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Ending the AIDS epidemic requires the concerted efforts of society.

Ending the AIDS epidemic requires the concerted efforts of society. 最后更新:2024-02-28 20:47:46
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UNAIDS "2023 Global AIDS Prevention and Control Progress Report-The热点新闻 Road to Ending AIDS" (hereinafter referred to as the "Report") pointed out that in 2022, there were 39 million people infected with AIDS, 1.3 million new AIDS patients and 630,000 people died of AIDS-related diseases.

In China, in 2022, there were 1.223 million living HIV-infected people and AIDS patients, and the number of newly reported cases was 107,800. "New AIDS patients show a trend of' two-headed', that is, 20-29 years old and 50-59 years old are high-incidence ages." What is even more worrying is that about 38% of the patients are in the late stage of HIV infection, that is, the number of CD4+T cells is less than 200 /μl, said Lu Wei, chairman of the Special Committee on Immunodeficiency Monitoring and Transformation of China Association for the Promotion of Human Health Science and Technology and a professor of infectious medicine at Peking Union Medical College Hospital.

December 1st is World AIDS Day. In order to promote the high-quality development of AIDS prevention and control work, the Office of the State Council AIDS Prevention and Control Working Committee has determined and released the theme of this year's publicity in China-"Uniting social forces to fight AIDS together".

HIV infection can lurk for many years.

The full name of AIDS is acquired immunodeficiency syndrome, which is a serious infectious disease that the cellular immune function is reduced after the human immunodeficiency virus (HIV) invades the human body, and the mortality rate is extremely high if it is not treated in time. The transmission routes include blood transmission, sexual transmission and mother-to-child transmission.

"Among them, sexual transmission is the main route of infection for new AIDS patients in China, especially for men who have sex with men." Lu Wei said that this reflects the awareness of gay men on AIDS prevention measures, as well as the lack of publicity and prevention of safe sex in the whole society. "The acute infection period of HIV is not specific, the asymptomatic period after infection is long, and the doctors and patients lack AIDS knowledge, which often makes people miss the 72-hour golden block period of the disease."

In fact, from HIV infection to AIDS, patients generally go through three stages: acute stage, asymptomatic stage and AIDS stage.

Lu Wei introduced that the acute phase usually occurs within 2 to 6 weeks after HIV infection. At this stage, HIV exists in the body but the antibody has not yet turned positive, which is a "window period" when HIV nucleic acid or antigen can be detected but the antibody test is negative or uncertain. "Infected people may have symptoms such as headache, fatigue, myalgia, sore throat, swollen lymph nodes, red rash on the trunk, fever, etc. Because they are similar to other viral infections such as influenza, and will disappear completely after 1 to 2 weeks, they are easily ignored."

After entering the asymptomatic period, untreated HIV will specifically destroy the human cellular immune system, resulting in a progressive decline in the number of CD4+T cells and impaired function. "It is reported abroad that the incubation period of HIV can reach 8 to 10 years on average, but the AIDS patients with AE subtype in China can be shortened to 4.6 years, and progress to AIDS stage faster." Lu Wei said frankly that once entering the AIDS period, the risk of patients eventually dying from various opportunistic infections or malignant tumors will be greatly enhanced.

The National Center for Disease Control and Prevention once conducted a survey on "high-risk groups" of AIDS, and listed eight high-risk groups. Among them, gay men, sex workers, STD patients and drug addicts are four clear high-risk groups for HIV infection and transmission, while long-distance truck drivers, floating population, pregnant women and students belong to sexually active groups second only to the first four.

"Police, doctors, laboratory doctors and other special professionals who are exposed to blood also have certain infection risks." Lv Wei suggested that high-risk groups should improve their awareness of safe sex, do HIV self-test regularly or go to the hospital for blood test to achieve early detection, early detection and early treatment.

We are not helpless about AIDS.

Over the years, due to the lack of radical drugs and preventive vaccines, people talk about "AIDS", but in fact, in the face of AIDS, a powerful "enemy", modern medicine is not helpless. With the progress of medical technology, AIDS has become a preventable and controllable chronic infectious disease that can survive for a long time.

In particular, the advent of highly effective antiretroviral therapy (cocktail therapy) is a milestone in the history of AIDS treatment. Cocktail therapy, through the combined use of three or more antiviral drugs, can reduce the drug resistance caused by a single drug, minimize the HIV load in patients, restore the number of CD4+T cells in patients, rebuild patients' immune system, reduce the spread of HIV, prolong patients' life span and improve their quality of life.

"In the past, HIV-infected people who received cocktail therapy had to take a large handful of drugs at a time and two or three times a day. Now they only take one tablet a day to minimize organ damage." Lv Wei said that since the implementation of the "four exemptions and one care" policy in 2003, once AIDS patients in China are diagnosed, in addition to doctors giving suitable medical insurance drugs and self-funded drugs according to their illness, they can also receive free drugs provided by the state at designated hospitals. It can be said that the accessibility of AIDS treatment has been greatly improved.

According to the Report, in 2022, 29.8 million people around the world are receiving antiretroviral therapy (ART). Since 2000, ART has saved 20.8 million lives and protected 3.4 million children from the threat of HIV.

"Clinically, it is often said that AIDS U=U, that is, Undetectable=untransmittable, means that after HIV-infected people receive effective ART, when the viral load in the body is at an undetectable level for more than 6 months, HIV will not spread through sexual contact." Lu Wei said that suffering from AIDS does not mean death. We should treat AIDS scientifically, neither demonize it nor treat it lightly. The whole society should not only give more care to HIV-infected people, but also remind the public to enhance their awareness of self-prevention and be the first person to be "sexually safe".

Correctly recognize and work together to resist "Ai"

As AIDS patients, what is more unbearable than illness is psychological trauma. "Due to information asymmetry and disease labeling, there is no lack of discrimination against AIDS patients in society." Lu Wei said that the pain can be alleviated, but the psychological trauma is difficult to repair. The public should try their best to create a fair and friendly social environment to eliminate the stigma of AIDS patients and help them return to society as soon as possible. "First of all, in terms of cognition, the most important thing is that daily contact will not be infected with AIDS."

Specifically, the HIV content in the tears, sweat and saliva of infected people is extremely low, and HIV can hardly survive without the human environment; It is safe to shake hands, hug, kiss, share tableware or toilet, swim and use fitness equipment with infected people. In addition, because mosquitoes will not transfuse the blood of the last bitten person into the next person, and the survival time of HIV in mosquitoes is very short, even in countries with high incidence of AIDS and many mosquitoes, there is no possibility of mosquito transmission of AIDS.

Secondly, AIDS can be prevented. For example, stay away from drugs; Avoid sharing needles, needles, gauze, cotton wool and other appliances; Do not go to medical institutions or other places where disinfection is not strict for injections, tooth extraction, ear piercing, tattoo, acupuncture or surgery; Do not share toothbrushes, toothpicks, razors and daily necessities that may puncture the skin or mucous membranes with others. In terms of sexual life, lead an honest and clean life, abide by sexual ethics, and avoid unprotected sex; Timely and active treatment after suffering from sexually transmitted diseases to avoid the risk of HIV infection caused by existing lesions.

"Even if high-risk behaviors occur, don't panic too much. As long as it is screened early or regularly, at present, we not only have pre-exposure preventive measures (PreP), but also 72-hour post-exposure blocking treatment (PEP) of gold. " Lu Wei said.

Han Mengjie, director of the China Center for Disease Control and Prevention, said, "It is still necessary to continuously strengthen comprehensive prevention and control measures. It is necessary to formulate appropriate prevention and control strategies according to local conditions and do a good job of "one place, one policy"; In terms of key prevention and control measures, it is necessary to prevent high-risk behaviors, detect people at risk of infection as soon as possible, strengthen ART coverage and successful treatment measures; In the integration of medical care and prevention, it is necessary to give full play to the role of medical and health institutions at all levels, cultivate talent teams, create standardized treatment clinics and consultation clinics, and implement the' one-stop' service process. "

The World Health Organization's goal of "global elimination of AIDS in 2030" proposes that by 2030, 95% of infected people will know their infection status through testing, 95% of diagnosed infected people will receive ART, and 95% of infected people who receive ART will have their virus suppressed.

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