Untreated, HIV typically turns into AIDS in about 8 to 10 years. When AIDS occurs, the immune system has been severely damaged. The patient will more likely to develop diseases that would not usually cause illness in a person with a healthy immune system. These are called opportunistic infections or opportunistic cancers.

Since the outbreak of coronavirus, HIV care and treatment services were affected due to the fear of patients referring to treatment centers. This year’s slogan emphasizes the need for access to diagnostic services for all, epidemiologist Seyed Ahmad Seyed-Alinaghi told ISNA on the occasion of World AIDS Day.

A campaign called “I test for HIV, too”, started on November 11 aiming to identify HIV patients, and increase universal access to training and diagnosis.World AIDS Day, designated on December 1 every year since 1988, is an international day dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection and mourning those who have died of the disease.

The 2022 theme is “Putting Ourselves to the Test: Achieving Equity to End HIV”.

Pointing to the statistics of HIV incidence in the country, Seyed-Alinaghi stated that the estimate shows that 55,000 people are infected. But the statistics indicate 44,000 registered HIV infections, not all of them are alive and the alive patients are 23,000, and not all of them are receiving treatment.

But those who are under treatment are in good condition and the disease is controlled in their body. About 16,000 of them go to counseling centers, and continuously receive medical services, he explained.

He went on to note that about 19 percent of the 44,000 patients are women and 81 percent are men. Of course, it seems that the percentage of female patients is increasing now, despite the fact that it was single-digit in the past.

Currently, about 58 percent of people are infected with unsafe injecting drug use, about 24 percent through unprotected sexual relations, mother-to-child transmission constitutes 1.7 percent, and about 0.2 percent through blood products.

Most of the patients, accounting for over 50 percent, are aged 25 to 39 years, he said.

Referring to the birth of healthy children from mothers and fathers with HIV, he said that if these people adhere to the treatment and the virus is contained in their bodies, they can have healthy children.

Being treated for HIV, in addition to being beneficial for the patient and their quality of life, causes the number of viruses to decrease and prevents the transmission of the disease in society; he said, emphasizing the need for early diagnosing of the disease.

Currently, there are effective HIV treatments that can keep the disease under control by taking one or two pills a day, he added.

 HIV campaign

A campaign was launched to test the public for HIV, through which over 100,000 tests have been carried out nationwide, ILNA reported.

The campaign, called “I test for HIV, too”, began on November 11 for a month, aiming to identify HIV patients in targeted populations, and increase universal access to HIV training and diagnosis.

The results showed that in total from the beginning of the campaign, 100,221 diagnostic tests were carried out in 1,411 centers, and from 310 primary positive cases, 114 cases have been referred to counseling centers for confirmation.

 Prevalence in the world

The human immunodeficiency viruses are two species of Lentivirus that cause HIV infection and over time acquired immunodeficiency syndrome. AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.

Since the beginning of the epidemic, 75 million people have been infected with the HIV virus and about 32 million people have died of HIV.

Globally, 37.9 million people were living with HIV at the end of 2018. An estimated 0.8% [0.6-0.9%] of adults aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions.

The WHO African region remains most severely affected, with nearly 1 in every 25 adults (3.9%) living with HIV and accounting for more than two-thirds of the people living with HIV worldwide.

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The international body says mortality among Pakistanis living with the virus, which causes the deadly AIDS disease, is also rising, in spite of the availability of lifesaving antiretroviral therapy.

The latest government figures show that only 16 percent of the estimated 150,000 people living with HIV had been tested and only 9 percent have access to lifesaving treatment.

“The remaining 135,000 people are walking around in the communities as carriers of (HIV) infection who are ready to transmit infections to those who are not infected, even to their unborn babies,” Dr. Saima Paracha of the National AIDS Control Program, was quoted saying in media.

Pakistani officials say the HIV epidemic in Pakistan remains largely concentrated among the key populations, including people who inject drugs, the transgender community, sex workers and their clients and men who have sex with men.

The fear of maltreatment, and punitive actions by law enforcers impacts the willingness of these populations to pursue testing, which remains a major challenge facing national efforts to treat and prevent the spread of HIV, Dr. Paracha lamented.

Official estimates show that Pakistan has seen a 45 percent increase in new HIV infections since 2010.

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Early diagnosis of AID/HIV patients, educational and preventive programs for controlling the disease and devoting extra attention to sexual transmission of the disease are the main topics of this year’s conference, Masoud Mardani announced.
It is estimated that over 66,000 people in Iran have AIDS/HIV but over one third of them don’t know they have the disease or deny it. This leads to adverse consequences for the society as they may transfer the disease to other people, he said, adding that identifying and treating these people is among the most important topics of the conference.
AIDS epidemiology in Iran has changed as using infected needles for injection of drugs is still the main method of transmission of the disease, but the rate of sexual transmission of the disease is growing, affecting specially the young and teenagers, he said.

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Harm reduction refers to policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community.

According to Harm Reduction International (HRI), a non-governmental organization in Special Consultative Status with the United Nations Economic and Social Council, harm reduction began to be discussed frequently after the threat of HIV spreading among and from injecting drug users was first recognized.

Harm reduction complements approaches that seek to prevent or reduce the overall level of drug consumption. It is based on the recognition that many people throughout the world continue to use psychoactive drugs despite even the strongest efforts to prevent the initiation or continued use of drugs.

Therefore, harm reduction accepts that many people who use drugs are unable or unwilling to stop using drugs at any given time. Access to good treatment is important for people with drug problems, but many people with drug problems are unable or unwilling to get treatment.

“Harm reduction is different from treating drug addiction and prevention of drug misuse,” Kambiz Mahzari said, adding that the office mainly targets drug addict who inject drugs and help decrease the harm gradually within the framework of long-term plans.

Harm reduction helps reduce the damages drug use can bring about for the addicts regardless of the efforts for treatment of prevention of drug misuse, Mahzari explained.

He went on to say that harm reduction can gradually lead to treatment of the drug users as addicts are physically and mentally hurt and cannot stop using drugs at once.

But since harm reduction is easier than getting treatment they prove to be more effective, he said, stating that, many of the drug addicts would voluntarily ask for treatment after receiving harm reduction services.

limited budget for supporting HIV/AIDS patients

The organization has a tight budget for supporting HIV/AIDS patients, director for addiction prevention and treatment department of the organization Farid Barati-Sadeh has said.

It is the only entity that offers services to these patients and this is while such people should be provided with special supports, Barati-Sadeh explained.

The organization offers services to 15,000 patients with HIV/AIDS, but such people need special social support and should be provided with minimum services, however, the Welfare Organization’s limited budget won’t do, he regretted.

He went on to say that other entities such as the Budget and planning Organization, the Ministry of Health, the Ministry of Welfare and the Ministry of Interior should also support such patients.

Currently “positive clubs” affiliated to Welfare Organization in various provinces are offering services to people with HIV/AIDS and their family members, he added.

Positive clubs teach the patients techniques for living positively with HIV, creating jobs, conducting recreational activities and partially covering the patient’s medical expenses, Barati-Sadeh highlighted.

While now participating in risky sexual behavior are increasingly constituting HIV transmission, still addiction [and sharing needles to inject drugs] is the primary cause of HIV spread in Iran, he explained.

HIV/AIDS prevalence in Iran 

As per the figures announced by Ministry of Health center for communicable diseases management some 37,650 are diagnosed with HIV/AIDS until the end of the previous Iranian calendar year 1396  (March 20) in Iran.

Some 83 percent of the patients are men and the rest are women. Almost half of the patients are ageing 21-35. Out of the 37,650 individuals diagnosed with the virus so far some 13,393 have died. The HIV have led to AIDS in 15,278 of the patients, the report stated.

Sharing the same needle for injection of drugs with 61.7 percent accounts for the highest number of HIV transmission in the country, while high risk sexual behavior are responsible for 21.3 percent of the infections. The report also indicated that some 1.5 percent of the infection transmission are passed from mother to her child. The rest of the cases are infected with the virus for unknown reasons.

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He made the remarks during his speech at the 71st World Health Assembly (WHA) side event titled “towards universal coverage with HIV prevention services and commodities – the Global Prevention Coalition and Roadmap” held on May 22.

Delegations of Ecuador, Haiti, the Islamic Republic of Iran, Luxembourg, Maldives, Mexico, Panama, Ukraine, the United Kingdom of Great Britain and Northern Ireland and the African Group are the organizers if the event.

“It is globally proved that once prevention programs ceased to be implemented, epidemics strike,” the minister said, adding, “Iran not only pursue Joint United Nations Programme on HIV and AIDS (UNAIDS) goals but also carry out prevention of mother-to-child transmission (PMTCT) programmes.”

Moreover, special centers offering services to vulnerable women also provide them with consultation, HIV testing, tips for healthy pregnancy and social support, he noted.

Offering services to couples living with HIV when one partner is positive and the other is negative, is part of the HIV prevention programs in Iran as well, he highlighted.

The mission of UNAIDS is to lead, strengthen and support an expanded response to HIV and AIDS that includes preventing transmission of HIV, providing care and support to those already living with the virus, minimizing the vulnerability of individuals and communities to HIV and alleviating the impact of the epidemic. UNAIDS seeks to prevent the HIV/AIDS epidemic from becoming a severe pandemic.

UNAIDS has five goals including leadership and advocacy for effective action on the pandemic; strategic information and technical support to guide efforts against AIDS worldwide; tracking, monitoring and evaluation of the pandemic and of responses to it; civil society engagement and the development of strategic partnerships; and mobilization of resources to support an effective response.

The World Health Assembly is the supreme decision-making body for WHO. It generally meets in Geneva in May each year, and is attended by delegations from all 194 Member States. Its main function is to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget. The Health Assembly is held annually in Geneva, Switzerland. The 71st World Health Assembly is underway in Geneva on May 21-26.

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The number only accounts for 30 percent of the individuals who are affected with the virus and the ministry have reasons to believe that some 70 percent of those who are infected by the virus are still undiagnosed, Parvin Kazerouni, head of AIDS department of the Ministry of Health, explained.

Of the 36,039 patients suffering the infection 84 percent are men and the rest are women, ISNA news agency quoted Kazerouni as saying. “52 percent of the HIV sufferers age between 21 to 35 years old.”

Some 9,764 individuals diagnosed with HIV are dead and 14,656 are at the very final stage of HIV infection, known as AIDS, she added.

Overall sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs is still the major cause of HIV transmission in Iran.

However, the ministry have worries over the shifting patterns of HIV transmission in the country as having unprotected and high risk sexual intercourses are becoming the leading cause of the virus transmission.

For one, as Kazerouni have explained some 33 percent of the cases diagnosed with HIV over the first three months of the current year (March 21 to June 21) were women and that 47.8 percent of the cases have most probably contracted with the virus by having unprotected sexual relationships.

Some 32.7 are infected by sharing drug needles with someone who is infected with HIV, 2 percent of the cases are attributed to mother-to-child transmission of Aids [the spread of HIV from a woman living with HIV to her child during pregnancy, childbirth, or breastfeeding] and 17.4 have got the virus through other ways, she highlighted.

Iran joined “Ending the AIDS epidemic by 2030” international program to halt spread of the disease by 2030 and committed to “Target 90-90-90” which aims at HIV treatment and prevention for 2020, she said.

Ending the AIDS epidemic by 2030 is a fast-track strategy of the United Nations which proposes rapid and massive acceleration of HIV prevention and treatment programs for ending the AIDS epidemic by 2030. Target 90-90-90 would enable 90 percent of people living with HIV to know their HIV status, 90 percent of people who know their status to access Aids treatment and 90 percent of people on HIV treatment to achieve viral suppression.

According to World Health Organization (WHO) HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2016, 1.0 million people died from Aids-related causes globally.

There were approximately 36.7 million people living with HIV at the end of 2016 with 1.8 million people becoming newly infected in 2016 globally.

54% of adults and 43% of children living with HIV are currently receiving lifelong antiretroviral therapy (ART).

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