opinion: progress made to end hiv/aids 'nothing short of remarkable'

the early years of hiv/aids

in the early days of the epidemic, the medical community was still trying to unravel the enigma that was hiv/aids. treatments were limited and primarily focused on managing symptoms, not slowing progression or eliminating detectability. the emergence of azt, an antiretroviral drug, was a game-changer. azt was the first drug to be approved by the fda to treat aids, and although initial iterations of the treatment could lead to severe side effects, it was a sign of better days to come in the fight against hiv/aids.

in the mid-1990s, protease inhibitors were introduced, revolutionizing hiv/aids treatment. these treatments were typically used in combination with antiretroviral drugs, creating a cocktail that kept people with hiv/aids living longer. however, side effects such as vomiting, diarrhea, insomnia, elevated liver enzymes, and bone marrow suppression were still major concerns of those taking the drugs.

early treatments for hiv/aids also leaned heavily on prevention and supportive care. the promotion of safe sex practices and needle exchange programs became more widespread, slowing the spread of hiv/aids, especially in major metropolitan areas. studies show that the impact of the promotion of condom use alone averted 117 million hiv infections . the more that was learned about how hiv was spread, the better prevention initiatives became.

improvements and advancements

antiretroviral therapy (art) continues to be the cornerstone of hiv/aids treatment. through a combination of antiretroviral drugs, replication of the hiv virus can be successfully suppressed, lessening the viral load and improving the immune system. this leads to less detectability of the virus and less chance of passing the virus on to others. activists have coined the phrase “u=u” meaning undetectable equals untransmittable or treatment as prevention to hail these advances. art can be achieved through a cocktail of different drugs or single-tablet regimens.

although not as widely known, two medications are game changers in preventing new hiv infections. the key is to prevent new infections (think birth control but for hiv). pre-exposure prophylaxis (prep) is a medication that, when taken as prescribed by people without hiv, has been shown to help prevent contracting hiv when exposed to the virus through sexual contact or injection use by up to 99 per cent.

even less known is post-exposure prophylaxis (pep) , an emergency medicine that must be started within 72 hours of possible exposure to the hiv virus. pep is critical for sexual assault victims, occupational exposures, and condom breaks.