Dr Ahluwalia reports on 10 key discussions from the conference in Melbourne that will form the basis of a new strategy moving forward.

Director and Head of the Higher Education and Training  HIV/AIDS Programme (HEAIDS) Dr Ramneek Ahluwalia attended the AIDS 2014 conference in Melbourne, representing South Africa on various forums as a panel member and speaker. Upon his return, Dr Ahluwalia reported on 10 key discussions that took place that will form the basis of the new strategy as a way forward. The conference this year was attended by approximately 107 Ministers of Health including our own Minister of Health. Further, close to 10 000 scientists, researchers, Academics, Activists, Pharmacists and other health care workers across the globe presented their work at this prestigious conference. He insists that it is very important to keep ourselves aware of the latest across the globe to help strategise efforts towards a better HIV/TB/STI and General Health and wellness response. The 10 key areas are as follows:

 1. There may be fewer people living with HIV than we thought.

A study published in The Lancet to coincide with AIDS 2014 found that there were 29.2 million people living with HIV in 2013, compared to the estimate of 35 million people released by UNAIDS. The study also estimated that there were 1.8 million new infections and 1.3 million deaths in 2013.

2. Decriminalizing commercial sex work could significantly decrease new HIV infections among sex workers.

Female sex workers are 14 times more likely to have HIV than other women. In an article published in The Lancet this week, researchers studying HIV among sex workers in Canada, India, and Kenya have concluded that decriminalization could reduce infections by 33 to 46% in those countries.

3. Ninety is the new zero.

For years now, we have been hearing a chorus of ‘zero new HIV infections, zero HIV-related discrimination, and zero AIDS-related deaths.’ But this week, UNAIDS changed course, promising to have 90% of all people with HIV aware of their status, 90% of people on treatment, and 90% of those on treatment with lasting viral suppression by the year 2020.

4. Women using injectable hormonal contraceptives are at greater risk of contracting HIV, but WHO isn’t planning to inform women before they choose birth control methods.

A meta-analysis of 37,000 women shows that the use of injectable hormonal contraceptives is linked with higher rates of HIV infections in women. At the same panel, the World Health Organization announced that it had no plans to change the current guidelines on women and hormonal contraceptives.

5. UNAIDS is still leaving out one of the most at-risk groups of all: women.

AIDS is the leading cause of death of women of reproductive age in sub-Saharan Africa. And while pregnant women and young women aged 15-24 are getting their share of the spotlight, it is vital that we identify women as a group in need of special attention and support. The Global Fund’s Mark Dybul got it right in a blog post this week when he stated that "Gender-based violence, inequality and lack of legal protection fuels the spread of this plague among this highly vulnerable group."

6. Children and adolescents are dying at an alarming rate.

Even with efforts to provide universal access to treatment, the availability of pediatric drugs for children with HIV has lagged far behind, with only 24% of children who need treatment receiving it. In low- and middle-income countries, only 42% of HIV-exposed infants receive testing during the first two months of life, when disease progression occurs very rapidly, often leading to death. Adolescent deaths among children increased by 50% between 2005-2012. Researchers at the conference highlighted that cash grants, school feeding programmes and psychosocial support can reduce HIV risk behaviour by half in adolescent boys and girls.

7. There is a huge shortfall in funding for harm reduction.

Injecting drug users (IDUs) are consistently included in lists of groups that are most vulnerable to HIV, but donors have kicked in just 7% of the funds needed to provide safe injection sites and other HIV prevention and care services for IDUs.

8. HIV-positive women are being pressured to undergo sterilization by health workers.

A study released at AIDS 2014 revealed that one in four women in Central America are being forcibly sterilized and misled about the risk that HIV posed to their children. This isn’t an isolated incident: cases of forced sterilization have been documented around the globe from Namibia to Uzbekistan and are an egregious violation of human rights.

9. Undetectable viral loads.

Calling it “the closest thing we have to a cure for HIV,” activists issued a challenge this week to bring viral loads to undetectable levels by 2020.

10. Funding for activists is drying up, and with it, the voices to spur governments and agencies to action. 

Activists issued a 'cri de coeur' to delegates of AIDS 2014, lamenting that "AIDS is fast becoming just another disease of the poor, criminalised and marginalised...just another manifestation of global complacency about poverty and inequality."