HIV: Late diagnoses and the absence of PrEP obstacles to reduce cases

Late and the absence of prophylactic antiretroviral therapy (PREP) are obstacles to reducing cases of infection. Increasing new HIV diagnoses and delayed detection, is the image shown by scientists in Greece, on the occasion of the World AIDS/HIV Day. Early diagnosis and prevention through prophylactic antiretroviral therapy (PREP) are crucial tools to stop the spread of HIV infection. However, as highlighted at the press conference organized by the Greek Society for the Study and Treatment of AIDS (SEMAA) in view of the World AIDS/HIV Day (1 December), Greece continues to face major problems. According to EOPI data, in 2023 657 new HIV cases were recorded, with an increase compared to the 526 of 2022. In the first quarter of 2024 550 new diagnoses were reported, with the 30–39 age group at the top of the list. At the same time, there is a worrying increase of 20% in cases of infection by using intravenous substances, while sexual contact between men remains the most frequent mode of transmission. However, what causes particular concern is the delayed diagnosis. Over half the new cases of 2024 (55%) were detected at an advanced stage of infection. The highest percentages were recorded: In heterosexuals (62.5%). Experts have pointed out that women and older people are often out of sight of preventive controls, due to the misconception that the infection concerns mainly men who have sexual intercourse with men. Could not use PrEP Although preventive treatment prior to exposure to HIV (PREP) has been established since 2022 and the conditions for its administration have been established in 2023, patients still have no access to it. As the representatives of the EMAA explained, the problem is technical: the non-interconnection of hospital pharmacies with the EDDIA delays the prescription and needs additional assurance of the patient’s personal data. This inactivity has led to minimal use of PrEP in our country, with only 100 people having received it through research protocols, while at global level this treatment has been granted to more than 8 million people. The ESA stresses that rapid activation of PrEP is necessary to reduce new infections. Subdiagnosis and delayed diagnosis are not only a Greek problem. According to the European Centre for Disease Control and Prevention (ECDC), over 50% of new HIV diagnoses in Europe are carried out late. At the same time, it is estimated that only 70% of people living with HIV in the EU are aware of their situation, with this percentage falling dramatically in Eastern Europe and Central Asia. The stigma and ignorance High rates of stigma and ignorance for modern scientific data were also recorded in a survey conducted in May 2024 by an independent polling company through random telephone or online interviews in a representative sample in Cyprus. 75% considers HIV/AIDS a dangerous disease for human life. 24% responded that HIV individuals pose a risk to society 21% that they cannot work in normal jobs (e.g. focus) 25% believe that the virus can be transmitted by toilet sharing, 28% by hug/kiss, 23% by sharing focus items (e.g. glasses, dishes) 31% by insect bites. The question as to whether it is true that people with HIV with undetectable blood virus do not transmit the virus to their partners, 22% replied, 21% do not apply 57% do not know Scientists focus on the need for proper public information. Concepts such as ‘undetectable viral load = non-communicable’ (U=U) must be communicated effectively in order to combat stigma and improve patient quality of life. Despite efforts, incomplete understanding remains a problem: only 75.9% of respondents in recent research fully understand the importance of U=U. By Janna Soulaki / iatropedia.gr