“This is the last interview I will give on this topic. Because 30 years have passed, because I am also working to change the cultural approach to HIV. It is not that the associations are happy with this, and the clinicians are not so happy either, because they are linked to a different modus operandi, which however was fine in my opinion until a decade ago. Now, if we really want to do good, we have to change. I think we need a pause for reflection on how to better communicate on the subject of infectious diseases. chronically ill. Let us join our voices to those of other chronically ill patients, therefore. Let’s fight on a shared agenda, against all those resistances and those walls that alone cannot be broken down “. This is the reflection of Rosaria Iardino, today president of the ‘The Bridge’ Foundation, a historic activist for the rights of people with HIV.
On the occasion of World AIDS Day, he explains that “the last mile that people with HIV have to go is that of stigma. But it also has to start a little from them. In the institutions a lot is being done. It is society. “now the link to work on,” and in society we must each do their part. The strong reason that pushes me to say this is that I am convinced that, if we are the first to remove ourselves from the stigma, perhaps we will help a process that at the moment is a bit stopped “. Today, argues Iardino, “the drugs are there, the treatments are there, we get older, the reduction of discrimination in the workplace is still an ongoing process. And we have many points in common with those suffering from other pathologies. Often not even those who have had cancer go back to their jobs and give it back “as before. “So we have to make alliances with people who have other pathologies and who like us suffer this discrimination in the working and even a little social environment. I start from the assumption that this last mile we have to do it together. We have to start again with us and we have to do it together with the others”.
Another example: “Today we see an increase in health insurance funds, we have a health service that offers, and in fact no patient with HIV or other diseases is without treatment, but if you have other tests outside your illness, unfortunately the pandemic he is proving it: either pay or wait. And if someone says ‘I want health insurance’, they don’t give it to you. , then. Unfortunately, a society is being designed that is not welcoming to people with chronic diseases. We need to take a step forward. We are chronically ill, the terms of our battle have changed “.
Together against the stigma, appeal to young people
In 2021, Iardino assures, “there is still stigma towards people with HIV. It resists in society, even in a slice of health workers. The state has tried to put all barriers to prevent discrimination. The real problem is in the culture. of society and that you can only correct with the ‘coming out’ of people with HIV. Here, it would take a collective coming out by everyone: politicians, professors, ordinary people, professionals. And I am convinced that we would have on our side also young people, committed young people like the children of the movement born to save the world “from climate change, Greta’s people.
The historic activist explains her idea to Adnkronos Salute: “If we engage this youth movement and launch the initiative of a coming out to get out of the stigma, I am convinced that we would be inundated with young people who would also come out, even if the They don’t have HIV, to shield them. And it would be wonderful – he says – Faced with this collective gesture, I expect a lot of society to say: oh well, so what? And this would be a victory. the other part of society, the one that has a prejudice linked to the mode of transmission of this disease, which is by means of sex and blood, remains crushed “.
Today, therefore, is there still a need for a striking gesture, such as the one that 30 years ago saw the Iardino as a protagonist? It was December 1991. At that time, under a shower of flashes, the immunologist Fernando Aiuti, a pioneer in research and in the fight against AIDS, kissed a young HIV-positive woman on the lips. That photo went down in history as one of the strongest and most successful messages against stigma. “Today perhaps other striking gestures would be needed – reasons Iardino – Gestures to make people aware of the fact that there are tools to reduce HIV risk”, therapies that make the virus undetectable and therefore not transmissible, strategies for safe sex. “I don’t know if any minister would be willing to take the field for this – he smiles – It would be nice”. For the rest, he concludes, “Covid has upset everything, even the concept of being infectious. The fact that Sars-CoV-2 is transmitted by speaking has overcome any prejudice compared to other infectious diseases. So the reasoning becomes: the sexual transmission is nothing in comparison, it can be avoided. The stigma still resists in any case. “
The new infections
“In 2020 we had about 1,300 new HIV infections in Italy”, a number halved compared to 2019. “Behind this figure, 3 factors could be hidden: two negative and one positive – Iardino region – Surely the pandemic has determined a certain percentage of failure execution of tests by infected people “, who therefore do not know they are infected,” but this is also associated with a problem that we are observing of missing notifications “, that is, there were diagnoses, but they were not communicated for the count. “And then there is a third positive aspect: and it is that perhaps fewer viruses circulate in Italy than in other countries where adherence to treatment is not so high. I would like to open a new window. On the one hand, Covid has reduced diagnoses , but of all pathologies. But on the other hand we have achieved extraordinary scientific successes, so that if today a person adheres to his treatment he is no longer able to infect. This is what we summarize in the formula ‘Undetectable = Untrasmittable’ (virus undetectable, thanks to treatments, is equivalent to non-transmissible, ed). We can therefore hypothesize that, at least in Italy where we have a very high adherence to treatment, above 90%, fewer viruses circulate. On the other hand, Covid it has certainly slowed down new diagnoses “.
The combination of the two factors, continues Iardino, “leads us to have around 1,300 cases in Italy. But there is another factor that we are discovering, for example in Lombardy, and that is that doctors do not notify us of new infections. . It would seem that for some centers, in this pandemonium that was Covid, with the staff that was what it was and the priorities that were other, there was even an under-notification of 40%, as far as Lombardy is concerned. that we have brought to the attention and in fact tomorrow we will have a regional AIDS Commission on this. And I believe that Lombardy is not the only Region to have had this problem “.
Campaigns for the new generations, ministry not received
Today, however, “of ‘undetectable’ there is not only the virus in people with HIV who adhere to therapies – says Iardino – Even the ministry of health and that of education are ‘undetectable’ as regards the campaigns of raising awareness among young people on the issue of AIDS prevention. For all the great issues that we have the opportunity to eradicate, there is a great void in the part that concerns young people. Training for them is zero. make an adult change their behavior, but young people are completely devoid of any information today “. There is one aspect that is culture and which, according to Iardino, would be a fundamental lever.
And then there are the prevention tools, the ‘allied’ strategies. Weapons like Prep, (pre-exposure prophylaxis), ie drugs used for preventive purposes by high-risk groups? “Yes, I have expressed a positive opinion in this regard – replies Iardino – because there is evidence, scientific data, which shows its usefulness and I remain of this opinion. The theme, however, is that the Prep remains a damage reduction tool. , should be legalized and paid for by the National Health Service, but it is not enough “. Among other things, he adds, “the drug for Prep is also generic and I don’t understand the reluctance to give it for free. There is a bit of ideology: it is as if one thought that it is much better for one not to have sex, and that the state shouldn’t pay for your lifestyle. ”
“After that, however – specifies the activist – the State is also primarily responsible for the fact that there is no culture on the use of condoms. And let’s go back to the discussion above. Some operations are completely undetectable, not received: the risk reduction strategy in our country is not detectable, the Ministry of Health with the awareness campaigns is not detectable, the Ministry of Education is not detectable, because it is also the school’s duty to provide correct information. that all are not detectable leaves the associations a very onerous task, taking into account that they do not receive a euro of public funding “.
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