explore potential avenues towards a cure. Various strategies, such as gene therapies and immunotherapies, are being investigated to eliminate the virus from the body or achieve long-term remission[xii]. Additionally, the development of an effective HIV vaccine is an ongoing global effort[xiii]. A vaccine would significantly contribute to preventing new infections and potentially eradicate HIV altogether. Although progress has been made, the complexity of the virus poses challenges, and extensive research and clinical trials are required before a safe and effective vaccine becomes available.
By promoting access to HIV testing, treatment, and prevention methods like PrEP, as well as supporting ongoing research for a cure and vaccine, we can empower individuals and contribute to the reduction of HIV stigma. It is essential to prioritise comprehensive healthcare, education, and support systems that address the holistic needs of people living with HIV, fostering a society that embraces inclusivity, understanding, and compassion.
Zero HIV Stigma Day, falling on July 21st, serves as a rallying cry for action, a call to challenge the status quo, and an opportunity to champion the rights and dignity of every individual affected by HIV/AIDS. Addressing HIV stigma requires a collective effort from individuals, communities, healthcare providers, policymakers, and society as a whole. By placing the focus on the humanity of those affected by HIV, promoting access to testing, treatment, and prevention methods, and supporting ongoing research, we can create a world free from discrimination and prejudice. Let us work together to break down barriers, challenge stereotypes, and foster a compassionate and inclusive society that stands against HIV stigma.
[i] HIV.gov 2023, What Are HIV and AIDS?, HIV.gov, viewed 19 July 2023, <https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids/>.
[ii] World Health Organization 2023, HIV and AIDS, World Health Organization, viewed 19 July 2023, <https://www.who.int/news-room/fact-sheets/detail/hiv-aids>.
[iii] HIV.gov, 2023 HIV and Opportunistic Infections, Coinfections, and Conditions, HIV.gov, viewed 19 July 2023, <https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-sexually-transmitted-diseases-stds#:~:text=become%20a%20disease.-,HIV%20is%20a%20sexually%20transmitted%20infection%2C%20but%20it%20can%20progress,HPV)%20infection%2C%20and%20syphilis>.
[iv] Terrence Higgins Trust 2020, How HIV is transmitted, Terrence Higgins Trust, viewed 19 July 2023, <https://www.tht.org.uk/hiv-and-sexual-health/about-hiv/how-hiv-transmitted#:~:text=HIV%20is%20passed%20on%20through,by%20spitting%2C%20sneezing%20or%20coughing>.
[v] Mayo Clinic Staff, 2022 HIV/AIDS, Mayo Clinic, viewed 19 July 2023, <https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524>.
[vi] Wacher, M., 2015 7 Symptoms of the Early Stages of HIV, Ending HIV, viewed 19 July 2023, <https://endinghiv.org.au/blog/7-symptoms-of-hiv-early-stages/?gad=1&gclid=Cj0KCQjw8NilBhDOARIsAHzpbLBPMy6heNme8F6dcKWuWOepoSQCz99OxxZ87zWmxG2lf99equmlGicaAuXxEALw_wcB>.
[vii] Zero HIV Stigma Day 2023 Zero HIV Stigma Day, Zero HIV Stigma Day, viewed 19 July 2023, <https://zerohivstigmaday.org/>.
[viii] Zero HIV Stigma Day, 2023 Why is Zero HIV Stigma Day Taking Place on July 21st?, Zero HIV Stigma Day, viewed 19 July 2023, <https://zerohivstigmaday.org/why-july-21st/>.
[ix] Nyblade, L., Stangl, A., Weiss, E. & Ashburn, K. 2009, ‘Combating HIV stigma in health care settings: what works?’, Journal of the International AIDS Society, vol. 12, no. 15
[x] Pan American Health Organization 2023, Antiretroviral Therapy, PAHO, viewed 19 July 2023, <https://www.paho.org/en/topics/antiretroviral-therapy#:~:text=Antiretroviral%20therapy%20(ART)%20is%20treatment,HAART)%20that%20suppress%20HIV%20replication.>.
[xi] NIH.gov 2021, Pre-Exposure Prophylaxis (PrEP), NIH.gov, viewed 19 July 2023, <https://hivinfo.nih.gov/understanding-hiv/fact-sheets/pre-exposure-prophylaxis-prep#:~:text=Pre%2Dexposure%20prophylaxis%20(PrEP)%20is%20when%20people%20who%20do,sex%20or%20injection%20drug%20use.>.
[xii] Ward, A. R., Mota, T.M. & Jones, R.B. 2021, ‘Immunological approaches to HIV cure’, Seminars in immunology, vol. 51, no. 1
[xiii] Tatoud, R., Snow, W. & Esparza, J 2021, ‘A transformed global enterprise for an HIV vaccine’, Journal of the International AIDS Society, vol. 7