Since the beginning of the HIV epidemic in the 1980s, 86 million people globally have been affected by the virus.1 Many stakeholders across the HIV response continue to prioritize and invest significantly to overcome the epidemic. Cutting-edge science has led to biomedical innovations, transforming HIV into a preventable and treatable chronic condition for millions of people. While tremendous progress has been made, the epidemic persists as one of the most formidable public health challenges.
To end the HIV epidemic, we must go beyond a biomedical approach and fully integrate social determinants of health into the collective response. There is more work to do to achieve the United Nations’ (U.N.) goals of ending the epidemic by 2030. To achieve these goals, thereby forging a more equitable and innovative HIV response, we must continue to prioritize person-centered HIV research and development and to partner and collaborate for work that is diverse, inclusive and grounded in the voices of communities most affected by HIV.
A new report titled Going the extra mile to end the HIV epidemic provides a comprehensive framework for individual countries. The report illuminates how local decision makers can take actionable steps, informed by progress in other regions, and affect real-life impact to help achieve the UNAIDS 2030 goals.
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Redefining long-term success in HIV treatment
Many strategies are necessary to overcome HIV, and it will be impossible to end the epidemic without bringing HIV treatment to all who need it. The scientific community has made incredible progress with the development of effective HIV treatments that provide virologic suppression, helping people with the virus to lead healthier lives and eliminating the risk of transmitting HIV. At the same time, not everyone is achieving long-term HIV treatment success.
Only two-thirds of people living with HIV globally are virally suppressed.2 Closing the HIV treatment gap must be a top global priority to eradicate the virus. Long-term success includes selecting the right treatment to prioritize long-term outcomes from the beginning. The HIV treatment landscape is evolving. People are living longer, healthier lives. The increased use of antiretroviral treatment (ART) regimens has been accompanied by the emergence of HIV drug resistance.3 Long-term HIV treatment and drug resistance remain significant challenges that require diverse, person-centered drug development strategies.
Each person has different day-to-day treatment needs and preferences. There is no “one size fits all” approach. The complexities of HIV care require person-centered innovations that put people at the center of developing new therapies as we keep striving to offer options for all those living with HIV. These evolving needs propel our research teams at Gilead.
One Size Doesn’t Fit All – Tailoring Antiretroviral Treatment
Consider the day-to-day realities of three separate people with HIV. One person is retired and has been living with HIV for 30+ years, in addition to heart disease and diabetes. The next is unhoused and is unable to access and safely store their medication. The third is a person of color whose family has had terrible experiences being mistreated by the healthcare system. They are all living with HIV and need to be virologically suppressed for their entire lives. What each of them needs to achieve successful long-term health outcomes is vastly different. Being able to offer options for a wide range of people requires a holistic approach to care that empowers people affected by HIV to be equal partners in decisions that affect their long-term health and well-being.
Understanding how a person lives and what they are able to do is an essential part of caring for someone affected by HIV. As a collective HIV community, we must look to the future of tailored treatments to meet the needs and preferences of people affected by HIV. This means examining dosing options, such as new single-tablet regimens and combination medications on the horizon. It is about looking closely at the range of administration options available and emphasizing the importance of tailoring those options into the daily lives of those taking the medications.
Advancing health equity
The HIV epidemic is fueled by racial, gender, class and sexual discrimination at the community and systemic levels. These inequities must be addressed to end the epidemic. Ensuring that all people affected by the virus have equitable access to the quality care they need and deserve, particularly those disproportionately affected by other health inequities, is at the forefront of the HIV community’s efforts.
Achieving health equity requires partnership with governments, scientists, clinicians and community. It will continue to take togetherness to reduce disparities, advance education among healthcare professionals and support the local communities in which they operate. We work closely with partners and grassroots organizations to address deep-rooted barriers to access—like stigma—to reach underrepresented and disproportionately affected communities, including Black, Latine, LGBTQ+ and aging individuals.
Bringing community voices into the research process is another way to advance health equity. From planning to execution, while looking at real-world and participant-reported outcomes, they have direct line of sight into how treatments work. For example, our team is spearheading additional innovative programs which include communities that have been historically underrepresented in HIV clinical research such as members of the LGBTQ+ community, women, young people and people of color. It is paramount that our research is directly informed by the diverse voices of people affected by HIV and the advocates and communities that surround them during every step of our development process.
Going the extra mile to end the HIV epidemic
The response to the HIV epidemic is at a crossroads. We cannot break the trajectory of this epidemic unless people and communities are at the center of the collective response.
To further reduce stigma, improve healthcare access and quality, and enhance local leadership and advocacy, we require more than medicine – we need ongoing and substantial community investment.
Gilead recognizes the need for innovative approaches to address the diverse needs of individuals and communities affected by HIV. Our dedication to transformational innovation extends beyond the laboratory. We believe in collaborating at the global, national, and local levels to bridge gaps in HIV awareness and improve linkage to and retention in care.
