The End of AIDS?

It’s a bold mission by any standard: to end the AIDS epidemic. But the tools are there, say officials of the Joint United Nations Program on HIV/AIDS. Here’s what the UNAIDS plan, known as “90-90-90,” looks like.

90%

know their Status

90%

on treatment

90%

virally suppressed

The three 90s stand for testing, treatment and prevention. That means 90% of all people with HIV need to be tested and know their status, and 90% of those people must be on treatment and 90% of those people need to be treated consistently enough that the virus is undetectable in their blood.

Mother of two in South Africa

A South African mother of two young boys is shocked when she learns she has HIV. She says her boyfriend either didn’t know — or didn’t tell her — about his status.

She stares for hours at the slip of paper containing her diagnosis.

She thinks she will not live to see her sons grow up. She hasn’t told them the news.

Her eyes light up when she learns treatment will likely give her decades more life.

You mean I can be a grandmother?

South Africa has more people infected with HIV than any nation. Most are women.

A 15 year-old girl in parts of KwaZulu-Natal, South Africa has an 80% chance of becoming infected during her lifetime.

It's our culture that we need to be submissive to men, because we cannot really say no to men, and no to sex. Especially no to unprotected sex.

—an HIV positive woman in KwaZulu-Natal, South Africa

90% Should Know their status

An estimated 19 million people worldwide have HIV and don't know it. Those people may unknowingly spread the virus, especially since it can take years for any symptoms of HIV to appear. This is why widespread testing is viewed at the crucial first step in ending the AIDS epidemic.

Kevin in Mfangano Island, Kenya

Kevin suspects he was infected the same way many of his fellow fishermen catch the virus; visiting with sex workers while working away from home.

Fishermen in this part of Kenya have extremely high rates of HIV — 30% to 40%.



HIV is also spread through what’s known as “jaboya.”
Women seeking fish to sell must trade sex for access to the catch.

When they are fishing, they think they're at risk of death, and therefore HIV is less risky than the work they do.

— Moses Kamya, co-principal investigator of SEARCH

Kevin’s wife is now HIV positive as well.

But Kevin and his wife have been on treatment, thanks to a large HIV test-and-treat study happening on the island known as “SEARCH.”

The study’s test communities — in Kenya and Uganda — are some of the only communities in the world to successfully reach the 90-90-90 goal.

They've achieved this through mobile health events designed to reduce the stigma of HIV/AIDS by focusing not just on the virus, but on many other health problems in the community, such as malaria and hypertension.

People are free to access care there, because it comes to the community and everyone's going, so no one will suspect anybody.

— Kevin

90% on treatment

HIV is no longer a death sentence thanks to antiretroviral treatment. Starting daily treatment as soon as possible can prolong the life of infected people by decades and make them much less infectious to others. As the cost of these drugs has plummeted across the developing world, immediate treatment is now the goal.

Luis in San Francisco, CA

Luis was a few days into taking PrEP, the HIV prevention pill, but didn’t realize he was already infected with HIV he’d contracted from unprotected sex. (It was too early to detect the HIV in blood tests.)

The moment the HIV was detected, Luis began taking antiretroviral medications.

The HIV preventative drug, "PrEP," or ‘pre-exposure prophylaxis,' is a daily pill sold under the brand name Truvada that has been shown to lower the risk of getting HIV from sex by more than 90%.

HIV is now at such low levels in his body that doctors are studying him to see if they can learn any clues about a possible cure for HIV.

I’m not just undetectable, I’m probably the most undetectable person alive right now.

In the past two years, doctors have scoured Luis’ blood, bone marrow, lymph nodes, guts, spinal cord for HIV. The virus is nowhere to be found.

I never felt any transition into feeling sick. When people first get the virus, they usually have a really intense fever, something like that. It never happened to me, because I just started so early.

Doctors are now wondering whether such rapid treatment may be one of the secrets to a cure.

90% virally suppressed

Modern HIV treatment can suppress the virus so completely that it is undetectable on standard tests. This dramatically prolongs the life of the infected person and makes it very unlikely that they will pass HIV to another person through high-risk behavior.

PBS NewsHour traveled to six places across the world to find stories of those in the middle of the AIDS epidemic. Will the world find an end to AIDS?

Watch our six-part series, starting July 11th.

San Francisco
Atlanta
New York
Rwanda
Kenya
South Africa
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Support for this series provided by:

Reported by William Brangham and Jason Kane. Photography by William Brangham, Jason Kane, Craig Matthew and Photo by Dot. Design and Development by Megan Crigger.

Sources: Africa Centre for Health and Population Studies