Understanding HIV/AIDS: The Treatment Cascade


The global HIV/AIDS epidemic does not seem to be a major threat anymore. These days, we see increasing news coverage about declining HIV rates, innovations in treatment, and even HIV cures. These success stories highlight incredible strides made over 30 devastating years of the pandemic, but the fact remains that there is so much work left to be done before we can even begin to contemplate an AIDS Free Generation.

The concept of global health is relatively new within the international relations and security spheres. Indeed, the HIV/AIDS pandemic was one of the first major examples of a disease that knows no borders and can affect anyone – gay or straight, Black or White, drug users or high-profile celebrities. Global health has profound implications for international relations practitioners. Whether you’re a Peace Corps Volunteer working in an HIV endemic area in Ukraine, a diplomat working at an embassy in Botswana, or a humanitarian aid worker assisting in a refugee camp in Lebanon, you will encounter global health issues, including HIV/AIDS.

Even within the US, 50,000 people continue to become infected with HIV each year, despite major advances in the struggle against AIDS. There has been no significant reduction in the disease rates in recent years, and it appears that despite our best efforts, HIV prevention has come to a standstill. If we can’t get to zero new infections at home, how are we expected to achieve an AIDS Free Generation globally?

Here is a new way of understanding the epidemic – it’s called the HIV Treatment Cascade. Watch the video, it’s great.

This waterfall concept clearly identifies the major pillars of HIV prevention, treatment and care that we need to focus on to successfully target and eliminate the drivers of HIV risk. HIV/AIDS is still a major global threat. We need to transform and revolutionize our response to this disease to meet individuals where they’re at in their unique circumstances. If we can improve health systems, link more people to HIV care, keep those people in care, expand treatment and bolster adherence support – all the while keeping in consideration the individual, cultural, social and economic context – then maybe someday we can get to zero new infections.

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