Delivering messages on the importance of prevention and of drug adherence, AIDS experts at last week's Conference on Infectious Disease presented perspectives on the epidemic from both Chicago and Southern Africa.
The conference, held June 7, was the national launch of the United Nations Association of the U.S.A.'s ( UNA-USA ) Global Health Initiative. UNA-USA is a national non-profit that seeks to enhance the role of the U.S. in the United Nations system. The health initiative will take place in five pilot cities, including Chicago, St. Louis, Tampa, Seattle and Minneapolis.
Panels were held on some of the world's most dangerous infectious diseases, including HIV/AIDS, malaria, polio and tuberculosis. Dr. Robert Murphy of Northwestern Memorial Hospital and Elhadj Sy, a representative of UNAIDS, spoke on the HIV panel, which was moderated by Brian Endless, president of the UNA-Greater Chicago chapter.
"When we talk about AIDS, we usually talk about numbers," Sy said. "The numbers will never say what it's like to host the virus in your body."
HIV/AIDS, he said, "reveals the dysfunctionalities we have in each of our societies," such as the lack of access to care and the lack of health prevention infrastructures. "If we want to respond to the epidemic, we should not use these dysfunctionalities as excuses."
He pointed to the success of prevention efforts in countries such as Uganda, the only African nation to see its rates of infection decrease. Sy said that the decrease stems from the government's commitment to fighting the disease and the overall destigmatization of HIV/AIDS.
The stigma still attached to the virus is making widespread HIV testing impossible in most African nations, leading to a situation in which an estimated 80% of those infected do not know their status, he said.
Of the 36 million people living with HIV/AIDS worldwide, 25 million live in sub-Saharan Africa. In two weeks, beginning June 25, the United Nations General Assembly will hold a special session on the international AIDS crisis, Sy said.
Prevention, he stressed, must go hand in hand with treatment in countries such as South Africa, where access to affordable HIV medication is still not widespread.
In the U.S., where meds are widely available, adherence is a significant obstacle for many patients, Murphy said, noting that overall regimen adherence is at less than 50%. He is the director of the HIV/AIDS treatment clinic at Northwestern Hospital and a professor of medicine at Northwestern University.
"At less than 95% you will ultimately fail," he said, adding that those who take their meds consistently are more likely to live a normal life span with the virus.
"Everybody has to be on board with the treatment," he said, including both doctor and patient. Most patients undergo a one-month adjustment period as their bodies get used to the drugs, he said.
Factors influencing adherence include the number of pills patients have to take and how often they must take them. He described a new treatment that has three drugs in one pill "the hottest thing in medications."