International AIDS Candlelight Memorial Day (May 19, 2024 – the third Sunday in May)

The International Day of Remembrance of those who died of AIDS has accompanied the World AIDS Campaign for over 40 years. In 1983, in San Francisco, USA, a small group of people personally affected by the issue held events for the first time to draw attention to a new, then little-known disease.

Subsequently, this movement was supported in many countries. Today, this day serves as a call to society and individuals to pay attention to the problems associated with HIV infection and to contribute to achieving the global goal of making HIV prevention, treatment, care, and support services accessible to all who need them. The Day of Remembrance has a long history filled with grief, loss, and undoubtedly, hope that humanity will surely overcome this disease. Many years ago, an HIV diagnosis sounded like a death sentence: humanity faced a new disease that was quickly learned to diagnose, but effective treatment was unavailable for a long time. Today, thanks to the advancements of modern medicine, people living with HIV-positive status have the opportunity to maintain their quality of life for many years, just like people without HIV infection.

According to World Health Organization statistics,
there are currently about 40 million people living with HIV-positive status on the planet, and since the beginning of the epidemic, over 40 million people have died from HIV-related illnesses. This diagnosis is no longer a death sentence: timely detection of the virus provides an opportunity to fight for the quality and duration of life for each individual. In this regard, today there is a call for HIV testing (self-testing). It is important to understand that a person may have been infected with HIV for a long time for various reasons and, without even realizing it, transmit the infection to others, while also depriving themselves of the opportunity to receive timely medical care.

Over the years of the epidemic's development, much has changed: thanks to modern medicine, HIV infection is no longer a fatal disease. The quality and life expectancy of people living with HIV (hereinafter referred to as PLWH) who adhere to antiretroviral therapy (hereinafter referred to as ART) are no different from those of people without HIV. However, many people diagnosed with HIV are afraid to seek medical help or register at a healthcare facility, fearing disclosure. This fear is caused by stigma* and the expectation of negative reactions from others.

*Stigma – (a "label," a "brand") – a prejudiced attitude towards an individual or group of people associated with the presence of specific characteristics or traits. Stigmatization – the process of imposing a negative social role on an individual or group of people.

To change society's negative attitude towards HIV infection and people living with a positive HIV status, a Unified Information Strategy on HIV Infection has been implemented in Belarus since 2011. This strategy represents an innovative approach to providing information for prevention campaigns. Currently, Belarus has adopted the third edition of the Information Strategy for 2024-2026*, which aims to further overcome stigma and discrimination against people living with HIV and key* population groups.

*Full text of the Information Strategy for 2024-2026:

*Key population groups – population groups at increased risk of HIV infection due to their behavioral characteristics. Key population groups include people who inject drugs; men who have sex with men; transgender people; sex workers, and people in places of detention.

The strategic priorities of the Information Strategy are based on the tasks of subprogram 5 "HIV Infection Prevention" of the State Program "People's Health and Demographic Security" for 2021–2025, the Sustainable Development Goals adopted by the Republic of Belarus, the UNAIDS "95-95-95" targets, the Political Declaration on HIV and AIDS: Getting to Zero, and the Global Health Sector Strategies on HIV, viral hepatitis and sexually transmitted infections for 2022–2030.

A significant contribution to HIV infection prevention is made by achieving the targets of the Joint United Nations Programme on HIV/AIDS (UNAIDS) "95–95–95", which aims to ensure that by 2030, 95% of people living with HIV (PLHIV) know their HIV status, 95% of PLHIV who know their diagnosis receive ART, and 95% of PLHIV receiving ART achieve viral suppression, thereby eliminating the possibility of virus transmission. This means that a person diagnosed with HIV infection who is receiving treatment and has achieved viral suppression according to laboratory monitoring of its effectiveness is not a source of infection for other people. The concentration of the virus in their blood is so low that they cannot transmit HIV to others, including through sexual contact. This is an undeniable proven fact.

[The role of viral suppression in reducing HIV transmission, WHO, 2023. ].

 Therefore, HIV infection treatment is considered not only an effective method for increasing the life expectancy and quality of life of PLHIV but also an important preventive component in curbing the spread of the infection. The Republic of Belarus demonstrates significant dynamics in achieving strategic targets: if in 2018, the achievement of these targets in our country was at the level of "77–58–37"; at the beginning of 2024, it was "92–92–83".

Currently, 25,154 people living with HIV infection reside in the Republic of Belarus. Over 10,000 people have died since 1987. The highest number of new cases is registered among men and women aged 30 to 49 years, with sexual transmission being the predominant route of HIV transmission, accounting for over 80% of all registered cases.

As of April 1, 2024, 1983 cases of HIV infection have been registered in the Vitebsk region, with 518 deaths. Currently, 1465 people living with HIV reside in the region. The predominant route of HIV transmission is sexual, accounting for over 83% over the entire observation period. The highest incidence rates in 2024 were recorded in the age groups of 30–59 years, at 87.8%.

Significant progress has been made in identifying patients with HIV infection and achieving treatment effectiveness over the past 5 years; HIV therapy is provided free of charge to all patients in our country.

Today, as many years ago, the International Day of Remembrance of People who Died of AIDS proclaims the opportunity to demonstrate significant progress in prevention and treatment, as well as the readiness and desire to counteract the further spread of HIV infection, and serves as a reminder of those who have faced this disease over the years of the epidemic's development. The red ribbon, pinned to the clothes of millions of people on our planet on this day, reminds us that HIV infection knows no borders, and joint efforts and adequate actions can overcome unfounded prejudices and promote further progress in prevention.

State Institution "Vitebsk Regional Center for Hygiene, Epidemiology and Public Health", Department for the Prevention of HIV Infection and Parenteral Viral Hepatitis