Overcoming HIV: the path to a healthy nation through an integrated approach

November 24, 2023

A look at how comprehensive strategies and providing leadership to communities can change the fight against HIV in Kazakhstan and the world.

It has been more than 40 years since we first heard about HIV and AIDS. A lot has changed since then, but the fight against this disease continues. Important tools in this fight are screening, timely diagnosis and effective treatment, which help not only to maintain health for many years, but also prevent the transmission of the virus.

HIV in numbers:
According to UNAIDS, in 2022, 86% of all people with HIV in the world knew about their status, 89% received treatment, and 93% had viral load suppression. In Kazakhstan, these figures were 87%, 84%, and 87%, respectively, in 2022. The goal by 2030 is to achieve 95% of all these indicators.

What is syndemia?:
To effectively fight HIV, you need to consider it not just as a virus, but as part of the big picture. The term "syndemia" describes a situation where several diseases interact with each other, worsening the overall state of health. For example, HIV can interact with hepatitis, alcoholism, or the presence of sexually transmitted infections, and these combinations can exacerbate the impact of each disease.

Why is this important?:
Understanding that HIV often does not act alone means that all factors affecting health, from medical to social, need to be taken into account. HIV does not exist in a vacuum. Many HIV patients also have other social or medical problems, such as STIs, viral hepatitis, or mental disorders. An approach that takes into account all these factors allows members of the medical community to provide more holistic care for an effective result.

HIV testing and participation in related services is a pathway to syndemic and holistic approaches that optimize the outcomes of HIV programs to end the HIV epidemic, and is a critical pathway to a cascade of prevention and treatment options. Knowledge of HIV status is necessary for making informed decisions regarding sexual and general health, it is a personal responsibility and a valuable investment in corporate public health.

If a person's test result is positive, they can start treatment for HIV infection (antiretroviral therapy or ART). People with HIV who take ART as prescribed and have and maintain an undetectable viral load (or maintain a suppressed viral load) can live a long and healthy life and will not transmit HIV to their sexual partners. If a person's test result is negative, they can take measures to reduce the risk of HIV transmission by using preventive means such as pre-contact prophylaxis and condoms.

What is Kazakhstan doing?:
Kazakhstan is actively working to improve HIV indicators, using the recommendations of WHO and UNAIDS. All 12 WHO-recommended prevention programs have been implemented, including information and educational activities, testing and counseling for HIV/STIs/VG, access to condoms and other protective equipment, as well as medical and social services to support health. Youth Health Centers (YHCS) play a key role in HIV prevention among young people, providing a variety of medical and social services to people aged 10 to 29 years.

Modern technologies, such as social networks and TikTok, are actively used to convey information to our citizens and especially young people. 

The country has seen a decrease in the rate of mother-to-child transmission of HIV from 8.4% in 2007 to 2.6% in 2022. Mortality from Acquired Immune Deficiency Syndrome per 1,000 people living with HIV infection decreased from 11 in 2016 to 6 in 2022, which indicates successful prevention measures. 

Despite the fact that the HIV infection rate in Kazakhstan is 0.3%, which is lower than the global average of 0.7%, problems persist. 

The potential of non-governmental organizations (NGOs) in HIV prevention remains untapped, although they play a key role in stabilizing the epidemiological situation and identifying new HIV cases. NGO participation has increased: 14 NGOs in 10 out of 20 regions received a state social order to work with key population groups, which means a threefold increase compared to the early statistics of 2022. However, half of the regions still remain without state social support, which affects the epidemiological profile of the country.

Our goal is to provide more people with the opportunity to prevent HIV, increase testing, provide access to treatment and eliminate stigma and discrimination. We strive to create a healthy society where every citizen can lead a long and healthy life free of HIV.

How can we defeat HIV?:
To defeat HIV, a comprehensive approach is needed. This includes prevention, screening, diagnosis and treatment, as well as innovative research. In addition, it is necessary to involve communities and non-governmental organizations that have access to closed key groups to work together and develop unique points of view on the problem.

HIV is not just a medical problem, it is also a matter of social justice and equality. Overcoming this threat requires joining efforts in many directions. As science advances new methods of prevention and treatment, social and cultural barriers remain critical obstacles. To truly confront HIV, an integrated and comprehensive approach is needed.

HIV is a multidimensional problem that requires a multidimensional solution. And although medical innovations continue to develop, real change will be possible only with the active participation of all participants in society - from medical specialists to ordinary people. Communities, especially those most vulnerable to HIV, are at the center of this fight. With advances in medicine and a deep understanding of how HIV interacts with other diseases and social factors, there is hope for a world without HIV. An integrated approach that takes into account all aspects of health and social causes can lead to victory over this disease. Through national efforts, the country strives to provide its citizens with vital HIV prevention opportunities, ensuring a longer and healthier life for all.

Zh. Musina, Head of the Prevention Department of KNCDIZ

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