Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
From the implementation of HIV diagnostic tests in 1985 to December 31, 2018, the infection was diagnosed in 23 Poles and people permanently residing in Poland. During this time, 931 HIV-infected people developed AIDS, as a result of which 3 people died (667). It is estimated that every day 1411-1 new people learn about HIV infection in our country (3).
HIV disease and the actual number of infected people
Experts around the world agree that the actual number of people infected with HIV is much greater. Therefore, the main challenge is to disseminate knowledge about the ways of HIV infection, methods of prevention and treatment.
- Embarrassing diseases are not only transmitted sexually. Here are other routes of infection
It is also crucial to disseminate HIV testing and to convince everyone that infection is detected early and started quickly modern antiretroviral therapy (ARV)allow the patient to function normally and live to an age comparable to that of people living without HIV. This is confirmed by the results of the latest survey conducted in May this year among HIV-positive (seropositive) patients by IQS, a research company commissioned by GSK (3).
HIV patients about the quality of their life
In this survey, 7 out of 10 people infected with HIV but using ARV therapy rated their quality of life positively: 49%. – very good, 23 percent – Okay. Only 10 percent. of people rated their quality of life “rather bad”. Surprisingly, more than half considered the situation of people living with HIV but using it antiretroviral drugs, it is better than people suffering from other chronic diseases, especially oncology.
Nevertheless, patients are aware of the limitations associated with the disease – from particular care for health to professional and material matters. More than half of the respondents indicated the need to pay much more attention to health and care for it. In addition, 30 percent. of the respondents admitted to avoiding sex because of the fear of infecting someone. Approx. 21 percent women and 10 percent. men have not started a family and have no children, seeing HIV infection as the cause of this situation.
Approximately one in ten respondents quit their job because of HIV and do not live with their relatives. However, every fourth respondent stated that HIV does not limit him in any way.
However, this does not mean that life of patients receiving antiretroviral therapy is easy. This therapy, as in any chronic disease, may be associated with the risk of increasing side effects related to the duration of medication. The survey shows that 60 percent. patients are concerned about the long-term effects of ARV drugs on their health, and as many as 7 out of 10 respondents are aware of the risks associated with the potential adverse consequences of continuous pharmacotherapy.
The problem of stigmatization and HIV infection
Every third respondent hides the therapy he or she uses from others. On the other hand, 6 out of 10 patients declared that their close family (all or only some people) knew about the pharmacotherapy of ARV.
- Embarrassing Diseases – Let’s overcome the taboo. The Point educational campaign
Why do patients hide their disease? Because, despite many (apparently insufficient) educational activities, people with HIV are stigmatized in our country. The most unpleasant thing is that – as the survey shows – most often patients experience various forms of discrimination from health service representatives.
To the question “Have you ever faced unpleasantness from others since obtaining a positive HIV test result”, the majority of respondents answered yes (57%) – 30% each. from the dentist and the medical staff, e.g. in POZ, 21% – from the internal medicine doctor or internist, 19% – from the nurse or midwife. Of course, some people also experience unpleasantness from family and friends, but these are rarer cases than discrimination against people with HIV in healthcare facilities.
HIV-positive people would therefore like to intensify the fight against stigma. Among the proposals for such activities, in the first place (86% of responses) they mention the broad education of Polish society, in the second (72% of responses) – training of medical personnel, and in the third (63%) – training of GPs.
Other proposals include more numerous educational campaigns organized by the National AIDS Center and the Ministry of Health, activities of non-governmental organizations and many others. 19% of respondents believe that cases of discrimination against people with HIV should be exposed and stigmatized.
Possibilities of modern therapy
Almost all patients included in the study (97%) believe that further progress in treatment and more modern drugs will improve their quality of life. As much as 76 percent. he also trusts that it will be possible in the future complete recovery from HIV infection. How is it now? Advances in antiretroviral therapy meant that HIV is now considered a chronic disease, which requires people infected with the continuation of multi-drug therapy throughout their lives.
- Chronic diseases of Poles – get to know them all
At the end of 2018, 11 patients in Poland were treated with ARV, including 063 children (101). The therapy is conducted and financed under the health program adopted by the Ministry of Health. Antiretroviral treatment of people living with HIV in Poland for 4–2017. The publicly funded ARV treatment program covers all HIV-positive and AIDS-infected persons eligible under the Healthcare Services Act. Several groups of drugs are used in different regimens in accordance with international standards.
ARV therapy allows to effectively control the activity of the virus – it blocks its multiplication, normalizes the immune system, inhibits the development of AIDS and prevents the transmission of HIV infection (5).
It is estimated that the average adult patient (around 30 years old) with HIV takes tens of thousands of doses of various antiretroviral drugs throughout his life (6). Many years of exposure to ARV drugs and their interaction with other drugs that the patient is taking for other conditions can have negative health effects. The more drugs you take, the greater the risk of gastrointestinal, kidney, cardiovascular dysfunction, metabolic disorders and many others (7). As the study mentioned above showed, patients are aware of this risk.
- Adverse drug reactions
Therefore, the main emphasis is now on optimizing and reducing the side effects of long-term therapy. The basic idea is to limit drugs to the necessary ingredients and the lowest effective dose.
The latest pharmacology achievements already allow the implementation of an innovative one dual therapy (in place of the current three-drug one), the equivalent effectiveness of which has been confirmed by new studies. Thanks to it, the drug load is lower and the patients tolerate it better. Two-drug regimens, which are already available in Poland, may in the near future become a common standard of treatment for patients living with HIV.
Information about the study
The opinion poll The Perspective of HIV Patients was conducted in May this year using the CAWI method (i.e. using the Internet for individual contact) on one hundred HIV patients receiving antiretroviral therapy. The respondents were recruited by doctors who work with people living with HIV on a daily basis and employees of non-governmental organizations operating in the field of HIV / AIDS.
The main purpose of the survey was to obtain knowledge about the feelings of patients receiving ARV therapy. There were 66 men and 34 women among the respondents. The two largest groups (31 people each) were patients aged 40–49 and 50–59 years. 25 of the respondents were aged 18–39, and 13 were over 60. More than half of the people declared themselves heterosexual, 32 people – as homosexual.
The research report is available at: https://grupaiqs.pl/sklep/perspektywa-pacjentow-zyjacych-z-hiv/
As a result of HIV / AIDS, more than 35 million people worldwide have died so far, of which 940 in 000 alone. However, HIV mortality is systematically declining, mainly due to effective treatment. At the end of 2017, there were approximately 2017 million people living with HIV in the world, 36,9 million of whom were infected in 1,8. In the same period, 2017 percent. adults and 59 percent children living with HIV received lifelong antiretroviral therapy (ARV). At the same time, thanks to a global effort, ARV therapy was used worldwide by 52 percent. pregnant and lactating women (80).
Press material prepared by the Association of Journalists for Health for the Quo vadis medicina? Workshop, 2019th edition: Innovations in the treatment of HIV infection, Poznań, June XNUMX.