HIV treatment is so effective that it lowers the virus to an undetectable level, and yet stigma around the virus persists. Here’s a look at five misconceptions on World AIDS Day.
First discovered in 1981, human immunodeficiency virus (HIV) has since then killed tens of millions of people globally, but can now be fully controlled with treatment. Researchers are even exploring the use of stem cell therapy to cure it.
Yet those living with the virus continue to face stigma as myths about it persist.
When Alex Sparrowhawk, HIV and ageing manager at the Terrence Higgins Trust in the UK, was first diagnosed in 2009, it was “like a tornado in my head”.
“You’re being told these tests are going to be done and it’s a lot to take on, and the questions just going around in my head [were] am I going to die? Am I ever going to be in relationship again?” he told Euronews Next.
“How is this going to affect work? How is it going to affect my health and other things in my life? And luckily, I think it takes time, but I was able to turn to organisations to get that support and that information”.
So, why does the stigma persist? Here’s a look at some common misconceptions about HIV and AIDS.
Myth 1. ‘HIV is a death sentence’
Jaime Garcia Iglesias, a postdoctoral research fellow at the University of Edinburgh in the UK, says one common misconception is that HIV is a death sentence.
“It is not [a death sentence]. With treatment, most people can live long, fulfilling lives with very few, if any, side effects, meaning that there is very little difference in HIV and diabetes diagnoses or any other kind of chronic condition that is very manageable,” Garcia Iglesias said.
Treatment for HIV is called antiretroviral therapy (ART) and can be taken as a pill or an injection.
The goal is to reduce a person’s viral load to an undetectable level so the person has no risk of transmitting HIV.
“I take one pill a day at the same time every day, and that’s literally all I need. The majority of people are on one pill. Some people still take maybe two or three, and a very small number may take it twice a day if they’re on some older medication that just takes a longer time,” said Sparrowhawk.
Since 2012, people at a higher risk of contracting HIV can also take Pre-Exposure Prophylaxis (PrEP) which is a preventive HIV medication that stops the virus from getting into the body and replicating.
The Terrence Higgins Trust recently sponsored a TV advertisement in Scotland about stigma being “more harmful than HIV”.
Myth 2. Ways of contracting HIV
Experts say there remain several myths about how HIV is transmitted, with outdated fears from the height of the epidemic in the 1980s and 1990s remaining.
“People still think you can get it from kissing, from touching someone, using the same bathroom as someone, cooking and eating with them,” said Sparrowhawk.
“All these things have never been true and they’re still not true now. So, we’re still having to do a lot of work just to kind of change those incorrect myths”.
According to the US Centres for Disease Control and Prevention (CDC), most people contract HIV through unprotected anal or vaginal sex or sharing needles, syringes or other drug injection equipment.
The only way you could get HIV from kissing would be if “both partners have sores or bleeding gums,” which would be very rare, the CDC said, but HIV does not transmit through saliva.
Myth 3. ‘HIV is nothing to be concerned about’
For Apostolos Kalogiannis, with the Brussels-based European AIDS Treatment Group, it is difficult to be optimistic about reaching the UNAIDS targets for ending the AIDS epidemic by 2030.
While the number of new HIV infections and AIDS-related mortality rates in Europe and Central Asia continue to fall, according to the European Centre for Disease Prevention and Control (ECDC), many countries are not on track to achieve the targets.
Only 83 per cent of people living with HIV know their status, according to the ECDC, which said that testing and treatment services need to be scaled up.
“We are progressing, but not at the pace that would be needed to achieve these goals. Also, the situation across Europe varies heavily. So, there are countries and cities that have already achieved many of the goals,” Kalogiannis said.
But in eastern or southern countries, “it’s practically impossible to achieve most or any of the goals”.
Garcia Iglesias said that HIV “remains a very important condition and cause of death in countries in sub-Saharan Africa and even within our communities”.
“In Europe, there are whole communities that remain in a crisis state because they don’t have access to testing, they don’t have access to communication,” he added.
Myth 4. ‘Only gay men get HIV’
HIV can impact anyone but certain populations are at a higher risk.
Men who have sex with men are at an increased risk of contracting the virus compared to their population size, but they are not the only ones. Sex workers and people who inject drugs are also at a higher risk of contracting the virus.
Prevalence can be higher in vulnerable populations such as migrants who accounted for nearly half the cases in EU/EEA countries in 2022. This can be due to limited healthcare access, communication issues, vulnerability to exploitation, and stigma.
According to the 2023 HIV/AIDS surveillance in Europe report, “heterosexual contact emerged as the main mode of HIV transmission in 2022,” with an upsurge in diagnoses linked in particular to an influx of patients fleeing regional conflict in Ukraine.
After Russia, Ukraine has the second highest rate of HIV per 100,000 population in Europe.
There has been a decline in HIV diagnoses in men who have sex with men since 2014 in EU/EEA countries, the ECDC and World Health Organization (WHO) added, with a slight increase in 2022 particularly among migrants from Latin America and Central and Eastern Europe.
There are also misconceptions about the disease only impacting young people. In EU/EEA countries in 2022, just 8.9 per cent of HIV and AIDS cases were in people aged 15 to 24 while 19.9 per cent were in people aged 50 and older.
Myth 5. ‘Sexual health is just about testing’
Experts argue that a holistic approach to sexual health is not just about increasing testing, but that people need to be educated and supported.
“For many of them it’s going to be very challenging emotionally, socially, and sometimes financially, and you need the support to do that,” Garcia Iglesias said.
“We still see concerning levels of late diagnosis when the disease has already progressed beyond what we would like among other communities such as heterosexual men and women, people over 60, or Black people in the UK,” he said.
“So we need a much more comprehensive effort that targets those groups that would most benefit from it”.
Campaigns are also focused on tackling stigma and discrimination, which can lead people to delay care.
“One thing feeds the other. So when there is not enough resources and enough information, then it’s like a vicious circle and people tend to have these discriminatory attitudes which are not helpful at all,” said Kalogiannis.