Written By: Adeniran Idris Isola
A few infectious diseases have reshaped global health like HIV. Four decades since its discovery, we stand at a turning point: HIV is no longer a death sentence. The discovery of antiretroviral therapy (ART) has extended life expectancy, and rate of transmission globally are reducing. Even though HIV treatment and prevention have advanced, still the virus still spreads and causes harm because many people lack awareness, social acceptance and access to care. The challenge is no longer just viral suppression; it is the reshaping systems, culture, and conversations to make an HIV-free generation a reality.
The epidemiology of HIV is improving, yet the work is not done. According to the global surveillance data, the new HIV infections have significantly dropped in the last decade. But key populations are still affected such as young women, men who have sex with men, sex workers, people who inject drugs, and adolescents. In settings that are limited in resources, these disparities are sustained by inadequate testing access, delayed diagnosis, and stigma. However, the real threat today is not viral strength but it is structural vulnerability.
Also, the treatment success has outpaced public understanding in the sense that the modern ART has allowed the populations living with HIV to achieve suppression in the viral load, no sexual transmission and effective treatment which is in accordance with the U = U principle (Undetectable = Untransmittable).
But public perception hasn’t caught up because many communities are still unaware that people whose viral loads are suppressed cannot transmit the virus sexually. The outdated myths and beliefs still continue to fuel discrimination in schools, workplaces, communities and even health-care settings. Science has moved on; stigma has not.
In addition, the prevention options have never been better. The HIV prevention kit now includes PrEP (Pre-Exposure Prophylaxis) which can be oral and injectable with over 90% protection against the risk of sexual transmission when used appropriately; PEP (Post-Exposure Prophylaxis) is highly effective if started within 72 hours; Self-testing and emerging vaccines and cure research. The uptake remains too low in communities that need these tools the most, especially the adolescence and the populations at risk.
Youths are the new frontier. In sub-Saharan African countries, adolescents and young adults are more prone to new HIV infections, yet youth-friendly HIV services, digital engagement, peer-led programs, and school-based awareness campaigns are limited and remain underutilized despite the effectiveness they all proved.
Ending HIV requires more than medicine. The socio-economic and cultural barrier that prolong HIV transmission cannot be addressed by medication alone. The stigma, economic burdens, gender inequalities, policy gaps continue to serve as barriers for the prevention and treatment outcomes. Putting an end to HIV requires intersectoral collaboration, leadership in health-care and continuous advocacy.
In conclusion, the path forward is a call to leadership. What remains is the leadership that pushes health systems beyond medicine and into social transformation.
To achieve an HIV-free future, we must normalize testing, provide accessible treatment care, prevent stigma, and increase awareness especially to the youth.