Medicine showed its most spectacular face seventeen years ago with the functional cure of the first patient with human immunodeficiency virus (HIV). But now the case of Timothy Ray Brown, known globally as the Berlin patient, is no longer an exception: there are now ten people worldwide who have managed to eliminate the virus through a complex but effective stem cell transplant. The most recent case is that of the so-called Oslo patient, a 62-year-old Norwegian and seropositive man, who was also diagnosed with a cancer of the immune system and required this intervention. Four years later, and despite having stopped receiving antiretroviral drugs, the virus remains undetectable. With one peculiarity compared to previous cases: his donor is his own brother.

Actor and film director Eduardo Casanova has announced his HIV status via his Instagram profile: "Today I break this unpleasant and painful silence after so many years. A silence that so many of us with HIV have kept and suffered."

There are now seven people in the world who have been cured of HIV. The seventh is a man known as the second patient in Berlin, who received a positive diagnosis for the virus in 2009 and another for leukemia in 2015. To treat the cancer, the patient received a stem cell transplant from a donor, a therapy that had previously resulted in the undetectable presence of HIV in the blood of a few other HIV-positive individuals. However, in all previous cases of cure, the donors were homozygous, meaning they had two identical copies of a gene whose mutation is considered protective against the virus. This time, however, researchers from the Berlin Institute of Health and the University of Berlin have managed to cure the patient using cells from a donor who only had one of the two copies with the mutation, suggesting that the pool of donors with the potential to eliminate HIV could be larger than expected.

A third of HIV diagnoses in Catalonia are made late, when patients have already suffered an opportunistic infection or when their immune system has already begun to deteriorate. The same is true for half of all diagnoses in Europe, as the World Health Organization (WHO) warned this week. These delays in diagnosis are precisely one of the main reasons experts cite for why diagnoses have not fallen below 3,000 new cases annually over the last fifteen years. Dr. Joaquín Burgos, from the Infectious Diseases Department at Vall d'Hebron Hospital, explains in an interview with ACN on the occasion of World AIDS Day, commemorated every year on December 1st, that the delay in diagnosis is one of the "main problems" that persists with the HIV virus. On the one hand, because these people have had the infection for years without knowing it and have been able to transmit the disease. Even if they haven't had any opportunistic infections, Burgos adds, and even if patients begin treatment after diagnosis and their condition improves, the time they have spent with HIV "has an impact on future comorbidities," meaning additional chronic health problems. On the other hand, the doctor adds, the prognosis for patients has changed radically in the last forty years: it has gone from being a death sentence for many people to being able to have an undetectable viral load and a quality of life equivalent to the rest of the population. Meanwhile, Burgos points out, challenges remain, such as breaking the stigma, achieving greater social awareness, and ensuring that the healthcare system doesn't miss opportunities for diagnostic testing. "There are what are called missed opportunities, when a person has been through the healthcare system with a condition associated with HIV infection, but hasn't been offered a test," he explains.

HIV emerged as an epidemic 40 years ago, and today, 32,579 people are living with the virus in Catalonia alone. In 2019, a treatment called pre-exposure prophylaxis (PrEP) was approved in Spain that prevents it; however, as reported by the ARAThere are waiting lists of up to 30 months, and infections are being recorded while patients wait to receive the drug. This Wednesday, the BCN Checkpoint community center—one of the few authorized to distribute it—asked the Catalan Health Department for more resources to reduce the wait and curb the unregulated black market for PrEP. BCN Checkpoint has 40,000 people waiting to receive the drug and only 40 new slots available per month. This causes the waiting list to climb to two and a half years. The center's coordinator of studies and manager of the waiting list, Félix Pérez, stated that since the treatment's approval, 20 infections have been detected among people on the waiting list, and he attributes this to administrative inaction. "It is unacceptable that there are new infections due to negligence on the part of the system. There are people who want to take care of their health, but they are waiting," denounced the center's director, Ferran Pujol.

Raphael J. Landovitz is one of the world's leading authorities on HIV prevention and control. He is the director of the Center for HIV Identification, Prevention, and Treatment at the University of California, Los Angeles (UCLA), and head of the Division of Infectious Diseases at the David Geffen School of Medicine at the same university, where he leads globally impactful clinical research on the disease. He visited Barcelona for a conference aimed at breaking down barriers to accessing the HIV prevention pill, a treatment called pre-exposure prophylaxis (PrEP), organized by BCN Checkpoint, a leading center for HIV infection control. In Catalonia, waiting lists for treatment are growing, and the Catalan government does not know how many people are waiting to receive it. The first infections have already been detected. among people who have been in line for over two years for a pill that would have protected them from the virus.

A completely effective strategy for preventing HIV infection has been in place for five years, but it is still not available to everyone in Catalonia. People seeking treatment, a pill called HIV pre-exposure prophylaxis (PrEP), must wait more than two years, and cases of infection have already been detected on the long waiting lists. As reported by the ARA, At least twenty people waiting have been infected due to access difficulties And specialized entities warn that this figure will continue to grow if more resources are not allocated. Furthermore, the department admits that it does not know how many people are on the waiting list. Now, however, it assures that it is working on a formal and regulated registration system that "will allow for accurate information on the number of people interested in receiving treatment" and, thus, sort out the current mess.

"I've had to completely change my life. It doesn't seem normal to me to have become infected after years of waiting for treatment. It's a problem with the healthcare system," complains Martí [a fictitious name to protect his identity], who has been on the waiting list for the HIV preventative pill, a treatment called "The Pill." Finally, he ended up getting infected, and like him, at least twenty other people have become infected because of him. lack of accessibility in treatment, according to the BCN Checkpoint, the leading center for infection control in Catalonia. Sources consulted by ARA warn that either there is greater investment to expedite access to PrEP, or there will be more cases.

Sexually transmitted infections (STIs) are a public health problem throughout Europe. In our country, they are increasingly common: since 2010, they have increased by an average of 32.4% each year, and in 2023 alone, 37,571 cases were diagnosed. There is now a long waiting list to obtain the HIV preventive pill, a treatment called pre-exposure prophylaxis (PrEP). At the BCN Checkpoint, the reference center for the fight against HIV and STIs in the Catalan capital, 4,000 people are waiting to begin treatment, but the wait time is already two years. Professionals complain that they do not have sufficient resources to treat everyone and regret that the process is taking so long that they are already detecting the first infected among users waiting. According to ARA, the center has already begun work to move to a larger building starting in February of next year to reverse these waiting lists.

"It's an insult to all of us who have been waiting for years. We just want to take care of our health. I feel like I could live my sexuality much more peacefully," explains with resignation Alexis, one of the people waiting to start taking the HIV preventative pill, a treatment called pre-exposure prophylaxis (PrEP). He is 27 years old and has been on the waiting list at the BCN Checkpoint for over a year and a half. This reference center for infection control in Catalonia has around 4,000 people waiting to start treatment, but the wait time is already two years. Professionals complain that they don't have enough resources to treat everyone and lament that the process is taking so long that they are already detecting the first infected people among the users waiting.

In just two months in office, the Donald Trump administration has jeopardized the progress made in eradicating AIDS over the past 25 years and has put global health organizations on alert. This Monday, the United Nations quantified the impact of the virus. cuts to the US cooperation fund USAID in the prevention and treatment of the human immunodeficiency virus (HIV) and have concluded that this can lead to up to 2,000 infections per day.