December 1st is World HIV/AIDS Day.

Infectious Diseases Reproductive Health

It’s World HIV/AIDS Day. Where do things stand with HIV?

Before we drop some knowledge, let’s take a moment to remember and honor those we have lost to HIV/AIDS.
This Nerd lost Stuart and Bob, uncle figures and mentors in my childhood and young adulthood. I credit them for my love and passion for public health. Put your remembrances in the comments below so we can hold them in our hearts. 💔❤️‍🩹

HIV/AIDS has been a critical health challenge affecting our globe since the early 1980s. As a reminder, HIV (Human Immunodeficiency Virus) is the virus that causes the disease we call AIDS – Acquired Immunodeficiency Syndrome. HIV leads to AIDS when folks don’t have access to treatment.

Approximately 39 million people currently have this virus worldwide. For perspective, that’s roughly the entire population of Canada. Approximately 630,000 people in 2022 and 40.4 million people since the start of the epidemic are estimated to have died from AIDS-related illnesses worldwide.

HIV is not just an issue for gay men, as it was once (wrongly) assumed to be.

Over half of those living with HIV are women and girls. It’s not just a health issue but a window into gender disparities and biology. For more on why female biology makes women and trans men vulnerable to transmission, see the resource below. About 1.5 million children have HIV.

Thankfully, we now have a pretty robust toolkit.

➡️ Behavior change programs: think education and awareness, condom use, needle exchange, etc.

➡️ PrEP: a preventative antiviral medication taken by those who are HIV-negative and want to protect themselves from getting the virus.

➡️ The U=U concept, that is, “Undetectable equals Untransmittable,” is a game-changer in how we view HIV transmission. Research has shown us that when a person takes treatment medication every day and reaches an undetectable viral load, they are unable to pass the HIV virus on to anyone else.

➡️ Treatment-wise, we use antiretroviral therapy (ART), a blend of medications that are not a cure but a powerful way to manage the virus. Antiretroviral therapy is so powerful that when taken as prescribed, it can make viral load undetectable in the blood, preventing virus transmission.

This toolkit has one glaring exception: a vaccine. Despite massive brainpower and resources funneled into research, an HIV vaccine has been elusive so far. One major reason this is so challenging is that the HIV virus evolves extremely rapidly – it’s common to find different variants even within the same person. HIV makes the SARS-CoV-2 virus look like an evolutionary slowpoke!

Globally, countries and organizations pooled $22.4 billion in 2022 to tackle this virus. The current goal is to end the HIV epidemic in the United States by 2030, including a 75% reduction in new HIV infections by 2025 and a 90% reduction by 2030.

Now, let us explore the most vulnerable groups for HIV in 2023 across the U.S., Canada, the UK, and globally.

Historically, this infection was thought to be limited to gay men, but the truth is people of any gender or sexual orientation are at risk if a person with the virus shares semen, pre-seminal fluid, blood, human milk, vaginal/cervical fluid, or rectal fluid.

Because of the lack of access to health care due to racism, stigma, transphobia, homophobia, economic oppression, and/or misunderstanding in the community of who is at risk, the following groups are particularly vulnerable:

▪️ Women, pregnant women, teens, infants, and children
▪️ Ethnic and racial minoritized people (of a given region)
▪️ Transgender people
▪️ Cis-gender men who have anal sex with other cis-gender men
▪️ People who are economically disadvantaged
▪️ People who exchange sex for money or other necessities
▪️ People who inject drugs​​​​
▪️ Indigenous peoples of colonized lands

The impact of HIV on the transgender and nonbinary communities is significant and distinct from the general population, with various factors influencing their risk and experiences. Here’s an overview based on the latest data:

Global Perspective: ​​A study of HIV in transgender populations around the world (2000-2019) found that roughly 1 in 5 trans women and 1 in 40 trans men were affected by HIV (results varied a lot by country). By comparison, roughly 1 in 150 adults aged 15-49 years old worldwide are living with HIV.

Of note, for many regions, data on trans folks is not collected. This lack of data underscores the need for better understanding and targeted support for trans individuals.

Given the diverse and complex nature of the epidemic and the people who are affected, tailored education, prevention, and treatment strategies with an eye toward inclusive, culturally competent, and accessible healthcare is a priority.

In knowledge, in science, and in remembrance,

Those Nerdy Girls+&

References and resources for more information:

Kaiser Family Foundation (KFF). The Global HIV/AIDS Epidemic.

Understanding female biology and HIV Risk

A Proclamation on World AIDS Day, 2023

Centers for Disease Control and Prevention (CDC). HIV by Group.

Canada.ca. People living with HIV in Canada

National AIDS Trust. UK HIV Statistics

The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis

CATIE – Canada’s source for HIV and hepatitis C information. What is the prevalence of HIV in trans people?

Current statistics gathered with the help of ChatGPT and then verified by this human:
OpenAI. (2023). Chat on HIV/AIDS Statistics and Vulnerable Populations. November 28, 2023. ChatGPT Session with OpenAI’s Assistant.

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