World AIDS Day 2021 – End inequalities. End AIDS

There were an estimated 37.7 million people living with HIV at the end of 2020. In 2020, 680 000 people died from HIV-related causes and 1.5 million people acquired HIV. Significant progress has been made in recent decades and the original 90-90-90 UNAIDS targets were updated for 2025 to aim for 95% of those living with HIV to know their status; 95% of those who know their status to be on treatment; and 95% of those on treatment to be virally suppressed. In 2020, for the first time, the UK achieved the UNAIDS 95-95-95 target with 95% of those living with HIV being diagnosed, 99% of those on HIV treatment and 97% of those having an undetectable viral load. Use of Treatment as Prevention, TAsP, and targeted Pre-Exposure Prophylaxis, PrEP, have contributed to this result. 

Whilst the previous 90-90-90 targets for 2020 were met by some countries, they were not met globally. The goals of fewer than 500,000 annual new HIV acquisitions and 500,000 AIDS-related deaths was also not achieved. In 2020, globally, there were 1.5 million new HIV acquisitions, 680,000 deaths from HIV-related causes, and an estimated 37.7 million people living with HIV - with 73% of those receiving antiretroviral therapy. This year’s World AIDS Day focused on reaching those people who have been left behind and highlighting the growing inequalities in access to essential HIV services. 

The COVID-19 pandemic has exacerbated inequalities and disruption to services, making the lives of many people living with HIV more challenging. This has compounded pre-existing failures including division, disparity and disregard for human rights that facilitated HIV in becoming and remaining a global health crisis. The last two years have been stressful and it is important to keep sight of the progress made whilst also focusing on capturing the 5% who are left behind and unaware of their status. The message U=U (Undectable = Untransmissable), that if a person is taking antiretroviral treatment and has an undetectable viral load, they are unable to pass on HIV is key in addressing stigma and in tackling this issue. Pharmacists are ideally placed to communicate this vital educational message to people living with HIV during consultations relating to their care and antiretroviral treatment.