Initial trends from five cities shed light on stigma experienced by people living with HIV, but reveal that overall quality of life is good among those who are on HIV treatment

London, UK, 30 November 2018 – Early findings from the Fast-Track Cities Quality of Life Survey fielded in 29 cities around the world, show that almost one in three people living with HIV (38%) report feelings of stigma by their community, and almost one in four in a healthcare setting (23%), of which 78% identified a healthcare worker as the source of stigma. These figures, alongside others highlighted in the survey, provide an insight into how the quality of life of people living with HIV is affected on a daily basis by a myriad of factors including stigma.

The Fast-Track Cities Quality of Life Survey was developed by the International Association of Providers of AIDS Care (IAPAC), in partnership with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Global Network for People Living with HIV (GNP+), and the International Community of Women Living with HIV (ICW). Supported by a grant from ViiV Healthcare, the survey aimed to seek answers to questions about the overall health and wellbeing of people living with HIV, as well as factors that can affect a persons’ quality of life while living with the disease, particularly in a city setting.

The initial findings released today, just before World AIDS Day[1], are the first to be announced from the survey and provide an overall global picture as well as specific city read-outs from five Fast-Track Cities: Bangkok (Thailand), Durban (South Africa), Madrid (Spain), Miami (USA), and Salvador (Brazil). Results show that there is a significant disparity in the levels of stigma experienced in a healthcare setting, and within communities, by people living with HIV in these five cities.

Reported stigma and discrimination experienced within the community within the past 12 months were relatively low in Salvador and Bangkok, at 16% and 11%, respectively, with stigma experienced in healthcare facilities and by healthcare workers in these two cities within the same timeframe similarly low at 7% and 12%, respectively. However, the figures jump sharply for Miami, Durban, and Madrid with 66%, 42%, and 32% of respondents, respectively, saying they had felt stigmatised by their community in the past year.

Moreover, 47% of Durban respondents said they had been stigmatised in a healthcare facility or by a healthcare worker, while Miami and Madrid respondents reported considerably less stigma experienced in their healthcare facilities at 16% and 13%, respectively.

“One of the four commitments undertaken by all Fast-Track Cities was to reduce the negative impact of stigma and discrimination experienced by people living with HIV, both as a human rights imperative but also as a means of increasing access to and utilisation of HIV services to attain the UNAIDS 90-90-90 targets,” said Dr José M. Zuniga, President/CEO of IAPAC, the core technical partner of the Fast-Track Cities initiative. “Where stigma exists against people living with HIV, the dignity that should be afforded every human being and the benefits that ‘Knowing Your Status’[2] (HIV prevention and treatment services) can confer are denied. We aim to use the findings from the Fast-Track Cities Quality of Life Survey to inform a global and local dialogue about the need to take a holistic approach to improve the quality of life of people living with HIV.”

Globally, initial trends indicate that approximately 40% of the more than 4,300 people living with HIV who responded to the survey, reported being satisfied with their quality of life. Percentages were significantly higher in Miami with 56% reporting satisfaction, followed by Durban and Salvador, both reporting close to 50% satisfaction. Eighty-eight percent and 70% of respondents from Salvador and Durban, respectively, who reported satisfaction with their quality of life were consistently on antiretroviral therapy (ART), while in Miami, 60% of respondents who were satisfied with their quality of life were on ART but admitted occasionally missing doses. With regards to their outlook on life and living with HIV, respondents in Bangkok (44%), Miami (43%), and Salvador (39%) most often reported a positive outlook. Significant percentages of people living with HIV who are consistently on ART across three cities reported a positive outlook on life – Madrid (100%), Bangkok (94%), and Salvador (94%), while in Durban and Miami only 66% and 65% of respondents consistently on ART, respectively, reported a positive outlook on life.

Michele Robbins, Senior Director, Global Strategic Initiatives, ViiV Healthcare said, “It is vitally important to recognise that quality of life is an essential part of HIV care and to understand how people living with HIV perceive it affects their ongoing care. We look forward to using these insights and working with partners to develop meaningful interventions[3] that can support optimal care in HIV.”

Additional interim global findings from the survey showed that 25% of respondents had disclosed their status to their intimate partner or spouse, and that about the same proportion worry about disclosing their status to their intimate partner or spouse. Despite Salvador and Bangkok reporting low stigma and discrimination in the healthcare setting and within their communities, people living with HIV in all three cities were notably worried about disclosing their HIV status to family and friends – 62%, 50%, and 50% for Salvador, Bangkok, and Durban, respectively. In Miami and Madrid, 26% and 21% of respondents, respectively, reported being almost always worried about disclosing their HIV status to family and friends, while 27% of respondents in Madrid and 24% of respondents in Miami reported being worried about disclosing to their intimate partners or spouses.

Full findings from the Fast-Track Cities Quality of Life Survey are expected to be announced in 2019. The total number of respondents is expected to reach 7,500.

-  ENDS -

About Fast-Track Cities

Cities bear a large share of the global HIV burden. In countries with large HIV epidemics, the numbers of people living with HIV (PLHIV) in urban areas are so high that effective city-level action is likely to influence national outcomes. Even where an HIV epidemic is smaller, cities are home to large numbers of people belonging to key populations at higher risk of HIV infection but which often receive limited attention in HIV programs. The Fast-Track Cities is a global partnership between more than 250 high HIV burden cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the United Nations Human Settlements Programme (UN-Habitat), and the city of Paris. The initiative was launched on World AIDS Day 2014 in Paris. For more information please visit: www.iapac.org/fast-track-cities.

About the International Association of Providers of AIDS Care (IAPAC)

IAPAC was founded more than three decades ago with a mission to improve access to, and the quality of, prevention, care, treatment, and support services deliver to people living with and affected by HIV and comorbid diseases, including tuberculosis and viral hepatitis (HBV and HCV). With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals who are working to end AIDS as a public health threat by 2030. For more information, please visit: www.iapac.org

About ViiV Healthcare

ViiV Healthcare is a global specialist HIV company established in November 2009 by GlaxoSmithKline (LSE: GSK) and Pfizer (NYSE: PFE) dedicated to delivering advances in treatment and care for people living with HIV and for people who are at risk of becoming infected with HIV. Shionogi joined in October 2012. The company’s aim is to take a deeper and broader interest in HIV/AIDS than any company has done before and take a new approach to deliver effective and innovative medicines for HIV treatment and prevention, as well as support communities affected by HIV.

For more information on the company and our work towards 90-90-90, please visit www.viivhealthcare.com .

Media contact

[1] The theme for World AIDS Day 2018 is Know Your Status. The theme recognizes the importance of ensuring that people living with HIV, especially those disproportionately affected by HIV, have equitable access to and utilize timely care, treatment, and supportive services if they are diagnosed with HIV. Click here for more information: https://knowyourstatus.unaids.org/

[3] Through support from ViiV Healthcare, IAPAC developed training modules for clinicians in 35 Fast-Track Cities regarding the importance of eliminating stigma in healthcare settings. The modules were developed in partnership with UNAIDS, GNP+, and the International AIDS Society (IAS). Click here for more information: http://www.fast-trackcities.org/hiv-stigma

Episodes 1 Through 3 of Season 1’s 12 Episodes
Now Available on iTunes and Google Play

Amsterdam, Netherlands (July 24, 2018) – The International Association of Providers of AIDS Care (IAPAC) today launched an innovative podcast series focused on telling the story of the urban AIDS response globally. The podcast series is named, Fast-Track Cities, after an initiative of the same name that is working with more than 250 cities worldwide that are accelerating their local AIDS responses to end AIDS as a public health threat. Through compelling storytelling, each episode features interviews from some of the most prominent voices in the global AIDS movement – including people living with and affected by HIV, clinicians, scientists, government officials, representatives from community organizations, and many more. The Fast-Track Cities podcast was officially launched today during a Fast- Track Cities reception held in conjunction with the 22nd International AIDS Conference (AIDS 2018) and with the first three episodes of its 12-episode first season now available for free download on iTunes and Google Play.

“After spending the last almost four years focused on advancing the Fast-Track Cities objectives, we want to give voice to the inspiring stories about the urban AIDS response that uniquely vary city-by-city,” said Dr. José M. Zuniga, President and CEO, IAPAC. “We are excited to launch the Fast-Track Cities podcast to tell these stories in a powerful way through the podcast medium. Our goal is not only to educate our audience about HIV/AIDS globally, but to share the best practices that cities working in partnership with communities are advancing to ensure that no one is left behind as we strive to end AIDS as a public health threat. I would like to personally thank everyone who graciously participated in the first season as we could not have done this without you and your personal anecdotes.”

The genesis of this podcast was born out of the successes that IAPAC observed working with cities that form the Fast-Track Cities initiative, which was launched on December 1, 2014. To date, the initiative has catalyzed high HIV burden cities around the world towards attaining the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 and zero stigma targets by 2020. With more than 250 cities now having signed the Paris Declaration on Fast- Track Cities Ending AIDS, and unprecedented momentum achieved by most Fast-Track Cities, there is a powerful story to be told regarding a reinvigorated urban AIDS response.

The Fast-Track Cities podcast’s first three episodes include a history of the HIV epidemic from the perspective of cities such as Amsterdam, Cape Town, Nairobi, New York City, and San Francisco (Episode 1); an overview of the science of HIV, with a review of the current state of HIV prevention and treatment interventions (Episode 2); and a description of the Fast-Track Cities initiative, from its genesis in 2014 through to the work that it is advancing today.

“Given the current global push to end AIDS as a public health threat, it is critical that the voices of local everyday heroes engaged in accelerated urban AIDS responses are heard and that their stories be told,” said Dr. Zuniga. “We must do everything we can to protect and gain funding for high HIV burden cities; ensure sustained political will; employ innovation to scale-up HIV prevention, linkage to care and access to treatment; and eliminate barriers such as stigma that jeopardize sustained progress. It is our goal that the Fast-Track Cities podcast series will leverage the successes of almost four decades of urban AIDS responses and spur conversation and advance positive action in every city of the world.”

Season 1 Episode Guide:

 IAPAC has curated significant content for the Fast-Track Cities podcast and plans to add on a second season to share many more powerful urban AIDS response stories across every region the world, several of which are untold. Additionally, IAPAC is looking for other stories and perspectives, as well as feedback on podcast episodes, which can be shared by emailing iapac@iapac.org. For more information about sponsorship opportunities, please visit the Fast-Track Cities Podcast webpage.

About the Fast-Track Cities Initiative

Fast-Track Cities is an approach for cities to accelerate their local AIDS responses, supported by four core partners – IAPAC, UNAIDS, UN-Habitat, and the City of Paris – in collaboration with local, national, regional and international implementing and technical partners.

Combining the efforts of city governments, Mayors, affected communities, local health departments, and clinical/service providers, the initiative aims to build upon, strengthen and leverage existing HIV programs and resources to accelerate locally coordinated, city- wide responses to end AIDS as a public health threat by 2030. Visit www.fast-trackcities.org for more information.

About IAPAC

The International Association of Providers of AIDS Care (IAPAC) represents more than 30,000 clinicians and allied health care professionals in over 150 countries. Its mission is to improve the quality of and increase access to HIV prevention, care, treatment, and support services for men, women, and children affected by and living with HIV and comorbid conditions (e.g., tuberculosis, viral hepatitis). For more information about IAPAC and its 32- year history of marshaling the health professions to end the HIV epidemic, please visit www.iapac.org.

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For more information:

Lindsay G. Deefholts
Global Communications and Advocacy Consultant
ldeefholts@gmail.com
+ 1 416 301 7966

CONTACT: Stephen Head, Media (EU)
+44 (0) 7768 705945

- New Survey of >24,000 People in Europe Reveals HIV Stigma Still Widespread -

July 23, 2018 – Results from a new, large-scale, Europe-wide survey of over 24,000 people in 12 countries[1] demonstrate that, despite significant progress over almost four decades, HIV-related stigma persists as a major challenge for people living with HIV (PLHIV). While experts in the field, PLHIV and allies recognize that stigma and discrimination are unfounded, the Is HIV Sorted? survey has revealed there is still much work that needs to be done among the general public. Negative societal attitudes towards PLHIV pose a barrier to achieving the Joint United Nations Programme on HIV AIDS (UNAIDS) 90-90-90 treatment targets by 2020, as stigma discourages testing and can impede PLHIV’s access to and engagement and retention in HIV care.^[i]

HIV transmission remains a significant concern across the European continent. According to the World Health Organization (WHO), in 2016 more than 160,000 people were diagnosed with HIV in the European region. This is the highest number of people ever newly diagnosed in one year, with the greatest number of new diagnoses in the Eastern European region.^[ii]

Initial results from the Is HIV Sorted? survey, jointly conducted by the International Association of Providers of AIDS Care (IAPAC), the core technical partner of the Fast-Track Cities initiative, and Gilead Sciences, were released today at the 22^nd International AIDS Conference, Amsterdam. Although results from the survey were broadly consistent across Europe, there were some notable differences between Eastern[2] and Western[3] regions:^[iii]

• Across Europe a significant proportion of respondents (68%) would not feel comfortable dating someone who is living with HIV (66% in Western Europe and 74% in Eastern Europe)
• In Eastern Europe, over half (52%) of respondents have negative attitudes about working with PLHIV; around a quarter (24%) in Western Europe also have the same negative attitude
• Across Europe half (50%) of respondents believe that PLHIV should not be allowed to work as healthcare professionals
• In Eastern Europe only one in five (20%) respondents believe that PLHIV should be able to do any job, regardless of their status; a quarter (25%) believe that PLHIV should not even be allowed to work in a store

Successful HIV treatment and management that yields an undetectable level of HIV in the blood (viral suppression) means that the virus is virtually untransmittable from HIV-positive to -negative sexual partners (the premise of the Undetectable=Untransmitable [U=U] message). However:³

• Only around one in 10 respondents (12%) understood the meaning of ‘undetectable,’ with approximately one third believing that being undetectable means that you can still transmit HIV to someone else
• More than half (53%) of respondents believed that it would still be possible to transmit HIV to others, even if the treatment was having the best effect possible (viral suppression)
• Only approximately half (47%) of respondents were aware that it is possible for women living with HIV who are undetectable to conceive HIV negative children

“Although we have taken significant steps forward in addressing HIV-related stigma experienced by PLHIV, the Is HIV Sorted? survey results demonstrate that we cannot be complacent,” said Dr. José M. Zuniga, President/CEO, International Association of Providers of AIDS Care (IAPAC). “There is still a significant lack of understanding about HIV. Fear of stigma is a major barrier to people getting tested, which is the first step necessary to achieve the 90-90-90 targets. We must expand our education and awareness-raising efforts to ensure the wider public are more informed, so that people can live positively with HIV.”

The survey also found worrying levels of complacency with respect to HIV prevention. Almost a quarter of respondents said they had a new sexual partner in the last year but, of these respondents, only 44% always used a condom, and almost one in four respondents rarely or never used a condom with a new sexual partner.³

Encouragingly respondents, particularly those in Eastern Europe, appear to believe that HIV is still a significant issue, with nearly half (47%) across Europe believing that HIV is still a major health concern and less than one in five (18%) Eastern European respondents believing that HIV is under control in their country. Linked to this, the majority of respondents (73% in Western Europe and 82% in Eastern Europe) believe that funding for HIV should be a priority for their government or health service.³

“These data are a wake-up call to all of us involved in efforts to attain the 90-90-90 targets. 2020 is just two short years away,” continued IAPAC’s Dr. Zuniga. “We must not allow HIV to be deprioritised - either in the halls of government or in the minds of the general public. These data are valuable to initiatives such as Fast-Track Cities enabling us to work with local stakeholders to eliminate misperceptions about HIV, strengthen primary HIV prevention efforts and maximise use of the tools that we have to treat and prevent HIV infection.”

Gregg Alton, Executive Vice President International Operations & Corporate Affairs, Gilead Sciences, said, “These results reinforce the critical need for the whole HIV community to work together to tackle the significant issues that still remain in HIV prevention, diagnosis and care. We hope that these results will contribute to robust and productive discussions at this conference, as we focus on breaking down barriers and building bridges to reach key populations, and ensure that no-one is forgotten as we collectively work to stop the virus.”

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- Notes to editors –

About Is HIV Sorted?

The Is HIV sorted? Survey was commissioned by the International Association of Providers of AIDS Care (IAPAC), the core technical partner of the Fast Track Cities initiative, and Gilead Sciences. The survey respondents included 18,169 HIV-negative[4] adults living in nine countries in Western Europe, including seven with Fast-Track Cities (France, Germany, Italy, Spain, United Kingdom, Ireland, Austria, The Netherlands and Switzerland) and 6,043 HIV-negative§ adults living in three countries in Eastern Europe, two with Fast-Track Cities (Romania, Ukraine and the Russian Federations). The survey aimed to provide insights into the general publics’ awareness, perceptions, knowledge, and attitudes towards HIV. The survey was fielded in June 2018 by the independent market research company Opinium. Additional survey data will be made available during 2018 and 2019.

About Fast-Track Cities

Cities bear a large share of the global HIV burden. In countries with large HIV epidemics, the numbers of people living with HIV (PLHIV) in urban areas are so high that effective city-level action is likely to influence national outcomes. Even where an HIV epidemic is smaller, cities are home to large numbers of people belonging to key populations at higher risk of HIV infection but which often receive limited attention in HIV programs. The Fast-Track Cities is a global partnership between more than 250 high HIV burden cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the United Nations Human Settlements Programme (UN-Habitat), and the city of Paris. The initiative was launched on World AIDS Day 2014 in Paris. For more information please visit: http://www.fast-trackcities.org.

About the UNAIDS 90-90-90 Targets

The Joint United Nations Programme on HIV/AIDS (UNAIDS) asserts that attaining the 90-90-90 targets is a means of placing national and municipal jurisdictions on a trajectory towards ending AIDS as a public health threat by 2030. The targets translate into:

• 90% of people living with HIV (PLHIV) knowing their HIV status
• 90% of PLHIV who know their HIV-positive status on antiretroviral therapy (ART)
• 90% of PLHIV on ART achieving viral suppression

About Gilead Sciences

Gilead Sciences, Inc. is a research-based biopharmaceutical company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. The company strives to transform and simplify care for people with life-threatening illnesses around the world. Gilead has operations in more than 35 countries worldwide, with headquarters in Foster City, California.

For nearly 30 years, Gilead has been a leading innovator in the field of HIV, driving advances in treatment, prevention and cure research. Today, it’s estimated that more than 11.5 million people living with HIV globally receive antiretroviral therapy provided by Gilead or one of the company’s generic manufacturing partners.

For more information on Gilead Sciences, please visit the company’s website at www.gilead.com, follow Gilead on Twitter (@GileadSciences) or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000.

References

[1] The 12 countries included 9 with Fast-Track Cities: Austria, France, Germany, Netherlands, Romania, Spain, Switzerland, Ukraine and United Kingdom

[2] ‘Eastern Europe’; Romania, Russia, Ukraine (n=6,043)

[3] ‘Western Europe’; Austria, France, Germany, Ireland, Italy, Netherlands, Spain, Switzerland, United Kingdom (n=18,169)

[4] Self-described

^[i] Centers for Disease Control and Prevention (CDC). HIV Stigma Fact Sheet. Available at https://www.cdc.gov/actagainstaids/pdf/campaigns/lsht/cdc-hiv-TogetherStigmaFactSheet.pdf [last accessed July 2018]

^[ii] ECDC. HIV/AIDS surveillance in Europe 2017. Available at https://ecdc.europa.eu/sites/portal/files/documents/20171127-Annual_HIV_Report_Cover%2BInner.pdf [last accessed July 2018]

^[iii] Opinium. Is HIV sorted survey (sample: 18,169). June – July 2018. Survey commissioned by the International Association of Providers of AIDS Care (IAPAC) and Gilead Sciences.