In 2021, around 110,000 children and adolescents aged between 0 and 19 died from causes related toAids. In addition, another 310,000 new infections have brought the total number of young people living with HIV to 2.7 million. This is what emerges from the latest Unicef global estimates on children and HIV-AIDS, released in view of the World AIDS day which is celebrated today, December 1st. “With each passing day without progress, more than 300 children and adolescents lose their battle against AIDS“said Anurita Bains, UNICEF Associate Chief on HIV/AIDS.
According to the latest ISS report, in 2021, 1,770 cases were reported in Italy, with an incidence of three new diagnoses per 100,000 inhabitants. “While recording an incidence lower than the European average, in our country almost five people continue to get infected a day” he declares to our editorial team Giusy Giupponipresident of Lila (Italian League for the fight against AIDS).
President Giupponi, let’s start with the good news. Since July 2022, a new therapy has been available for people with HIV. What is it about?
“Yes. Since July 2022, two injectable antiretroviral drugs have been available, to be used in combination, with a new long-acting, i.e., slow-release formulation. This means that instead of daily pills, patients receive intramuscular injections every two months. From a clinical point of view, this is an important milestone because it undoubtedly improves the quality of life of the person with HIV who has the possibility to choose whether to use the daily pill or the long acting”
Data from UNAIDS on the HIV and AIDS epidemic estimate that 38.4 million people live with the HIV virus worldwide. What is the situation in Italy?
“Every day, in Italy, almost 5 people contract the HIV virus. Despite the progress made over time, the numbers continue to be alarming. Compared to the previous year, in 2021 there was an increase in new diagnoses: we are gone from 1,303 cases to 1,770 cases in 12 months. Not to mention that the data relating to deaths is also relevant: we are talking about 500 deaths a year”.
How do you explain this increase in cases?
“In part, the Covid-19 pandemic has something to do with it, which has inhibited access to hospitals and, in particular, to HIV tests. But the real, real problem remains the lack of a widespread awareness campaign that incentives for awareness and prevention of HIV infection”.
The lateness of the diagnoses is also highlighted in the ISS report.
“The data collected by the ISS tell us that 63.3% of the new diagnoses arrived with serious delay, that is, when people were already in AIDS or close to this condition. Among the 382 new AIDS cases reported in 2021, well 83% had discovered they had HIV only a few months before the diagnosis. This happens because, as I said earlier, there are no prevention campaigns and then because there is an altered, confused perception of the risk”.
What do you mean?
“Many people who have unprotected sex do not consider the possibility of contracting HIV. Although 40 years have passed since the AIDS ‘pandemic’, as it was originally defined, it is still believed that the infection affects only some ‘ categories’ of people: homosexuals, prostitutes and drug addicts”.
And instead?
“It’s not like that, it can happen to anyone. In the last year, the new diagnoses have mainly been heterosexual, both men and women. Followed by men who have sex with other men. Instead, the percentage of people”.
Which sections of the population are most exposed to the risk of contracting the virus?
“The risk affects all segments of the population across the board. HIV is linked to unprotected sexual relations with people whose serological status is unknown, not to certain categories of individuals. We need to disprove some false beliefs about the possibility of contagion “.
Meaning what?
“HIV is not contracted either with a kiss or simply by touching a person with HIV. There is no reason to fear contagion through daily contacts, at work or in other social contexts. We still have to work hard on this aspect”.
In this regard, can you clarify what are the only modes of transmission?
“The only three modes of transmission of the HIV virus are: sexual, blood and maternal-fetal”.
Have there been any cases of women being HIV positive during pregnancy?
“Yes. In the last year, there were 36 women who discovered they had HIV while pregnant. Two of these gave birth to HIV-positive children. And it is inconceivable that with the prevention tools we have today such situations still occur. It would be enough to take the HIV test before the third month to prevent HIV-positive children from being born”.
About prevention. How can a person protect himself?
“The first way, the simplest one, is to use a condom during sexual intercourse. Then, for those who decide to have unprotected sex, there is the possibility of undergoing a Pre-Exposure Prophylaxis, the so-called PrEP. Finally, there is also a Post Exposure Prophylaxis for those who believe they have run a real risk of contracting HIV”.
What is Pre-Exposure Prophylaxis?
“PrEP consists of the preventive intake of antiretroviral drugs that have already been used for some time in the treatment of HIV. The therapy is agreed with an infectious disease specialist, after a series of tests, and the person is subjected to periodic monitoring. There are two methods of intake: continuous or as needed. The first method consists of taking one tablet a day, every day, and is indicated for people who have sex frequently and without planning. The second method, also called ‘on demand’, consists instead in the intake limited in time and circumscribed to the period in which it is expected to have sexual relations”.
And instead, what is Post Exposure Prophylaxis?
“Ppe (or Pep) is a short-term treatment with antiretroviral drugs that is started immediately after exposure to the HIV virus, in order to reduce the risk of infection. Prophylaxis must be started within 48 hours of intercourse sexual intercourse, in which the condom has broken, and lasts 4 weeks, followed by a new HIV test. Anyone who believes they have run a real risk of contracting HIV can go to the emergency room”.
The UN has set the goal of eliminating HIV infections by 2030. In your opinion, is this a feasible goal?
“To date, I would answer no. Not because there is a lack of tools to be able to do it, but the prevention campaign must be encouraged. Above all, it is necessary that people have the possibility of free and anonymous access to HIV tests. Even the condoms should be free because the costs are prohibited for a young person who, perhaps, only has 20 euros in his pocket to go out with friends We have certainly made progress compared to the 90s but we still have to work hard both to restore dignity to people with HIV who, even today, suffer discrimination, both to get to zero infections. What is certain is that we at Lila will continue to do everything possible so that fewer and fewer people have to live with this virus. Let us remember that HIV is an everyday problem , not just December 1st”.