Marking World AIDS Day in 2020 will be very different. The theme this year is global solidarity and shared responsibility, requiring all of us to come together to ensure that health is fully financed, health systems are bolstered to ensure the provision of equitable access to lifesaving medicines, and diagnostics and human rights are respected. In 1988, World AIDS Day was the first ever global health day. It provides an opportunity for people across the world to come together in the fight against HIV, to offer support for those who are living with the virus, as well as remembering those who have died from an AIDS-related illness. COVID-19 is also bringing people together globally in attempts to fight the pandemic and to minimise the increasing number of deaths and associated morbidity.
The number of people newly diagnosed with HIV in the UK continues to decrease. The fall in new diagnoses is showing that prevention tools are working, for example, frequent testing and access to pre-exposure prophylaxis (PrEP). However, there are concerns: the decline seen in recent years is slowing and is less steep in some areas outside London and among some communities (National AIDS Trust, 2020). Late diagnosis remains high, with 1279 people diagnosed late in 2019 (Public Health England (PHE), 2020), suggesting that testing strategies may not be reaching enough people. National AIDS Trust (2020) is calling for a significant increase in opportunities to offer testing for HIV outside of sexual health clinics and a quicker roll-out of PrEP, including health promotion activities that are targeted at specific populations, for example, women and those from black African communities.
In the UK, in 2019 a total of 98 552 people were seen for HIV care (PHE, 2020). In 2019, globally, there were 38 million people living with HIV and 770 000 AIDS-related deaths (UNAIDS, 2019). At the time of writing there have been 54.7 million confirmed cases of COVID-19 and an estimated 1.3 million deaths reported as a result of the coronavirus (World Health Organization, 2020).
HIV/AIDS was one of the most destructive pandemics in history. HIV has not gone away, there is still a need to increase awareness, challenge prejudice and improve education. For nearly 40 years a vaccine for HIV has eluded scientists. Several trials are being undertaken in relation to a vaccine for the SARS-CoV-2 virus, with some positive signs recently. In the meantime, it is collaboration with public health that will offer as much protection as possible. Public health interventions (where, very often, it is nurses who are at the forefront) have saved lives during the HIV epidemic with nurses advocating safer sex practices as they make every contact count.
In the early days of HIV, those with HIV died alone as a result of stigma, discrimination and unfounded fear, often rejected by their friends and family, with few people attending their funerals. In severe cases of COVID-19 people are still dying alone and few people are attending their funerals. However, this is not because of lack of support, but as a result of the isolation that is required.
The vital role of nurses is irrefutable. Nurses not only provide critical care to those in need, they also act as agents for change. Nurses advocate for patients and promote improvements across health systems; they provide marginalised communities with access to health care, be this in relation to COVID-19 or HIV.