IDWeek 2015: Sex workers, injection drug users and men who have sex with men continue to be most affected by HIV epidemic, panelists say

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IDWEEK2Science Speaks is at IDWeek in San Diego, California this week, bringing live coverage of sessions on HIV, TB, Ebola and more.

SAN DIEGO, Calif – Despite steady progress made against the HIV pandemic over the past decade, only one third of people living with HIV are on antiretroviral therapy, leaving over 23 million people in need of treatment, said John Brooks, chief medical officer of the Division of HIV Prevention at the Centers for Disease Control and Prevention here on Friday.

The number of new HIV infections each year has steadily declined over the past decade, with an annual reduction of 100,000 new infections each year since 2005, Brooks said. Still, more than 5,000 people become infected each day, and more than 3,200 people die every day from HIV-related illnesses, he said.

People who earn income through sex work, inject drugs, and men who have sex with men continue to be disproportionately impacted by HIV, Brooks said. People involved in sex work are 12 times as likely to be infected than others, men who have sex with men are 19 times more likely, and people who inject drugs are 28 times more likely to become infected than the general public, he said.

Brooks cited stigma and discrimination, social exclusion and HIV criminalization among continuing challenges preventing people from seeking services, on top of poor access to testing and care and other health services in low-income countries.

Accessing HIV testing, care and treatment is also highly difficult for transgender individuals and prisoners, Brooks noted.

He highlighted one improvement. The uneven distribution of resources to combat HIV that characterized responses to the pandemic 10 years ago has changed, with resource distribution more proportionate to burden, Brooks said.

With updated World Health Organization guidelines recognizing the need of millions for antiretroviral therapy, Dr. Carlos del Rio of Emory University said, getting people to adhere to treatment regimens in the absence of symptoms may present a challenge. “It will be interesting to see what happens with people with a high CD4 count,” he said. “We’ll need to develop interventions for healthy people to adhere.”

None of that will matter though if people who are newly qualified for treatment don’t have access to it, he said. “Adherence most suffers when patients don’t have access to medicines,” del Rio said.

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