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From the original  Translated by ESTI How Else Could I Live Longer? All the people with HIV in Cuba needing antiretroviral treatment receive it in a controlled and free way / Juventud Rebelde

Lucas wants to have a child and this is the best time of his life for that. He thought 12 years ago he could not have children “because living with HIV changes everything, your whishes, makes you believe there are things you cannot do any longer.”

However, for the last nine years, Lucas has started treatment with antiretrovirals and has strictly followed the indications of specialists. Today, as he did five years ago, his analysis shows that his viral load is undetectable, and this guarantees him to conceive a healthy son.

“I have always received the right guidance and I have been aware that my health depends primarily on my discipline. I respect my meal schedules, I maintain a strict diet, I exercise, I do not smoke or drink alcohol … I take great care and I do not stop taking my tablets. How else could I live longer? “

With discipline and consistency

In late 2016, there were 21 750 people in Cuba living with HIV, 80% out of them were male and they averaged 30 years of age. 81% of those people receive the necessary drugs for their retroviral therapy in a controlled and free way, in line with the country´s strategy since 1998.

Epidemiologist María Isela Lantero, head of the STI / HIV / AIDS Department in the Public Health Ministry (MINSAP), stressed that through great efforts the country guarantees the delivery of these medicines to achieve that 90% of people living with HIV receive them in 2020, in accordance with the guidelines drawn up by the World Health Organization (WHO).

“A lot of resources are destined for the patients so they can receive the medicines they need and we have had international cooperation. The number of people living with HIV and receiving treatment is higher each year. In the past, when we had difficulties with the supply, we always planned alternatives to avoid interrupting the therapy.”

Lantero said that a combined strategy of antiretroviral drugs is carried out in the country, including the Cuban manufactured by BioCubaFarma (zidovudine, lamivudine, nevirapine, efavirenz and abacavir) and the WHO-certified overseas drugs.

Those living with HIV initiate antiretroviral treatment according to the results of the analyzes performed, Lantero said. “It does not matter how many years or months the person has been diagnosed with the virus.”

People living with HIV receive free drugs once a month at the main pharmacy in their municipality of residence, and it is recorded on their card. “They are identified by a code and only one person who works at the pharmacy has the responsibility to supervise this delivery. You should know your location information, because if the patient is absent at the time the medicines should be acquired, this information is offered to the health personnel and the promoters who are responsible for visiting  the patient, to inquire about the reasons why he did not go to the unit promoting that they comply with the medical indications,” the doctor said.

Lantero said that the aim of the antiretroviral therapy is to keep low virus levels in blood and to control their multiplication, which ensures that the patient feels good, that he does not have complications of any kind and that his health keeps stable, Allowing him to live a normal life. The effectiveness of the therapy is measured from the drop in blood viral load to undetectable levels, which is achieved with discipline and consistency.

“In addition to Cuba´s commitment to guarantee the supply of the five antiretrovirals produced in the country and the importation of those produced in other nations, we have the active participation of the community of people with HIV, in the work to achieve high levels of adherence to the treatment in order to protect their health and ensure their well-being.”

The specialist stated that if women who live with HIV respect the treatment to the letter, they will be able to give birth to a healthy baby, because they will arrive at the end of the pregnancy with the undetectable viral load, the result of a good discipline in line with the recommended treatment. However, the newborn is given preventive antiretrovirals for six weeks.

Apart from HIV-infected patients, whose results in the analyzes show the need to receive antiretroviral treatment, this is also received by others with specific health conditions, in which the World Health Organization recommends its use. Among them, those with hepatitis or tuberculosis, the elderly and members of the discordant partners (one with HIV and the other not) to reduce the possibility of virus transmission and positively influence the patient´s health status, she added.

The MINSAP official insisted that, although one of the priorities of the Health System is to guarantee antiretroviral therapy, the idea is to avoid contagion. “Maintaining protected sexual intercourse with the use of condoms prevents the transmission of HIV and other sexually transmitted infections, and therefore the need to undergo some lifelong treatment, regardless of whether the Cuban State ensures it,” she said.

  • The first case detected in Cuba with HIV / AIDS was in late 1985, four years after the disease was discovered by American scientists. He was a Cuban who had been for two years in Maputo, capital of Mozambique, in Africa.
  • In 2015 the World Health Organization awarded Cuba the certification that validates it as the first country in the world to eliminate HIV and syphilis transmission from mother to child.
  • A therapeutic vaccine aimed at reducing the viral load of patients with HIV, which has an impact on the patients´ quality of life is in the first stage of clinical trial. This is the TERAVAC-VIH vaccine, a proposal of the Genetic Engineering and Biotechnology Center.