HIV/AIDS Infection Continues to Rise in Gay Communities Says Former UNAIDS Director

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The incidence of HIV/AIDS continues to rise in gay communities because of drug abuse, according to former UNAIDS Executive Director, Professor Peter Piot.

Speaking at a seminar at UKZN’s Africa Centre for Health and Population Studies in Mtubatuba, Piot’s address was titled: “AIDS – A Long Term View”.

‘They say that there is an end in sight for the disease, but the truth is, treatment isn’t enough to cure the disease. Behavioral interventions don’t work and integration of these aspects isn’t always the answer. Stigma and discrimination still exist among many cultures, and domestic funding doesn’t cover all costs for HIV treatment.

‘HIV continues to rise in gay communities due to drug abuse. Swaziland has a very high ARV coverage due to drug use and the use of dirty needles for injecting of heroin which increases HIV infection,’ said Piot.

He gave a global as well as an African perspective on HIV in his talk, saying that with 200 000 new infections occurring annually, prevention of mother-to-child transmission was a growing challenge.

HIV had increased globally due to rising drug incidence around the world. ‘There are also many factors that one has to acknowledge to combat this disease. With crimes against humanity and with criminalisation of same sex couples and the death penalty, there has been a massive neglect of prevention in recent years. Furthermore, with management inefficiencies, there is a collective denial of the long term consequences of HIV.’

Piot addressed a variety of issues concerning HIV/AIDS in Africa such as male circumcision infection rates and ARVs.

Between 2009 – 2012 there was an increase in male circumcision due to the information that circumcision reduces the risk of contracting HIV by 50%. However, in countries like Kenya, the average risk of HIV infection for low risk women is estimated to vary 10 fold between countries. Uganda was the first country where there was a decline in infection in 1996 but now the country has increased in infection due to its population growth. With all this happening across the continent, it is important for resistance to develop in order to combat the disease for those who are undergoing treatment. ‘It was found that the price of ARVs in South Africa was among the highest in the world,’ said Piot.

He said people living with HIV and on treatment were living longer. ‘There is no one single magic solution to end the epidemic. But what we can do is bring the levels lower. Service delivery and drug resistance can be achieved for a long term method. Delivery of innovation of new drugs, and political as well as technical leadership can aid it.

‘How do we stop HIV spreading? Through increasing knowledge, reducing transmission, and sustaining prevention and implementing research. There are many pressures that are increasing HIV, such as drug abuse and we need to address these transmissions and risk determining factors. Integrated decision making is needed in addressing health and social needs, and service delivery and political science need to fuse together in order to bring about empowering development.’

Piot, a former Under Secretary-General at the United Nations and the former Executive Director of the UN specialised agency, UNAIDS, is the Director of the London School of Hygiene and Tropical Medicine, and a Professor at the Imperial College in London. He is also the Author of the book: No Time to Lose: A Life in Pursuit of Deadly Viruses which details his experiences of discovering the fatal Ebola virus and AIDS in Zaire, 1983. 

*The Wellcome Trust Africa Centre for Health and Population studies is based in Mtubatuba and works closely in partnership with the rural community to conduct policy relevant health, population