Achievements and Challenges in the Global Fight against HIV/AIDS: Interview in Deutschlandfunk Kultur with Prof. Janina Steinert

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On the occasion of the 12th conference on HIV Science of the International AIDS Society in Brisbane, Prof. Janina Steinert talks in a radio interview with Deutschlandfunk Kultur about achievements and remaining challenges in the global fight against HIV/AIDS, explains which risk populations still need attention, and highlights that stigmatisation of people living with HIV remains a important concern.

Globally, one person dies every minute as a result of HIVAgainst this background, UNAIDS (Joint United Nations Programme on HIV/AIDS) has declared the “95-95-95 target” by 2030. According to this target, 95% of all infected people living with HIV worldwide should receive a diagnosis. Of these, 95% should receive antiretroviral therapy and 95% of these should react so well to the treatment that their viral load is very low.

In order to effectively tackle the HIV epidemic, countries in the Global South, especially in Africa, need well-developed health systems. Therefore, Prof. Steinert pleads for an expansion of health investments. A second concenr remains the stigmatisation of people living with HIV. This can cause poor adherence to HIV medication plans and even deter people to get tested for HIV in the first place.

Many people who have access to antiretroviral therapy will never actually fall sick of AIDS, explains Prof. Steinert,  Through access to antiretroviral therapy, people living with HIV can by now have the same life expectancy as people not infected with HIV. Another important breakthrough is the principle of "U=U" - "Undetectable = Untransmittable". This means that people living with HIV and adhering well to antiretroviral therapy can no longer infect a sexual partner who is HIV-negative, despite having unprotected sex.

Yet, HIV infection rates are still high in some specific risk populations. These include sex workers, men who have sex with men, and injecting drug users. Decriminalisation can be an important step to decrease risk in these groups and allow sex workers and men who have sex with men better access to health care and prevention services such as pre-exposure prophylaxis (PrEP).

Prof. Steinert notes that particular focus should be placed on these risk populations in the Global North. In the Global South, however, the most important risk group are still adolescent girls and young women. A major risk factor here, besides limited capacity of health care services, is the economic dependence on sexual partners. This could be improved through effective development cooperation that aims to empower women economically.

There are also important political measures to reduce HIV infection rates. A prominent example is the abolition of patents on HIV drugs, which was backed by US President Bill Clinton in 2007. This policy change allowed a large group of people living with HIV in low-income countries to gain access to the life-saving treatment. The impact was immense: in many African countries, the average life expectancy rose by 10 years since the patents were lifted.

Prof. Steinert also draws links to the COVID-19 pandemic and stark inequities in the global distribution of COVID-19 vaccines. As Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, put it, "No one is safe until everyone is safe". Thus, global equity in the distribution of medication and vaccines is crucial in the management of emerging pandemics.

The entire interview can be accessed and downloaded via the website of radio channel Deutschlandfunk Kultur.

Prof. Steinert also leads the research project entitled "Impact of the COVID-19 Pandemic on Child Marriage, Sexual and Reproductive Health, and Domestic Violence in India and Zambia".

The PhD student Nikolay Lunchenkov is also part of her team. Currently, he works on his PhD thesis on "Sexualized Drug Use Among Gay and Bisexual Men in Kazakhstan: a Mixed Methods Study of Prevalence, Reasons for Engagement and Associated Risk Factors".