HIV: Farewell, fear

The text continues the joint project of Colta.ru with the official website of Sweden in Russia Sweden.ru - “For example, Sweden” .

HIV, Brand New

“HIV today is not HIV yesterday” - such is the slogan of the official Swedish portal about the fight against an infection available in 12 languages, including Russian. It has a video on it, which the doctor and scientist from the Caroline Institute of Anna-Mia Extrage begins with a bold statement: “Personally, I perceive HIV as an ordinary chronic disease similar to diabetes or hypertension.”

And it only sounds too bravur. In the fall of 2016, Swedish scientists said they live in a country that was the first in the world to take a serious step towards eradicating HIV infection.

The point here is that the Swedes reached the so -called goal of 90–90–90, which was invented by WHO and Unaids . And this goal is a simple, at first glance, statistical equation. 90% of HIV-positive people should know about their diagnosis, 90% of those who know-receive antiretroviral therapy, be treated, and in 90% of patients everything should work as a doctors, the virus should be crushed. Such percentage steps are usually called a cascade of assistance.

So, in Sweden this cascade runs away (or, rather rises) by such a curve. 90% of people with HIV in the country know that they are sick. Of these 90% 95%, treatment is obtained. And out of 95% of patients in 95% of cases, people live with a depressed virus. And with the depressed - how is it? But how.

Last year, in the prestigious medical journal, Jama published the results of a large study , where for more than a thousand couples from 14 countries of Europe it was shown: for four years with unprotected sex with an HIV-positive partner taking the necessary drugs, not a single case of infection was revealed.

And this means that seven out of ten HIV-positive people in Sweden have a completely ordinary life. They work, relax, create families, grow children, live to old age - and all this almost without risk to transfer the virus or quickly get AIDS, the last, tragic stage of the development of the disease. So it looks in Sweden “HIV Today”.

The Swedes reached the so -called goal of 90–90–90, which was invented by WHO and Unaids.

These are fantastic indicators, and other countries are very far from them. In the USA, according to centers for the control and prevention of diseases, 86% of Americans with HIV know about their status, but only 30% live with an uncertain viral load, with a depressed disease - and these are three of ten, almost half as much as necessary. Well, in Russia, the alignment, of course, is also very sad. Instead of 90–90–90, our indicators, according to official and unofficial estimates, are more similar to 70–30–73 - with a particularly offensive failure in medicines.

How did it work out?

Magnus Gislen from Gotyrogg University and his colleagues calculated that by the end of 2015 in Sweden, 78% of patients were covered with effective treatment - a little more than 73% at that time at WHO targets. Gislen explains that the success of the Swedes helped to achieve several factors.

First of all, of course, the total number of people living in Sweden with HIV does not exceed, according to scientists, 8 thousand by 9.6 million people. And this, of course, helps impressive statistics. But this is not enough, because for such impressive results, the collective efforts of the state, medicine and society were needed.

In general, the first case of AIDS was discovered in September 1982 in the country, and already in 1985 the National Committee with the Minister of Health at the head that answered the problem appeared. The arsenal in the fight against the disease of the Swedes was (and remains) wide: from the sex interval of schoolchildren and youth through the state program for the exchange of needles and syringes, operating in the country since 2006, until testing and replacement therapy.

For more than a thousand couples from 14 countries, it was shown: for four years with unprotected sex with an HIV-positive partner taking medications, not a single case of infection was revealed.

The HIV-positive assistance system in Sweden is similar to Russian, but only “on steroids”, in its ideal version. People with infection are expected by specialized centers, where teams from doctors, nurses and social workers immediately work with patients. They will have free treatment, which since 2014 officially provide everyone in general, regardless of the stage of the disease. (By the way, it was also innovation: it was previously believed that until some point the medicine can not be taken, they do it in Russia, but the last recommendations of the WHO are emphasized: there is no need to wait for a person worse.)

Naturally, a serious role in success is played by strict adherence to the recommendations of doctors. At the same time, Magnus Gislen in a conversation with Kolta said that leading specialists from large clinics constantly go to small cities for training colleagues: for example, he himself annually goes to about 20 provincial hospitals.

The Swedish government in every possible way supports public organizations that work on the ground with risk groups, and here Russia definitely has something to learn, as Kolta already wrote . HIV-Sweden , the National Coalition of HIV activists, is engaged in everything-from protecting the rights of patients to dental care programs (because teeth suffer from both illness and drugs).

And activists, by the way, do not agree with the authorities in everything. For example, now, under the Swedish legislation, it turns out that a person living with HIV, under any circumstances, can not have unprotected sex - even if he reveals his status to a partner, and he will agree. In this case, people can go to jail, even if they have not infected anyone. And this is optional and harmful severity, Swedish public organizations believe and fight for the reform of the law.

- The statement “at the body of Christ HIV” emphasizes the need for conscious solidarity.

Even the Church of Sweden published a collection of research (yes, the Swedish church has a research department) on the role of religion in the fight against the global epidemic. The book contains, for example, an open letter of the Swedish bishops of 2007, which states that the inability of the Church to talk about sexual ethics (!), Silence or harmful recommendations (!!) made it part of the problem.

“The phrase“ body of Christ ”compares the churches with living organisms, and parishioners become parts of these bodies-even if they are HIV-positive. The statement “at the body of Christ HIV”, thus, emphasizes the need for conscious solidarity, ”is such a quote.

Meanwhile, since the end of 2016, the so -called PREP - preventive drugs are available in the country, taking which, you can significantly reduce the risk of HIV. They have not yet replaced condoms, but complement them, but this is just “tomorrow” in the fight against the disease. While they need to be bought yourself, but the Swedish authorities are already looking for opportunities to make these medicines more affordable.

Yes, but how to change consciousness?

For more than 30 years, the Swedes have significantly “updated” their ideas about the infection, writes Lars Planin from the University of Malmo, who has analyzed the data of sociological surveys with colleagues since 1987. The best residents of Sweden figured out how HIV is not transmitted - for example, through saliva, kisses, public toilets or insect bites.

And yet, even in 2011, 14 years after the first modern antiretroviral drugs appeared in the country, 82% of the respondents could not correctly answer the question of how the use of drugs affects the contrast of a person living with HIV (the correct answer, as we already know: greatly reduces).

These people are still “stuck in the 80s,” says a colleague and co-author Planin Louise Mannheimer from the Swedish department for public health. And this fuel discrimination that those living with HIV still experience, including in Sweden, even when the quality of their life has grown greatly thanks to treatment.

But this is part of the common problem, because in fact the world does not know. And it's time.

Now in the United States more than half of the people living with HIV are over 50 years old.

We didn't even notice

In general, the story of the fight against HIV, seemingly daily and slow, is still underestimated. But American scientists somehow calculated: if in 1996 a conditional 20-year-old patient with HIV in the United States was morally preparing for death before a middle-aged crisis, then in 2011 the same 20-year-olds could well expect to get to a disco for those in seventy!

The situation has changed so much that last year one of the main awards in the world of scientific journalism from the American Academy of Sciences received a completely fantastic story : it turns out that now in the United States more than half of 1.25 million people living with HIV are older than 50 years. Here is another Swedish portal about HIV, HIV updated , begins with the “HIV and aging” bookmark.

The global “task of 90–90–90” Humanity hopes to solve by 2020. And according to the calculations of UNAIDS experts, if you drive the virus into such an angle, then after another ten years, by 2030, an epidemic of HIV infection on Earth will end.

In one of the numerous HIV-Sweden projects- we are Survivors -simple and affordable information for immigrants is given in ten languages ​​(almost three quarters of new cases of HIV infection in the country falls on this group ): what is HIV, how to be treated, can you deport you from the country if it is found that you have a virus (cannot).

In one of the videos on the site, a woman named Ophelia says that once, after she was diagnosed during pregnancy, she bought a dress and shoes in which she was supposed to bury.

Shoes are now sometimes borne by an adult daughter, who actually wants to leave for Singapore, and the son of Ophelia became a basketball player and plans to live in Canada. The woman herself thinks what to do now when the children are separated: maybe become a stand-up comedian?

Because HIV is not an “obstacle to the dream”, firmly resembles the site.