Since the publication of the first cases of Acquired Immunodeficiency Syndrome to date, the extraordinary scientific findings reported in the last three decades in relation to the infection by the Human Immunodeficiency Virus (HIV) have diametrically changed the gloomy prognoses had on the evolution of the disease.
The development of effective, powerful, safe and simple combinations of antiretrovirals has achieved that a large percentage of infected people manage to remain with the infection controlled for many years, which led to the international setting of ambitious goals aimed at controlling the pandemic . The concept of undetectable = untransmissible promoted the possibility of substantially reducing the transmission of HIV infection as never before. The foregoing strengthened with the clear demonstration of the efficacy proportional to adherence of the use of antiretrovirals as a preventive measure. Studies in the real world that report a clear decrease in the incidence of new cases of infected people have multiplied.
If the panorama described has demonstrated the feasibility of reaching the 95-95-95 goal for the following years, why in our country are we not seeing this possibility clearly? Just over a year ago, it was finally possible for us to have access to single-tablet antiretroviral combinations that are the first treatment option, both in people without prior treatment and in those who meet clinical and laboratory criteria for therapeutic simplification , according to multiple international guides.
Unfortunately, it is still frequent to detect people who debut with the diagnosis of AIDS due to the presence of opportunistic infections. The tuberculosis , terrible and constant impact on the health system, manifests itself not rarely in people who are immunologically or with significant aggressiveness in the presence of drug resistance reconstitution.
We must analyze what prevents us from combining all that has been advanced in some areas of HIV infection and implement the measures aimed at using what we have available in a more forceful, rational and practical way. As in the whole world, we are facing a historic moment to be able to positively affect the number of new cases of the infection in our country.
The pre-exposure prophylaxis program is a fundamental part of this , let us remember that for its implementation it is important, not only to have the combination of antiretrovirals available (in our country in generic presentation). It is also important to consider an application plan that considers the methodology that includes the essential resources for its application, the population to whom the plan is directed, the criteria for it, the follow-up and the interventions to ensure adherence, among other items.
To the extent that the program is implemented and expanded, progress towards the goals defined for the coming years will be more feasible to achieve, which will result in progressively minimizing the impact of HIV infection in our country.