2015 saw the lowest number of lives lost to HIV in almost two decades, as well as the least number of newly infected people with HIV since 1991 (WHO, 2016). Approximately 17 million people received life-saving antiretroviral medications (such as antiretroviral therapy and pre-exposure prophylaxis) by the end of 2015 (UNAIDS, 2016), reducing the number of lives claimed by HIV-related causes to roughly 1.1 million in 2015 - 45% lower than in 2005 (WHO, 2016).

Yet, while great strides have been made in the fight against HIV/AIDS, it is threatened by a growing sense of complacency and false security. According to a 2013 New York Times article, HIV is often seen as a chronic disease, akin to health problems such as smoking cigarettes and eating trans-fats; to many, HIV is no longer regarded a serious disease. Not combatting this complacency would severely impede our progress and ultimate goal of ending this pandemic. 

https://www.unaids.org/en/resources/documents/2014/SlidesFastTrack

Sustainable Development Goal 3 (UN): Ensure healthy lives and promote well-being for all at all ages

https://www.avert.org/infographics/unaids-90-90-90-target

UNAIDS 90-90-90 target for reducing HIV by 2020

1. "HIV is no longer a death sentence"

The increasing understanding that an HIV diagnosis is no longer a "death sentence" has led to a false sense of security that HIV is simply a "chronic disease". Often, people overlook the fact that HIV affects everyone differently, and that the outcome of treatment or non-treatment in one individual may not be the same for another.

2. The reduction in stigma around HIV/AIDS

This is a double-edged sword; while it can promote greater awareness and prevention of HIV/AIDS, as well as more people receiving the treatment they need, the reduction in stigma also contributes to complacency about the gravity of HIV/AIDS.

3. Treatment optimism

Optimism among many people has increased, with regards to the efficacy of HIV treatment, since the rise of antiretroviral therapy in the mid-1990s. This, combined with the fact that many people who are HIV positive receive treatment and live nearly as long as normal people today, has contributed to complacency. 

1. Lack of proper treatment

Under the false security that HIV is a "chronic disease", those infected may discount the importance of proper treatment or choose to delay treatment. However, starting treatment early is crucial to living a long and healthy life, and even with modern treatment and longer life expectancies, HIV can still impact those infected the same way it did thirty years ago. Not gaining proper treatment will severely compromise an infected individual's quality of life, and not to mention affect those around him/her. It also poses a risk of transmission of the disease to non-infected people.

2. Continuation of/engagement in unsafe sexual behaviour

As a result of this complacency, people who are receiving HIV treatment may be less motivated to use condoms because they are being treated. People may also continue to engage in risky sexual behaviours, such as unprotected sex with people of unknown HIV status, contributing to the spread of HIV.

3. Less investment in AIDS research & HIV treatment

If HIV complacency continues to rise, politicians may reduce investment in AIDS research and HIV treatment, compromising the global fight against HIV/AIDS. Unfortunately as well, complacency has affected donors. According to a MEDICC Review article, donations to the Global Fund to Fight AIDS, Tuberculosis and Malaria first stagnated and then dropped significantly, from $16 billion available in 2010 to just $11.7 billion in 2011-13. This has serious repercussions as many people will not have access to the treatment they need.

In the words of Prince Harry, "As people with HIV live longer, AIDS is a topic that has drifted from the headlines. And with that drift of attention, we risk a real drift of funding and of action to beat the virus. We cannot lose a sense of urgency..." 

Especially at this point of time where we have come so far, we cannot afford to turn a blind eye to complacency and the millions of HIV positive people who will lose access to the treatment they need, if funding is cut back. It is therefore imperative that governments and societies worldwide commit to advocate, raise awareness and fight for the rights of people living with HIV to help them live healthy lives as well as end AIDS by 2030.  

"We must say no to complacency at this moment. There is no space for it. AIDS 2016 will help us as individuals and politicians to fast-track the ending of the AIDS epidemic as a public health threat by 2030."

- Aaron Motsoaledi, Minister of Health, South Africa

"In the name of humanity, I ask each one of us to recommit to advocate, act and commit to make the biggest difference we can in our daily work."

- Linda-Gail Bekker, Incoming President of the International AIDS Society

Websites

Huffington Post. Complacency and Stigma: Is HIV No Longer a Death Sentence? [Internet]. White, V; US: Huffington Post; 2014 Jan [cited 2017 Sep 9]. Available from: https://www.huffingtonpost.com/verneda-white/complacency-and-stigma-is_b_4366132.html

WHO. Prevent HIV, test and treat all - WHO support for country impact Progress report 2016 [Internet]. Switzerland: World health Organization; 2016 Dec [cited 2017 Sep 9]. Available from: https://www.who.int/hiv/pub/progressreports/2016-progress-report/en/

UNAIDS. The 2016 International AIDS Conference closes with a call to reject complacency in the AIDS response [Internet]. Switzerland: UNAIDS; 2016 Jul [cited 2017 Sep 9]. Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2016/july/20160722_aids2016closing

The New York Times. Rise in Unprotected Sex by Gay Men Spurs H.I.V. Fears [Internet]. McNeil, DG Jr; USA: The New York Times; 2013 Nov [cited 2017 Sep 9]. Available from: https://www.nytimes.com/2013/11/28/health/unprotected-sex-among-gay-men-on-the-rise-health-officials-say.html?mcubz=1

BBC. HIV life expectancy 'near normal' thanks to new drugs [Internet]. Roxby, P; UK: BBC; 2017 May [cited 2017 Sep 9]. Available from: https://www.bbc.com/news/health-39872530

Lloyd MR. An Examination of HIV/AIDS Complacency, Attitudes and Sexual Risk Behavior Among Men Who Have Sex with Men: Implications for Community Based Prevention Efforts, Practitioners and Social Work Education [dissertation on the Internet]. [Chicago (USA)]: Loyola University Chicago; 2015 [cited 2017 Sep 9]. Available from: https://ecommons.luc.edu/cgi/viewcontent.cgi?article=2478&context=luc_diss

Canadian Foundation for AIDS Research. INTERNATIONAL AIDS CONFERENCE 2016: COMPLACENCY IS THE NEW CONSPIRACY [Internet]. Bunting, C; Canada: Canadian Foundation for AIDS Research; 2017 [cited 2017 Sep 9]. Available from: https://www.canfar.com/news/international-aids-conference-2016-complacency-new-conspiracy 

Images

CG Society. Human Immunodeficiency Virus [Internet]. Kashpersky; 2013 [updated 2013 May 1; cited 2015 Jul 22]. [Figure], Human Immunodeficiency Virus; [about 1 screen]. Available from: https://mrriddick.cgsociety.org/art/hiv-3ds-virus-max-micro-cell-after-science-effects-medicine-microscope-photoshop-microworld-organic-zbrush-human-immunodeficiency-1104942 

UNAIDS. SLIDES (PDF) - FAST-TRACK: ENDING THE AIDS EPIDEMIC BY 2030 [Internet]. Switzerland: UNAIDS, 1996 [updated 2014 Nov 24; cited 2017 Sep 9]. [Figure], FAST-TRACK: ENDING THE AIDS EPIDEMIC BY 2030; [about 1 screen]. Available from: https://www.unaids.org/en/resources/documents/2014/SlidesFastTrack

AVERT. UNAIDS 90-90-90 Target [Internet]. UK: AVERT [updated 2017 January 27; cited 2017 Sep 9]. [Figure], Infographic; [about 1 screen]. Available from: https://www.avert.org/infographics/unaids-90-90-90-target