35 years ago, and more than 36 million deaths later, the first reports appeared in the Morbidity and Mortality Weekly Report describing what we now understand to be HIV and AIDs. Initially identified as a cancer endemic to gay men (later labeled GRID), public panic and misconceptions of the disease abetted its proliferation, and it wasn’t until four years later that President Reagan finally addressed the epidemic of AIDs publically as a “top priority”, when confronted with national outcry.
Now pandemic, methods for defeating the global health crisis are vigilant and varied; HIV is treated with antiretroviral therapy to stall its progression, but only for those lucky enough to access ARV drugs; destigmatization, safe sex, and public information campaigns encourage testing and aim to mitigate new cases; and very recently, emerging technologies are being wielded in the fight against AIDs.
Yesterday, on World AIDs Day (12/1), Obama’s administration released its strategic plan and “Progress Report” to the reduce incidence of HIV/AIDs in the US. The comprehensive roadmap includes tasking the Substance Abuse and Mental Health Services Administration with incorporating “evidence-based technology to support” patients infected with HIV in tandem with comorbid disorders, and “to support adherence to HIV medication and PrEP”. It goes on to assign the Health Services and Resources Administration (HSRA) with providing “assistance and advice regarding health information technology (HIT) infrastructure enhancements to support improved linkage to care and care coordination.” A 2016 action item for the HSRA instructs the agency to “pilot a virtual technical assistance program involving experts and peers regarding provision of MAT in primary care settings utilizing teleconferencing technology.”
In November, DNA Electronics and scientists from the Imperial College of London revealed their pioneering device which could empower patients living with HIV to measure their own viral load. Similar to a glucose monitor, patients deposit a droplet of blood onto the disposable usb, which is then plugged into a computer or mobile phone. Sending an electronic signal, it takes less than half an hour to read the amounts of HIV-1 in the blood. This tool arms patients previously diagnosed with HIV with the agency to quickly administer their own tests. If and when they have limited access to care providers, this could prove a valuable tool for ongoing care coordination, as well as the future of viral detection.
Working within a broader scope, Right to Care, with the help of Boston University and the National Health Laboratory Service, unveiled their “National Viral Load monitoring dashboard” last month in Johannesburg. The dashboard is a national surveillance system which compiles near-real time data monitoring patient viral loads in South Africa. The purpose of the project is twofold: to understand patient management, and to recognize HIV hotspots, where treatment can be provided for viral suppression, aligning with the UN’s ambitious “90-90-90” program to eradicate the threat of AIDs. Collecting the national data, Right to Care anticipates the analysis will be used to inform planning and policy, guide strategy, and document and track progress. The information culled will also be redistributed to health care providers, provinces and districts, to meet patient needs.
In additional to public advocacy and advancements in HIV/AIDs research, it appears that innovative software and the use of health information technologies will become the gold standard for patient management and coordinated care.