World AIDS Day turns 30 years old today. The very first global commemoration to raise awareness of the HIV (human immunodeficiency virus), the virus that causes AIDS (acquired immunodeficiency syndrome) was observed on December 1, 1988 – seven years into the struggle against HIV/AIDS. Normally, this type of anniversary would be a cause of celebration. However, the fact that humanity still suffers from this disease is no reason for jubilation. Yes, we have had a few remarkable successes in fighting this pandemic; but the fact remains that we continue to lose both lives and talent.
World AIDS Day, 2018 Theme
On this 30th commemoration of World AIDS Day, the United Nations AIDS collaboration (UNAIDS) is making a global appeal for increased access to HIV testing and an increased uptake of HIV testing. This is to ensure that the almost 10 million people around the world who are unaware of their HIV – positive status can seek treatment and that people who are HIV – negative can continue to protect themselves against the virus.
The theme for this year’s World AIDS Day is: “Live life positively – know your HIV status.”
Author’s Note: Source for 2018 Theme section: UNAIDS Press Release, UNAIDS.org
What is HIV?
HIV targets and attacks the human immune system. The virus replicates itself inside these cells which then become additional agents of infection that, over time and without treatment, eventually destroy the entire immune system – the body’s defense against all manner of diseases and infections. This results in a slow and painful death that drains persons infected with HIV physically, emotionally and in some cases mentally. It leaves families and friends shattered and communities financially strapped.
Why all the hate?
The initial instances of what is now known as HIV first began appearing in communities already marginalized from mainstream societies: same gender loving (gay) men, intravenous drug users (inject drugs and share needles and syringes), homeless and medically indigent persons (without medical insurance and fixed addresses) and immigrant communities of color. For all of the above reasons, extremely few in the medical professions, public health officials and even fewer politicians became concerned over the increase in infections within the initial target groups.
It was only later, when HIV began to creep into the mainstream populations, that anyone of importance began to take notice. By that time, HIV had already entered into the various national blood supplies worldwide and new infections were being reported among populations considered “normal” by society. Churches and governments alike were harshly critical and judgmental against persons practicing a “deviant lifestyle” or “questionable lifestyle.” The fear and ignorance over HIV developed during these early years of the HIV epidemic and unfortunately remain with many even today.
The graphic at the beginning of this section was created by a gay artist, Keith Haring, who succumbed to complications resulting from AIDS in the 1990’s. His art clearly reflects to the mindset of the times and was frequently used by HIV/AIDS activists to illustrate their protests against homophobia and prejudice against persons living with HIV.
The very first World AIDS Day observance organized by the World Health Organization (WHO) focused on removing the many stereotypes surrounding HIV and AIDS and combating the misinformation and prejudice. Subsequent World AIDS Day initiatives continue this message of compassion by encouraging awareness and education.
The Red Ribbon Campaign
Red Ribbon Campaign Background
It is traditional to wear a red awareness ribbon on World AIDS Day. The color red represents blood, passion and love. The Red Ribbon Project was initiated by the New York City, USA – based Visual AIDS Artists Caucus (founded by visual artists living with HIV) in 1991 to implement a visually identifiable symbol to indicate a commitment to HIV/AIDS awareness, compassion and education. This collaborative effort’s purpose was to preserve individual anonymity in design credit and to keep the visual image (the red ribbon) copyright-free so that no individual, organization or commercial business would profit financially from the use or sale of the red ribbon and to preserve the red ribbon as a consciousness-raising symbol and not a copyright or trademark tool.
The 1991 launching of the Red Ribbon Project captured the attention of the international public. Soon, globally, AIDS activists and advocates quickly adopted the red awareness ribbon as their own. By the middle of 1990’s decade, the symbolism and meaning was widely recognized throughout the world. So much so that the WHO also incorporated the image as part of its media releases worldwide in anticipation of World AIDS Day.
After 30 years, most of us are aware of prevention strategies to use in order to protect ourselves from HIV infection. Abstinence, latex condoms, polyurethane condoms, the list is endless and almost requires an encyclopedic knowledge and/or a medical degree. For many, what seemed as a long, arduous struggle to find a vaccine and/or a cure for HIV/AIDS is now showing some benefit. We now have a once-a-day pill that is proving to be effective in preventing HIV transmission.
What is PrEP?
Pre-exposure prophylaxis (PrEP) is a course of HIV drugs taken by HIV – negative people to reduce their risk of HIV infection.
Truvada is currently the only drug approved for use as PrEP. Truvada is a single pill that is a combination of two anti-HIV drugs, tenofovir and emtricitabine.
Yes, Truvada is a blue pill!
How does PrEP prevent HIV?
The anti-HIV drugs contained in PrEP stop the virus (HIV) from replicating (reproducing) in your body. If you are exposed to HIV but have been taking PrEP consistently and correctly, there will be sufficient amounts (high levels) of the drug to prevent you from contracting (getting) HIV.
How effective is PrEP?
If used regularly and correctly, PrEP can virtually eliminate (prevent) the risk of you becoming infected with HIV, the virus that causes AIDS.
A number of large, high profile trials (studies or tests) undertaken across the world have continued to prove PrEP’s effectiveness in stopping HIV infection.
Current statistics estimate that PrEP is effective in preventing HIV infection 90% of the time.
If I take PrEP, can I stop using condoms?
This will depend on your circumstances (situation). PrEP will protect you from HIV, but it doesn’t give you any protection against other sexually transmitted infections (STIs). Using a condom is the best way to prevent other STIs such as gonorrhea, chlamydia and hepatitis C.
Who can take PrEP?
PrEP isn’t recommended for everyone. It’s for people who are HIV – negative and more at risk of HIV infection.
Depending on local public health guidelines (rule), PrEP may be an option for you if:
- you’re in an ongoing sexual relationship with a partner living with HIV whose HIV is not well controlled
- you’re a gay (same gender loving) or bisexual man who has multiple casual sexual encounters (hook-ups) and you don’t always use condoms
- you’re a gay (same gender loving) or bisexual man in a new sexual relationship but not yet aware (don’t know) of your sexual partners HIV status and not using condoms
- you’re not using condoms with partners of the opposite sex whose HIV status is unknown and who are at high risk of HIV infection (for example, they inject drugs, have multiple sexual partners at the same time or have bisexual male partners)
- you’ve shared injecting equipment (needles and syringes) or have been in a treatment program for injecting drug use
Is PrEP effective for vaginal and anal sex?
PrEP can prevent (stop) HIV infection during both vaginal and anal sex, but the drugs in PrEP are absorbed much more effectively by rectal tissue (buttocks) than vaginal tissue. This means that the options (choices) for how you take PrEP are different depending on the type of sex that you have:
- to prevent HIV through the vagina, PrEP needs to be taken every day. You will need to take PrEP for 7 days before you are protected and then every day for as long as you want protection.
- if your risk is from anal sex (having sex in the buttocks, being the receptive partner or bottom) then you can consider daily PrEP (as above) or event-based (on demand) PrEP. There are different types of event-based PrEP depending on your pattern of sexual activity so make sure that you talk this option through with a health professional.
Event-based or on-demand PrEP is only suitable for anal (buttocks) sex. Daily PrEP is the only suitable method for both anal and vaginal sex.
Where is PrEP Available?
Currently, PrEP is not available everywhere in the world and even in countries where it has regulatory approval (meaning it has been determined effective) it may not be readily accessible for a number of political or resourcing reasons.
In some countries PrEP is available for free, or subsidized as part of the national health system and in other countries you will have to pay for it privately.
The good news is that international guidelines now recommend that PrEP should be made widely available so even if it is not available to you right now, it may be an option in the near future.
If you are interested in using PrEP contact a health practitioner who should be able to advise you on how you can do this. They will be able to offer the advice, monitoring and support to help you take PrEP correctly and ensure you are fully protected.
There are also dedicated websites that can help you buy PrEP. However, taking PrEP without medical advice and monitoring has health risks. You should always get a professional health examination if you do buy PrEP online.
How can I start PrEP and how long do I need to take it?
You must take an HIV test before starting PrEP to be sure that you don’t already have HIV. If you have HIV, starting and stopping PrEP may increase the likelihood of developing drug resistance.
While taking PrEP, you should visit your health practitioner for regular check-ups and HIV testing (at least once every three months).
Unlike HIV treatment, people do not stay on PrEP for life. PrEP is normally taken for periods of weeks, months or a few years when a person feels most at risk for HIV. This might be during specific relationships, after the break-up of a relationship and dating new people, when planning a holiday when you know you will be sexually active with new people whose HIV status you may not know, while dealing with drug use problems, or when trying to conceive and one of you is known to be HIV positive.
Does PrEP have any side effects?
In some people PrEPcan cause minor side effects like nausea, vomitting, fatigue and dizziness, but these usually disappear over time.
In rare cases PrEP can also affect kidney functions.
If you’re taking PrEP and experience any side effects that are severe or don’t go away, contact you healthcare professional.
Author’s Note: Source for information on PrEP: Avert.org
Definitely not a cure for HIV but the very existence of PrEP (Truvada) is proof that hard work, dedication and persistence often can and does make a major difference in how we can judge our accomplishments and count our achievements. PrEP is by no means the ultimate goal in HIV research and treatment, but it absolutely is a significant step down the path of eradication.
Don’t have a AIDS awareness ribbon? Make one.
The AIDS awareness ribbon is simple to make and doesn’t require more than two basic items and a few minutes of time. It is a powerful visual tool that reminds all those who see you that you are indeed aware of World AIDS Day and that you care about humanity.
Using the above image as a guide, create your own AIDS awareness ribbon following the steps listed below:
- A strip of red ribbon cut into a strip approximately five inches long
- A safety pin clasp
- Fold the ribbon strip using the pattern above
- Where the two ends of the folded ribbon intersect, use the safety pin to secure the ribbon to your clothing.
If you’re bare:
Cover your chest area (where you want to display your red ribbon) with an easily absorbed grease-less body lotion. Allow a few minutes for the lotion to be absorbed into the skin. Using red body paint or a tube of red lip gloss and paint a red ribbon onto your chest. Allow another five minutes to dry.