Today marks World Aids Day. But you might not be aware of the fact. The disease has probably slipped off the public radar this year amid the presence of well-publicised Ebola and bird flu outbreaks.
Medical personnel and scientists have, however, never stopped paying attention to HIV/Aids. The World Health Organization's (WHO) theme on World Aids Day this year is to improve HIV prevention and treatment services. There is a need in many parts of the world for treatment and prevention protocols.
Today the WHO also plans to release a new update to recommend antiretrovirals following HIV exposure to prevent infections that a large number of people living with HIV fall prey to.
One of the scariest diseases in the 1990s, these days HIV/Aids is more effectively kept at bay. Many countries have achieved their own targets in reducing the number of new cases and also providing HIV/Aids patients with antiretroviral medication.
So to mark World Aids Day today, here are 10 facts and figures on the current HIV/Aids situation both globally and nationally.
The prevalence of Ebola has overshadowed HIV/Aids awareness this year. But this will not happen for long.
President of the Thai Aids Society and infectious medicine specialist Dr Thanomsak Anekthananon said HIV/Aids has remained below the radar this year because people around the world are anxious about Ebola. That disease is quickly transmitted and has claimed thousands of lives this year alone. But the doctor is certain HIV/Aids will soon return to the public's consciousness.
"There is not yet any cure for Ebola. That's why people panic," he said. "HIV/Aids has attacked the world's population for a very long time so the health impact is actually tremendous. The disease has affected millions of people around the world.
"So even though there are other more significant health issues for people to think and to talk about this year, finally these things will be put under control and people will gradually start to feel less paranoid over those illnesses."
Though people around the world now see Ebola as a real health threat, for medical practitioners including doctors, scientists and healthcare organisations like the WHO or UNAids, HIV/Aids is still the priority.
"Medical staff not just in Thailand but also in other countries have continuously been striving to prevent new cases of HIV/Aids infection, to care for the infected and to reduce the death rate," the specialist added.
"International conferences on HIV/Aids have been held many times a year. So medically speaking, HIV/Aids is still our top healthcare concern."
Almost 35% There were 35 million people worldwide infected with HIV/Aids, according to WHO statistics in 2013.
The 35 million HIV/Aids-infected cases worldwide signifies a huge healthcare burden, said Dr Thanomsak. According to the WHO, Sub-Saharan Africa is the worst affected region with 24.7 million people living with HIV/Aids in 2013. Also Sub-Saharan Africa accounts for almost 70% of the total new HIV/Aids cases globally.
Last year, there were approximately 2.1 million new HIV/Aids-infected cases. But when compared to 3.4 million new cases in 2001, the number of newly infected patients has seen a 38% decrease.
There were 240,000 HIV/Aids-infected children in 2013. This showed a 58% decrease in the number of HIV/Aids-infected kids, compared to 580,000 cases in 2001.
In Thailand, last year there were around 450,000 HIV/Aids patients.
Thailand has witnessed a continuing decline in HIV prevalence, said Dr Thanomsak. Last year, there were about 8,000 new HIV/Aids-infected adult cases, a sharp decrease from 28,200 in 2000.
"Several factors contribute to the decline in HIV/Aids prevalence including more access to antiretroviral drugs, more availability of treatments and more widespread preventions," he said.
"Thais are also entitled to receive free HIV/Aids screening due to the 30 baht health scheme, which helps offer early detection. Counselling and medication is also provided by many healthcare providers. All this plays a part in the drop in the number of infections."
Almost 85% of HIV/Aids cases in Thailand were transmitted through sex, both heterosexual and homosexual.
Statistics collected from 1984 up to 2011 by the Bureau of Epidemiology, the Ministry of Public Health's Department of Disease Control, suggest the majority of HIV/Aids patients were infected with the virus through sexual activity. About 4% were transmitted through sharing dirty needles during drug use. Three per cent of infected cases in Thailand were mother-to-child transmission. Approximately 7% were reported to have unknown causes while only 0.02% were found to have been infected through blood transfusion.
Encouraging condom use is still one of the HIV/Aids-associated concerns in Thailand, especially given the largest part of the HIV/Aids-infected equation highlights sex-related transmission. Last year, studies of condom use in Thailand found that 56%, 37% and 28% of sexually active male, high school students reported using condoms for every episode of sex with female sex workers, another male or their girlfriend respectively. For sexually active female high school and vocational college students, only 25% and 19% respectively reported using condoms for sex with their boyfriends.
- HIV transmission for men who have sex with men is still high, especially among those living in large urban areas and international tourist destinations like Bangkok, Chiang Mai, Phuket and Pattaya.
People most at risk of contracting HIV/Aids, according to Dr Thanomsak, are men who have sex with men. But the heterosexual group is still the largest in terms of numbers.
"The overall HIV/Aids prevalence among men who have sex with women declined but still remained higher than for female sex workers and men who have sex with men," he said. "But a lot of unprotected sex among heterosexual middle-aged people and students plays a major role in HIV/Aids infection.
"According to my own personal observations, more new HIV/Aids cases are among younger people and a number of them are men who have sex with men. But overall in Thailand, the HIV prevalence is highest in working age people."
- It is claimed the development of a cure for HIV/Aids is under way. But for now, the disease is still incurable.
"In the past, there were studies claiming that early treatment can cure the disease," said Dr Thanomsak. "But research finally revealed that once patients stop medication, the virus returns."
Nevertheless, speaking of HIV/Aids treatments, Timothy Brown — the first person in the world believed to have been cured of the disease — is the light at the end of the tunnel for a number of HIV patients worldwide. Brown was diagnosed with HIV in 1995 and received antiretroviral therapy for 11 years, to which he responded positively.
In 2006, Brown was found to suffer acute myeloid leukaemia, for which his oncologist gave him a stem cell transplant. But instead of choosing a matched donor, his doctor used stem cells from a donor who had what is known as a CCR5 mutation — a mutation that makes cells immune to HIV. The transplant not just cured Brown's malignancy but also wiped out the HIV.
- Thailand has earned considerable success in reducing the number of mother-to-child transmission cases.
According to Dr Thanomsak, to prevent mother-to-child HIV/Aids transmission, it is crucial to provide pregnant women with antiretroviral medication and consider it as a form of treatment.
"In Thailand, the rate of mother-to-child infection is less than 2%, which is extremely low," he said. "In the past when the antiretroviral drug was not widely available, there was a 24% chance that the virus would be transmitted from mother to baby, given she was not provided with the medication.
"But today, if the antiretrovirals are given early enough to suppress viral load in mothers to an undetectable level prior to delivery, the chance that babies will be infected is almost zero."
According to the WHO, in 2013 almost 70% of all pregnant women living with HIV in low-and middle-income countries received medicine that prevented transmission to their babies. This is indeed significant progress.
- Stigma, discrimination and fear are still issues facing HIV/Aids-infected Thais.
From Dr Thanomsak's experience, a number of people at risk are not willing to be HIV screened. Often HIV/Aids-infected husbands, for example, say they will never let their wives take the test. The same occurs with HIV/Aids-infected wives.
Often there are cases of HIV/Aids patients being afraid of telling their girlfriends/boyfriends the truth for fear of being abandoned. "This is partly about people's attitudes towards the disease," he said. "But in part it is also about people not using condoms. These are all significant obstacles to beat."
- There were around 20,000 HIV/Aids-related deaths in Thailand last year, but this reflects a major improvement from the past.
Over 55,000 Thais died of HIV/Aids-related complications in 2000, 30,000 in 2005 and only 19,000 in 2011, thanks to more access to antiretrovirals. Infected patients around the world usually die of complications like pneumonitis, meningitis or tuberculosis. Medical practitioners worldwide also see an increase in cancer-associated deaths among HIV/Aids patients, like lymphoma, coronary artery diseases and strokes.
- If an HIV/Aids patient is able to follow his/her antiretroviral therapy regimen with discipline, he/she will be able to live close to his/her 'normal' lifespan.
"HIV/Aids is just a chronic infectious disease," Dr Thanomsak said. "Patients need to take their medicine for the rest of their lives. And after that, unless they fall victim to other opportunistic infections, then they will be able to live almost as long as uninfected people."
