In Italy, the fight against HIV / AIDS is progressing like a leopard. Two years after the entry into force of the National Plan of interventions against HIV and Aids (Pnaids) 2017-2019, in 2019 only half of the Regions had implemented it with regional resolutions, only in 38% of cases the Regional Commission was appointed AIDS and we met, only 37% of the Regions had carried out communication campaigns for the target populations and only 28% of the Regions had defined HIV Diagnostic Therapeutic Assistance Pathways (PDTA). This is what emerges from the results of the ‘Apri-Aids Plan Regional Implementation’ research project carried out by SDA Bocconi School of Management with the contribution of Gilead Sciences, presented today during the event ‘HIV 40 years later. Reviving the fight against the forgotten pandemic ‘.
The slowness at an organizational and implementation level of Pnaids – underlines the report – contributes to aggravating a scenario in itself critical in which the HIV pandemic seems to have been forgotten, in the shadow of the Covid-19 epidemic which caused a decrease in over 50% of HIV tests carried out and delays in accessing health services for visits and consultations. Lack of information and awareness – it is emphasized – fuel the spread of the infection especially among younger people exposed to less communication about HIV unlike in the past: the highest incidence of new diagnoses is in fact found in the age group 25- 29 years old.
In Italy 120 thousand with HIV
In Italy – according to the research – it is estimated that there are about 120 thousand people with HIV: of these, about 100 thousand have been diagnosed (83%), but the remaining 20 thousand (17%) are still ‘submerged’ – waiting to take the test – with the risk of late diagnosis and aggravation of the infection on the one hand and its continuous spread on the other. Thanks to therapeutic advances, those living with the infection can control its progress and symptoms, with an expectation and a quality of life that can become similar to an uninfected person. The lack of knowledge of HIV and the presence of discriminatory attitudes, however, negatively affect the quality of life of patients and the therapeutic path. For example, 32% of patients are or have been victims of discriminatory incidents.
“The historical situation that sees us face the consequences of the pandemic emergency from Covid-19 – says Claudio Mastroianni, president of the Italian Society of Infectious and Tropical Diseases (Simit) – can no longer represent an obstacle to the management and treatment of other diseases , especially the chronic ones such as HIV, on which delays in taking charge and follow-up weigh the most. In this sense, the implementation of Pnaids on the territory is not only desirable – he underlines – but necessary to adequately cope with the challenges HIV which, due to its now chronic nature, requires a strengthened model of taking charge, from diagnosis to access to treatment up to the management of follow up, within the care chain, integrating specialist centers with territorial network “.
Manifesto signed for a renewed commitment in the fight against HIV
The research project ‘Apri 2.0’ was born with a view to contributing to the application of some specific Pnaids actions and to review the models of HIV management. Starting from the critical issues that emerged from the first phase of the study in promoting policies and tools to combat the spread of HIV at the regional level, the second phase aimed at identifying more appropriate intervention strategies through the implementation of some ‘case studies’. The case of Piedmont made it possible to identify opportunities to enhance access to testing and early diagnosis, while the case of Puglia highlighted the conditions for improving the hospital-territory integration in patient care. The case study of Sicily allowed us to think about taking care of HIV patients as the government of the service supply chain and, finally, the case of Veneto investigated the perception of HIV patients towards the use of telemedicine.
Four cases that represent useful examples to outline that only through an integrated system can the fight against HIV be effectively relaunched with the aim of contrasting its spread, containing its impact and improving the quality of life and care of those affected . All this in line with the ‘6 95’, the goals set internationally in the fight against HIV, to be achieved by 2025. Ambitious goals that require joint and synergistic action by all the ‘souls of Health‘, starting from by institutions, called to work together precisely with a view to relaunching the fight against the forgotten pandemic by aiming to eliminate the structural and managerial-organizational limitations that prevent an effective fight against the spread of the virus and an adequate quality of life for patients.
An action by legislators, the scientific community, national and regional administrators that took shape today with the signing of the first Manifesto for a renewed commitment in the fight against HIV, an inter-institutional pact for the implementation of tools and models organization of epidemiological detection and surveillance, of prevention and management of chronicity that are dynamic and in line with the times, in a multi-channel perspective, without barriers in the implementation on the territory, without gaps between regions.