HIV Specialist - June 2021 - 13

POLICY BARRIERS TO HIV PROGRESS BY: THE HIV POLICY LAB
This article is an abbreviated excerpt of the 2020 Global HIV Policy Report created and distributed
by the HIV Policy Lab, a unique collaboration between academic, United Nations, and civil society
organizations to track, measure, and improve the HIV-related law and policy environment in countries
around the world. The HIV Policy Lab is produced by Georgetown University and Talus Analytics, in
partnership with UNAIDS, the Global Network of People Living with HIV (GNP+), and a growing set of
partners around the world, and with support from PEPFAR and USAID.To learn more about the HIV
Policy Lab or to read the 2020 Global HIV Policy Report in its entirety, visit www.HIVPolicyLab.org.
F
ORTY YEARS SINCE THE DISCOVERY and isolation of
the human immunodefi ciency virus (HIV), the science
of HIV has never been better. Today, we have a better
understanding of how the virus functions and how to
test, treat, and prevent HIV infection. We have clear evidence
on the biomedical, social, and structural drivers of new HIV
infections and deaths, and new tools to halt them. Antiretroviral
medicines (ARVs), for example, are available to save lives and to
stop transmission-with new long-acting injectable forms shown
just this month to be eff ective prevention for women.1 We have
clear evidence that diff erentiating delivery of HIV service delivery
to meet the needs of people works, that self-testing helps reach
populations poorly served by other methods, that healthcare
user fees push people out of HIV care, that criminalization of key
populations undermines access and drives HIV, and much more. 2
Yet the translation of science into law and policy remains a drag on
the AIDS response. Despite rapid scientifi c advances, the world will
not achieve the 2020 global HIV goals. This reality stems from progress
that is highly unequal. As shown in the UNAIDS 2020 Evidence
Review, some countries and communities are seeing real success
while others see little.3 Some countries have made remarkable use of
HIV science-14 countries from throughout the world had attained
the global target of at least 73 percent of all people living with HIV
achieving viral suppression by 2019. AIDS deaths were cut in half in
eastern and southern Africa.
Others see growing epidemics and are far off track. New HIV infections
have increased by 72 percent in Eastern Europe and Central
Asia, 22 percent in the Middle East and North Africa and 21 percent
in Latin America. Diff erences between countries are stark. While
most in Eastern and Southern Africa have
seen remarkable progress, in Madagascar
and South Sudan less than half of people
living with HIV know their status. In Angola
a majority of people who know they are
living with HIV are not accessing treatment.
Viral load suppression levels in the United
States are much lower than in the rest of
the Western and Central Europe and North
America region. The AIDS-related mortality
rate in Haiti, a low-income country, declined
by 52 percent between 2010 and 2019 and
is now lower than that of Jamaica, an upper
middle-income country where AIDS-related
mortality increased by seven percent over
the same period. Stark diff erences exist, too,
in populations within countries. Compared
to the general population, the risk of acquiring
HIV is on average about 26 times higher
for gay men and other men who have sex
with men, 29 times higher for people who
inject drugs, 30 times higher for sex workers,
and 13 times higher for transgender people
than for adults in the general public. This
can, at least in part, be explained by the
signifi cant gap that remains between science
and law/policy in much of the world. Laws
and policies drive who has access to the
benefi ts of science, how people living with
and aff ected by HIV are treated, how health
systems are structured, and how offi cials
engage with communities.
WWW.AAHIVM.ORG HIVSPECIALIST JUNE 2021 13
http://www.HIVPolicyLab.org http://WWW.AAHIVM.ORG

HIV Specialist - June 2021

Table of Contents for the Digital Edition of HIV Specialist - June 2021

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HIV Specialist - June 2021 - Cover3
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