SFGH Ward 86: Progress in the Fight Against HIV
Since the beginning of the AIDS crisis in the 1970s, the world has made incredible progress in medication to diagnose, prevent, and suppress HIV; however, we have yet to completely eradicate the disease. The staff at SFGH HIV Clinic, also called Ward 86, is working diligently at all levels of health regarding HIV to bring the world’s incidences of HIV at the lowest they can be and to bring in a new era of HIV treatment where HIV can be removed from the body entirely.
During BIE’s visit to Ward 86, we were given several presentations on the current state of HIV and AIDS prevention and treatment. Our first presenter, Dr. Gabriel Chamie, addressed the current barriers to HIV prevention in several African countries. The biggest barrier was simply lack of awareness that they may be at risk, given that infection of HIV is largely asymptomatic for a period of time before AIDS begins. His team in Africa found that using point-of-care technology to test patients quickly and easily with results in the same appointment gave people the best assurance of knowing their status, as well as bracelet identification, which helped make the screening process high-throughput. They set out on a goal to test populations within entire regions of countries, ranging thousands of people. In order to do so, they used fingerprint detection data from the country’s census to ensure that they tested as many people as possible and were able to contact those who did not come. In the end, they tested more than 1,000 people per day.
The second presenter, Dr. Hyman Scott, discussed HIV prevention methods, with an emphasis on PrEP. According to Dr. Scott, condoms are only 75% effective in preventing HIV infection due to misuse, lack of lubricant, or common failure to use a condom on occasions. PrEP, however, is safe to use and, while it is most effective when taken once a day, it is also very effective when taken one day before a sexual encounter as well as the once a day for two days after, a method called event-based dosing. In addition to PrEP, other solutions include regular STI screening, PEP, and microbicides. Some technology that can possibly solve this issue in the future are HIV vaccines and condoms that “kill” HIV before they can infect.
Dr. Rachel Rutishauser, an immunology researcher, presented the current merits of a potential HIV vaccine. According to Dr. Rutishauser, the largest barriers to producing an HIV vaccine is HIV’s ability to undergo genetic mutations that allow it to evade medication and the lack of any natural immunity to HIV in the population, which means researching have nothing to model an immune response after. However, a vaccine is extremely important because when when on antiretroviral therapy to control HIV, people who are HIV+ experience inflammation that puts them risk of cardiovascular and other problems, not to mention the necessity of adherence to therapy.
Overall, we have made extraordinary progress in the field of HIV as a species, but there are more advancements to be made. Moving forward, the future is looking brighter and brighter for the complete eradication of HIV and AIDS.
*Image from: https://ari.ucsf.edu/clinical-care/ward-86
**Image from: http://amfar.org/rachel/
