World AIDS Day

World AIDS Day is a chance for me to reflect on the many HIV infected patients I have treated and how far we have come. South Africa boasts the world’s largest antiretroviral therapy (ART) programme. Through the government’s prioritization of HIV, the national life expectancy of South Africans increased from 56 years in 2010 to 63 years in 2018. Yet despite the inroads made, KwaZulu-Natal remains the province with the highest prevalence of HIV and closer to home the leading cause of death and disability in our district is HIV and TB.

HIV has become one the most treatable chronic infections with medication that is not only convenient to take but ones that have excellent side effect profiles. These drugs are available in the public and private sector.

So where does one start?

• Get an HIV test. If you feel your risk is high test more frequently.
• A positive result is not a death sentence. Seek support from a family member or friend and speak to your doctor about starting treatment. You should start treatment when you are ready but the scientific evidence is clear that the earlier you start, the better for your health.
• Once you start ART you may not stop without instructions from your doctor.
• If you develop side effects, see your doctor immediately so that your treatment can be adjusted.
• Your CD4 count should be above 500 cells/uL. This generally means that your immune system is working adequately.
• Your viral load should be undetectable after 6 months of ART, reported as <40 copies/mL or <20 copies/mL. If your ART is working your viral load will be undetectable. If your viral load is detectable whilst you are on ART, you need make a plan to see you doctor immediately.

So if HIV is so easy to treat why the fuss? HIV has profound effects on the body. Long term the infected individual has an increased risk of malignancy and chronic illness like diabetes, kidney and heart disease. For these reasons we must try to curb the spread of HIV

How does one prevent the spread of HIV?

• The main mode of spread in South Africa is sexual transmission, so abstinence from sexual activity or an exclusive sexual relationship where both individuals are aware of their HIV status should keep one protected.
• Condoms are a highly effective method of protecting oneself from spreading or acquiring HIV if used correctly and consistently.
• In cases where an HIV negative individual feels that his/her risk of acquiring HIV is high, pre-exposure prophylaxis (PrEP) in the form of a tablet is encouraged. It must be prescribed by your doctor and taken daily in order to be effective.
• If you are HIV infected your viral load must be undetectable! Studies have shown that a person with an undetectable viral load generally does not spread the virus.
• If you plan on falling pregnant or are pregnant an HIV test is a vital! This will help you protect your baby. An expecting mom with an undetectable viral load is unlikely to transmit the virus to her baby.

This World AIDS Day let us remember those who have passed on and honour their memory by doing our best so that we can one day live in an AIDS free world.