As we mark 40 years since the identification of AIDS, it's time to reflect on the journey of the HIV epidemic. Since the terrifying peak in 1995, when 3.3 million people were infected and nearly one million lives were lost, significant progress has been made. In 2023, 1.3 million new infections were recorded, with 630,000 people dying from AIDS-related illnesses—an alarming statistic that reminds us the epidemic is far from over.

1. The Fight Is Still On

Despite advances in treatment and care, the HIV epidemic is not a relic of the past. In 2024, approximately 1.3 million individuals globally and 150,000 South Africans were newly diagnosed with HIV. This underscores the urgent need for heightened awareness and access to healthcare services. UNAIDS has established ambitious goals for 2030: 95% of people living with HIV must know their status, 95% should receive antiretroviral treatment, and 95% must achieve viral suppression. While global figures from 2023 indicate 86% of people living with HIV know their status, it’s clear there’s still much work to be done, especially for vulnerable populations like children and adolescent girls in Africa.

2. A Treatment Revolution

The landscape of HIV treatment has transformed dramatically over the years. The first drug, zidovudine, was laden with toxic side effects and provided limited relief. Fast-forward to today, and a single pill taken daily offers effective prevention and treatment. Pre-exposure prophylaxis (PrEP) is now widely available, significantly reducing the risk of contracting HIV. South Africa has implemented the largest HIV treatment program in the world, with 5.4 million individuals receiving lifesaving therapy as of 2022.

3. The Game-Changing Long-Acting Options

While researchers are still working on an HIV vaccine, the introduction of long-acting PrEP and antiviral treatments marks a paradigm shift in prevention strategies. Cabenuva is a groundbreaking two-monthly injection, while Lenacapavir, a six-monthly injection currently in clinical trials, promises even more convenience. These innovations not only facilitate adherence but also help reduce the stigma associated with daily pill-taking, particularly among young women.

4. The Importance of Testing

Despite the advances in treatment, many individuals remain unaware of their HIV status. A study across 13 sub-Saharan African nations revealed that 34% of men who tested positive for HIV were not aware of their condition. Regular testing is crucial for prevention and care, especially in community settings like schools and workplaces. For those living with HIV, annual viral load testing is vital to ensure they remain undetectable, which is instrumental in preventing transmission and maintaining their health.

5. Addressing Overlapping Challenges

As the demographics of people living with HIV shift, the intersection of HIV and non-communicable diseases—such as heart disease, cancer, and mental health issues—has gained importance. Older individuals living with HIV are particularly susceptible to these conditions, highlighting the need for integrated health services. By embedding non-communicable disease prevention into HIV care, with a focus on managing obesity, supporting mental health, and cancer prevention, we can create a more effective healthcare response.

With ongoing challenges such as stigma, limited access to tailored healthcare services, and the socioeconomic factors driving the epidemic, tackling HIV requires innovative strategies and community-driven solutions. The vision for a future free from HIV hinges on maintaining treatment access, increasing awareness, and ensuring comprehensive care for all—especially for the most vulnerable. We must rally together to curb new infections and provide lifelong support, so that we don't find ourselves facing the same epidemic in another 40 years. The time to act is now! Stay informed, stay empowered, and let’s ignite the momentum towards ending the HIV epidemic once and for all!