Last year, the US Food and Drug Administration (FDA) approved a drug called Truvada for use in combination with other medications for the treatment of HIV infection, marking the first step to making HIV/AIDS a history book chapter.
Truvada is a pill that combines the HIV medication emtricitabine (EMTRI) with the anti-HIV medication tenofovir (TENOF). When taken together, the medications form a treatment known as Truvada + EMTRI/TENOF.
According to the World Health Organization (WHO), about 740,000 people are currently living with HIV/AIDS, with 40,000 deaths recorded in 2017 alone. While many countries with generalized HIV epidemics have seen a decline in HIV-related deaths due to improved access to life-saving medication, including Truvada, in the US and a few other countries, like Brazil and Russia, the number of people infected with HIV is rising again. While there is no precise figure available, the US Centers for Disease Control and Prevention (CDC) states that 1 out of every 25 new infections in the US is due to people having sex without knowing their HIV status. This often occurs with men having sex with men and drugs.]
Due to its effectiveness, side-effect profile, and ease of use, the UK’s National Health Service (NHS) recommends taking Truvada for HIV as part of combination therapy. Nevertheless, in the US, where it was approved in 2014, health insurance companies, including Aetna and Cigna, have not yet determined whether to cover the cost of Truvada for HIV treatment. This has left many people with HIV undiagnosed or untreated.
Limited Treatment Options
While there are now a number of options for HIV-positive patients, including an oral solution called PrEP, which is approved in combination with other medications for HIV prevention, the fact remains that there is no cure for HIV, and treatment is only effective in the context of a healthy, intact immune system.
When taken together, the drugs in Truvada are known to be among the most effective against HIV. However, PrEP is not a good option for people with liver problems or those taking certain medications, such as statins, which work by lowering cholesterol.
Also, although Truvada has been shown to be both safe and effective in clinical trials among people with HIV whose viral load is suppressed (a measure of how much HIV is present in the blood), there is no long-term data available on its use in combination with other medications.
The Rising Prevalence Of HIV
Even among people with access to care, such as those living in the US, HIV infection is often not diagnosed until relatively late in the course of the disease. As a result, untreated HIV can lead to serious, sometimes life-threatening complications.
In 2017, about 40,000 people in the US were diagnosed with HIV infection. However, according to the CDC, about 1 out of every 25 new infections in the US is due to people having sex without knowing their HIV status. This often occurs with men having sex with men and drugs, including those who inject drugs. The CDC also states that one major reason for the increase in HIV infections is the so-called “silent epidemic” caused by people being unaware that they are infected with HIV. Without routine HIV testing, especially among at-risk populations, it is very hard to know how many people are actually infected with HIV, which means that prevention strategies such as PrEP are likely to be under-utilized. Even among people living with HIV who know their status, regular HIV testing remains important to ensure that the virus does not develop resistance to the medications in Truvada. This would be a dangerous scenario, given the lack of an alternative treatment.
Why Is Treatment So Important?
In general, the earlier HIV is diagnosed and treated, the less serious the disease will be. In general, the earlier HIV is diagnosed and treated, the less serious the disease will be. However, this is not always the case, and in some instances, early diagnosis can even lead to the patient becoming more ill. This can be due to a number of factors, including the viral load and the specific medications used in combination. The earlier HIV is diagnosed and treated, the less likely it is that it will go into full-blown AIDS, and the less likely it is that serious, opportunistic infections will supervene. Nevertheless, this depends largely on the individual and their health status. What is important is that patients are aware of their health status and that treatment is initiated as soon as possible.
HIV Testing Varies By Region
According to the Global HIV/AIDS Alliance (GHAAA), about 85% of people with HIV/AIDS are unaware of their infection. This has made it difficult to estimate the actual number of people living with HIV in the world. However, the GHAAA states that there are an estimated 35.3 million people living with HIV in Africa alone. This is almost certainly an underestimate, given that there is nowhere near enough funding or resources to test for and diagnose HIV throughout the continent. Especially in rural areas, people avoid going for testing for various reasons, the main one being the fear of being identified as having AIDS. In the US, for example, only about half of people living with HIV are aware of their status. As a result, the likelihood of HIV going undetected is high, and this has serious implications for their health and that of others. The fact that people often do not know their HIV status is also one of the major factors leading to the so-called “silent epidemic,” in which people are unaware that they are infected with HIV. Without routine HIV testing, it is very hard to know how many people are actually infected with HIV, which means that prevention strategies such as PrEP are likely to be under-utilized. The only way to truly eradicate HIV is through widespread testing and treatment. This would also mean that those who are found to be infected with HIV would then be able to access medications that can reduce the amount of virus in their bodies, leading to a lessening of the symptoms and a prolonged life for people living with HIV/AIDS. In order to achieve this, a number of different policies need to be put in place, including proper funding, education, and awareness among not just people living with HIV/AIDS but also those at-risk of getting it – including those who are not yet infected but who may still be carriers of the virus. This may mean increasing the already high level of education among these individuals so that they are better equipped to reduce their exposure to the virus – through, for example, safe sex practices or avoiding certain people and/or groups of people who are more likely to infect them with HIV. The more educated people are about HIV, the less likely they are to get infected with it – which is why it is so important to continue educating those who already have the virus about the prevention methods available to them.
The Rising Cost Of Living With HIV
Just because a person has HIV does not mean that they necessarily need to be treated. The fact remains that there is no cure for HIV, and treatment is only effective in the context of a healthy, intact immune system. This puts people with HIV in a bit of a catch-22 situation, as they generally need to take medications to stay healthy, but the medications come with a price. Especially among people living in large, urban areas, where access to care is usually easy, the cost of living with HIV is not generally considered to be a major issue. However, in smaller towns and rural areas, the cost of medications can quickly add up – especially if a person wants to take more than one drug in conjunction with each other. As a result, in some instances, people with HIV can find themselves struggling to pay for food and shelter. This is why it is important to have adequate insurance coverage when taking medications for HIV, as without it, the financial burden can be extremely high. When people with HIV are faced with the cost of medications on an everyday basis, it can have a serious impact on their quality of life – especially if they are taking multiple medications and/or if their treatments are not yet covered by insurance. Even when medications are covered by insurance, the co-payments can easily add up and become a financial strain. Most people with HIV eventually need to take at least partial relief from this burden through philanthropy or through volunteer work – as there is nowhere near enough funding or resources available for universal testing and treatment throughout the world.