AIDS is at a crossroads: Would governments expand the proven key population-led services?
BOBBY RAMAKANT - CNS

AIDS is at a crossroads: Would governments expand the proven key population-led services?
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"We are at a critical juncture in our response to end AIDS. As of now, we have 6.7 million people living with HIV in our region. Despite the progress we have made in our AIDS response, there are still 300,000 new HIV infections and 150,000 AIDS related deaths each year," said Harry Prabowo of Asia Pacific Network of people living with HIV (APN Plus) and Seven Alliance. Even one AIDS death is a death too many because we have the science-based tools to avert it.
If every person living with HIV was on effective and lifesaving antiretroviral therapy, and the level of the virus was undetectable, then not only they would live healthy lives but also, there would be zero risk of any HIV transmission from them. That is why this is often referred to as #UequalsU or undetectable equals untransmittable. So, treatment works as prevention too.
The latest UNAIDS report released last month at the 25th International AIDS Conference (AIDS 2024), contains evidence that most HIV transmissions occur with people who do not know their status. There are also relatively high numbers of infections linked to those who are diagnosed but not on treatment, and those who are on treatment but have not yet achieved viral suppression.
"In 2023, the region of Asia Pacific showed a 13% decline in new HIV infections and 51% decline in AIDS related deaths (compared to 2010). Our task is far from over," said Harry.
In some countries of Asia Pacific, HIV epidemic is growing at a faster rate: Bangladesh, Afghanistan, Fiji, Lao PDR, Papua New Guinea and the Philippines had an alarming rise in new infections. "In many of these countries, coverage of antiretroviral therapy remained below 50%, like Afghanistan, Fiji, Indonesia, Iran, Mongolia, Pakistan and the Philippines," shared Harry. "Most of the vertical transmissions of HIV occurred in Indonesia (26%), India (23%), Papua New Guinea (8%)."
Why are key populations not fully engaged in service delivery?
The latest UNAIDS report shows that there was a sharp increase in new infections among gay men and other men who have sex with men in Asia and the Pacific region (32% rise between 2010-2023). Same holds true for other key populations, such as sex workers, people who inject drugs, transgender people, among others.
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