Just 22 years old and a complete list of dreams to fulfill, maria jose fuster He came face to face with infection with the Human Immunodeficiency Virus, better known by its acronym HIV. A diagnosis that, in 1989, almost meant a death sentence. And so he verified it on the other side of the barrier, and just a few years later, Marisa Montes A young medical student who, during his clinical training at the 12 de Octobre Hospital in Madrid, was shocked by the dire effects of that pandemic.
passionate about infectious diseases, Marissa Opts For Internal Medicine To Fight HIV From Within, a difficult task that she has been practicing ever since, making her a reference specialist in our country who practices at the Hospital Universitario de La Paz in Madrid. for his part, María José learned to live with HIV and soon became involved in the activist movement, although it was not until the advent of highly effective antiretrovirals that it was formed to help others, already seeing the light at the end of the tunnel. Now, Doctor in Psychology and Professor of Social Psychology at UNED, she is the Executive Director of CESIDA.
Marisa and María José, now partners, share a candid conversation with A TU SALUD, in collaboration with ViiV Healthcare, with scars many have left behind but with the hope of being a more and more powerful tool, To whitewash all the progress achieved so far in HIV care, but also the pending challenges of an infection that affects 151,387 Spaniards and that changes the lives of almost nine people every day.
«Receiving an HIV diagnosis today has little to do with what it was three decades ago, because now, thanks to the efficacy and low toxicity of treatment, people who are diagnosed and treated early have a normal life expectancy. population is similar. He. HIV has become a chronic infection and the current chronicity, care and drugs have greatly improved the quality of life, to the extent that it may be more bearable than living with cancer or diabetes”, says Montes. Though Fester frowns, well «Despite the fact that new diagnoses no longer die from it, there are many needs to solve it, because the stigma is very strong, it is still very present in society and reduces the quality of life and affects mental health does. Just as transition has become chronic, so have some social problems, such as loneliness, inequality, disparity in rights or access by zip code… Fear of telling others that someone is behind it The stigma of the virus paralyzes many people and conditions their lives. Although mistrust is on the decline, there is a lot of room for improvement.
The horizon is bright for HIV, but the outlook is worrisome, because Transmission rate has remained unchanged over the past decade, In fact, although HIV testing is confidential and free, 13% of people with HIV in Spain are unaware they have it and almost half (48%) of new diagnoses are late. «There is still a lot of ignorance about it, because few people know that, although something can be achieved with treatment if the virus is undetectable, it is non-infectious. Despite this, studies confirm that 20% of people with HIV do not tell anyone. Raising awareness among the population is not an option, but an obligation”, highlights Fuster. “We are at a critical moment, a major public health challenge that requires action, as Spain seeks to end the spread of HIV. It’s in our hands to do”, predicts Montes.
The newly diagnosed have a very different profile from 30 years ago and remain in the clinic alongside long-term survivors who, like Maria Jose, face the challenge of aging with HIV. « We must move towards a model of care for people with HIV, capable of responding to problems of chronicity, but focused on the individual and the individualization of care. Like other specialties in which personalized medicine is discussed, this is also the way here”, explains Montes.
And that’s what Fester claims, who stresses the need to “alleviate the accumulated stress suffered by people with HIV, forced every day to demonstrate that they are the same as the rest of us, but the loneliness, the fragility , carry isolation bags. It is important to have psychology professionals in HIV units, but this service is not available in most of them. And outside them, to achieve early diagnosis and improve the quality of life of people with HIV A strong commitment must be made to reduce stigma.
it is necessary to take advantage of new equipment Which have been launched in recent years. In this context, and to join efforts in the same direction, arises the project National Policy, a multidisciplinary initiative promoted by ViiV Healthcare that seeks to bring HIV back into the health priorities of decision makers Contribute to Onusida’s 95-95-95 objectives for 2030. “Thanks to this project, the optimal model of chronic care and seven profiles of people with HIV have been defined, which allow us to see more clearly the global needs of each of them. It is a roadmap that allows us to shows the way to follow but it also allows us to defend our needs in front of our managers and suppliers”, acknowledges Montes, who emphasizes that “by creating care recommendation guides for each profile of people with HIV in 2023 A definite step has been taken”. And this is supported by Fester, who defends « This is the way for professionals to take care of people with HIV holistically that goes beyond the markers of analytics”.
Despite all the progress, there are several pending challenges: « I would ask the administration to bet on the Common Information System, as it will allow us to improve communication between different levels of care and be more efficient in caring for people with HIV. But it also means we are given more analysis time to care for each patient,” Montes demands. something that Fester also defends, who claims “To be able to provide each person with what they really need at all times is because HIV will be present at different stages of life, and you need to know how to adapt to this with training, resources and time .,