HIV+ to HIV + organ transplantation is a reality
It's no surprise that there's a severe shortage in this country of organ donors. It's a dire situation even if you have a clean bill of health. Those HIV+ recipients in need of organ transplantation (e.g. liver or kidney) are often less prioritized than those without HIV. To fill this gap, the HOPE Act was signed into law allowing HIV+ organs to be transplanted into HIV+ recipients given the success of treatment regimens for HIV. "Early studies show this is feasible and effective," says Amesh A. Adalja, MD, FIDSA, FACP, FACEP, Senior Associate, Johns Hopkins Center for Health Security. "As this practice becomes more universal, HIV patients on the organ waitlists will have a better outlook." Read about the incredible woman saving lives by matching kidney donors on Facebook.
Some people with HIV delay, decline, or discontinue HIV medications
Although this is more common among low-income persons living with HIV from African-American or Black and Hispanic backgrounds than among their white peers, Marya Gwadz, Ph.D., a senior research scientist at the Center for Drug Use and HIV/HCV Research at NYU Meyers College of Nursing, points out that this can be hard for healthcare providers to understand and can cause frustration in both patients and their providers. "The reasons someone would decline HIV medications are complex and there are a few patterns we see in research," she says. "For some people, lives can become disrupted, and they will stop taking HIV medications—for example, they may lose their housing, a partner will die or substance use problems can flare—and, when life destabilizes, they re-start medication. For others, deep emotions about living with HIV, and trouble accepting that fact, get in the way of taking medications." In many cases, distrust of the medical system and of medications, plays a role, adds Dr. Gwadz.
If we achieve the 90-90-90 targets, we should be able to end the HIV epidemic
"Statistical modeling data shows that if we are able to diagnose 90 percent of all people living with HIV and we start antiretroviral treatment on 90 percent of those and we are able to achieve complete viral suppression in 90 percent of those, the HIV epidemic would end," says Dr. Malvestutto. To achieve this goal, The Joint United Nations Programme on HIV and AIDS (UNAIDS) has set the 90-90-90 as a global target by 2020. "Although these targets may not be achieved everywhere by 2020, there are several countries that have already achieved these targets including several that are low- and middle-income countries," notes Dr. Malvestutto. "As we continue to improve access to effective antiretroviral treatment, we will be able to achieve the goal of ending the HIV epidemic in our lifetime."