"I remember when I started working on HIV prevention in 1989 researchers said that there would be a cure or a vaccine within 5-10 years. Unfortunately this was 25 years ago..."

Tristan Troby

Troby is an Expert on HIV Prevention & Education. Coordinator of AIDS Programme for Kurdistan at Ministry of Health & Kurdistan Save the Children currently lives in Iraqi Kurdistan. Follow him on Twitter: @TristanTroby

The treatment of HIV infection reached 8 million people in 2011, and the number of people who were eligible but without access has risen from about 13 millions in 2009 to about 14.8 millions in 2011. So even if the access to medicines increases, the number of people in need for medicines increases too. Globally in 2015, an estimation is that 25.9 million people, of the +37 million people living with HIV or AIDS, are in need of access to antiretroviral therapy (ART). The essence here is, whatever efforts used on medicines, we also have to work on stopping people becoming infected with HIV. 

In some cultures there is a strong belief in medicine and science and in others a similar mistrust in favour of more traditional alternatives. This is one of the reasons why people living with HIV in some countries do not take their medicines, despite the facts that they know about their HIV status and have access to ART. Perceptions of disease severity, susceptibility and the benefits or disadvantages of staying on treatment are supposed to be keys in determining clinical attendance. Believing that God or alternative medicine can cure AIDS can also influence treatment patterns. Similarly, misconceptions about ART can alter patients’ motivation to stick with them. 

Testing makes it possible to obtain data, statistics and prevalence estimates. Counselling does not provide such direct results; therefore it is an area, which tends to be abused as part of a comprehensive strategy to capture people with risk behaviour. I believe the counselling must be given a much higher status and that the development of discourse forms and methods of self-estimation of risk situations and personal action plans must be developed. This is something I will come back to in another article. 

When discussing the medical perspective we have to be aware of the virus’ development. Different strains of the virus are more transmittable than others, and the disease progression can be slower or quicker. Of approximately 60 HIV types that exist in the world today, a recent discovery in Guinea-Bissau (West Africa) reveals one type causing a much faster progress to AIDS. Normally it takes about 8-15 years from the HIV infection to AIDS, but this strain leads to AIDS in about 5 years. It is supposed to have developed as a consequence of a recombination, a double infection of two HIV strains, which can combine to form a cross between the two. 

HIV is an extremely dynamic and variable virus. New subtypes and recombinant forms of HIV have been introduced to the world, and it is highly likely that there are large number circulating recombinants of which we know little or nothing. We therefore need to be aware of how the epidemic changes over time. 

Regarding vaccine or cure for, this has been a slow process. Even if there are occasionally positive reports, there is still no solution in sight. I remember when I started working on HIV prevention in 1989 researchers said that there would be a cure or a vaccine within 5-10 years. Unfortunately this was 25 years ago, and in the meantime we have to rely on an effective HIV prevention. 

Sumber: http://basnews.com/en/opinion/2015/01/26/hivaids-medical-perspective/