Management of HIV epidemic is hampered by epidemic of stigma and discrimination

It’s time to recognize that HIV infection is the same disease as any other chronic illness with which you can live a full life. The world’s lowest estimates suggest that more than 37.6 million people now live with HIV, and 1.8 million still become newly infected every year – there are two new infections for the three people who start taking antiviral medicines. Overview of the HIV / AIDS epidemic peculiarities, evolution of the epidemic in Lithuania, achievements of the global and national response and lessons learned are presented in my latest article “Three Stages of HIV Epidemic”.

According to WHO, the world’s HIV epidemic peaked in 1999. Currently, in some regions of the world, the spread of HIV is declining, but not in the Eastern Europe or Central Asia, where HIV is spreading very rapidly, mostly among drug users and their partners. Available antiretroviral therapy is a very important, essential component of response. There is no administrative territory in Lithuania where HIV-infected people are not registered, but HIV treatment is only available in the biggest cities.

The HIV epidemic in Lithuania covers several periods. It started in the men who have sex with men community, and later, among injecting drug users, HIV is now more sexually transmitted. The ongoing spread of HIV among drug users indicates an inadequate response to the drug problem, especially in prisons.

However, no matter what are the transmission ways, HIV epidemic has three stages in any society. The first of these is the HIV epidemic that begins in the community silently and invisibly. Next is an AIDS epidemic that occurs when HIV causes life-threatening illnesses. Finally, the third epidemic is a stigma, discrimination, guilt and a collective denial epidemic, which makes it difficult to effectively stop the first two.

We have come to a new stage of response to AIDS, where the contribution of not only family physicians and other specialist physicians but also of other sectors (especially social sciences, education, law and order) and self-governance in response to the epidemic is becoming more and more important.

You will find the full article “Three stages of the epidemic” in October 2018 issue of the Lithuanian General Practitioner’s Journal and here.