Slowness and regional differences, from diagnosis to patient care, aggravate a situation made critical also by the Covid-19 pandemic. Scientists and institutions sign a manifesto for a new commitment in the fight against HIV
Forty years of “living together” with the disease require a budget. In fact, the event held on the 16th by SDA Bocconi School of Management with the contribution of Gilead Sciences (and the patronage of the Solidarity Medicine Institute) is entitled “HIV 40 years later” and which highlights how the fight against HIV / AIDS in our country proceed in patchy fashion. Two years after the entry into force of the National Plan for interventions against HIV and AIDS (PNAIDS), in 2019, only half of the Regions had implemented it with regional resolutions, only in 38% of cases the Regional AIDS Commission was appointed and only 37% of the Regions had carried out communication campaigns.
Slow start
Despite a recovery in 2019, the results of the research project APRI – Aids Plan Regional Implementation highlight slowness and regional differences that contribute to aggravating a scenario that is in itself critical. To complicate matters, the Covid-19 epidemic has caused a decrease of more than 50% in HIV tests carried out and delays in accessing health services for visits and consultations.
Lack of information and awareness have fueled the spread of the infection especially among the youngest: the highest incidence of new diagnoses is found in the 25-29 age group.
Submerged infection
In Italy, it is estimated that around 120,000 people are infected with HIV: of these around 100,000 have been diagnosed (83%) but the remaining 20,000 (17%) are still “submerged” – “waiting” to take the test – with the risk of late diagnosis and aggravation of the infection on the one hand and its continuous spread on the other. Thanks to therapeutic advances, today it is possible to live with the infection, with an expectation and a quality of life that can become similar to an uninfected person. The lack of knowledge of HIV and the social stigma, however, influence the quality of life of patients and the therapeutic path. 32% of patients are or have been victims of discriminatory incidents.
“The pandemic emergency from Covid-19 can no longer represent an obstacle to the management and treatment of other diseases, especially chronic ones such as HIV on which the delays in taking charge and follow-up weigh the most” commented Claudio Mastroianni , President of the Italian Society of Infectious and Tropical Diseases (SIMIT) and Full Professor of Infectious Diseases at Sapienza University of Rome. “The implementation of PNAIDS on the territory is necessary to face the challenges of HIV which requires a strengthened model of taking charge, from diagnosis, to access to treatment and management of follow up, within the care chain , integrating the specialist centers with the territorial network ».
New challenges
The research project APRI 2.0 was born precisely to contribute to the application of PNAIDS and review the models of HIV management. “From the photograph of the state of implementation and implementation of the PNAIDS on the Italian territory made in an initial design phase” explains Lucia Ferrara of the Cergas SDA Bocconi “some challenges and priorities for intervention emerged: strengthening the communication programs aimed at target populations, promoting strategies and continuous awareness-raising interventions, spreading the culture and access to the test, investing in the ongoing care of the patient. From here we started again, in a second phase of the project, with the development of four case studies that allowed us to develop exploratory lines of intervention to give concrete answers to these same areas of intervention “.
Special cases
However, the differences between the Regions have also made it possible to develop new intervention models, always with a view to contrasting the spread of the disease, limiting its impact and improving the quality of life and care of those affected. The case of Piedmont has made it clear how to enhance access to testing and early diagnosis, while the case of Puglia has highlighted how to improve the integration of the local hospital in patient care. The case study of Sicily highlighted the taking in charge of HIV patients as the government of the service chain and, finally, the case of Veneto made it possible to highlight the perception of HIV + patients towards the use of telemedicine. All this in line with the objectives set at an international level in the fight against HIV, to be achieved by 2025, which require joint action by the scientific community and institutions.
The poster
An action that took shape with the initials of the first manifesto for a renewed commitment in the fight against HIV, an inter-institutional pact for the implementation of tools and organizational models for epidemiological detection and surveillance, prevention and management of chronicity. “The APRI project is a concrete example of this commitment” underlined Valentino Confalone, CEO of Gilead Sciences Italia. “The study has highlighted important critical issues but its phase two, with the four lines of action identified at the regional level, offers a replicable model so that the National Plan can be fully applied”.
December 17, 2021 (change December 17, 2021 | 16:07)
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