FACTSHEET: Understanding Dangers of Unknowingly Living with HIV

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Scanning electron micrograph of HIV-1 budding (in green) from cultured lymphocyte. This image has been colored to highlight important features (Photo by the CDC, taken from Wikipedia)

By: Louise S.A. Alsan & Muhammed Lamin Touray

Although the Gambian National AIDS Control Program has increased HIV counselling and testing services substantially, testing coverage remains low, with less than 40% of the those living with HIV knowing their status in 2020,according to a report by BMC Infectious Diseases Published on 26 May 2023.

The results of the study, titled: “The association between HIV self-test awareness and recent HIV testing uptake in the male population in Gambia: data analysis from 2019–2020 demographic and health survey”, shows the following:

“Of 3,308 Gambian men included in the study, 11% (372) were aware of HIV status and 16% (450) received HIV testing in the last 12 months,” the study by the peer-reviewed journal on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases, stated.

“In the design-adjusted multivariable analysis, men who were aware of HIV status had 1.76 times (95% confidence interval: 1.26–2.45) the odds of having an HIV test in the last 12 months, compared to those who were not aware of HIV status.”

Raise Awareness

This factsheet seeks to raise awareness of the dangers associated with unknowingly living with HIV as a result of not seeking to test to know one’s status, and it raises important concerns about the impact of undiagnosed HIV infections on public health.

Numerous studies have established a correlation between delayed HIV diagnosis and poorer health outcomes.

Individuals who are diagnosed with HIV at later stages of infection are at increased risk of developing AIDS-related complications and experiencing higher mortality rates (The Lancet HIV Vol. 6 No. 2e93–e104 Published: January 22, 2019)

Early diagnosis and access to antiretroviral therapy (ART) have been shown to improve health outcomes and prolong life expectancy for people living with HIV.

Why are people not testing?

There is extensive literature documenting the impact of HIV-related stigma on testing uptake and disclosure of HIV status.

A systematic review published in BMC Public Health, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health, found that fear of stigma and discrimination was a significant barrier to HIV testing in many communities including The Gambia.

Additionally, Factsheet by UNAIDS published in 2021, there are negative consequences of stigma on individuals’ mental health and well-being, leading to social isolation and reluctance to access HIV services.

Impact on public health

Multiple studies support the claim that public health can be affected by demonstrating the potential for undiagnosed HIV infections to contribute to ongoing transmission of the virus within communities.

According to research published in the journal AIDS, individuals with undiagnosed HIV infections are more likely to engage in behaviors that can transmit the virus unknowingly, such as unprotected sex or sharing needles.

Increasing HIV testing rates:

Global efforts to improve access to HIV testing and healthcare services have been shown to be effective in increasing testing rates and reducing undiagnosed HIV infections.

Initiatives such as community-based testing programmes, mobile testing units, and the integration of HIV testing into routine healthcare services have demonstrated success in reaching underserved populations and improving testing coverage around the world.

Early diagnosis of HIV

Studies have consistently demonstrated the benefits of early HIV diagnosis in facilitating timely initiation of ART and reducing the risk of disease progression.

According to research published on January 8, 2024 by the JAMA Internal Medicine, early treatment with ART not only improves health outcomes for individuals living with HIV but also reduces the risk of HIV transmission to others.

Early diagnosis also enables individuals to access comprehensive support services, including counseling, adherence support, and linkage to care.

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