Despite decades of medical advancements, HIV remains a significant global health concern, with an estimated 39 million people living with the virus worldwide [[1]]. This report focuses on the current state of the epidemic in Colombia, where over 185,000 individuals are living with HIV, and highlights emerging trends in transmission, treatment access, and prevention strategies, particularly within vulnerable populations. experts warn that gaps in treatment and evolving prevention needs pose ongoing challenges to controlling the spread of the virus.
Atlanta, GA – Human Immunodeficiency Virus (HIV) progressively attacks and weakens the body’s immune system, leaving individuals vulnerable to infections and disease. As World HIV Day was recently observed, new data highlights ongoing challenges in treatment and prevention, particularly among young adults.
According to estimates from Colombia’s High Cost Account for 2024, over 185,000 people are living with HIV in the country. However, only 80% of those individuals are receiving antiretroviral therapy, leaving more than 20% without access to crucial treatment. Experts emphasize that untreated HIV increases the risk of transmission.
“If a patient is not in treatment, they are more likely to continue transmitting the virus,” explained infectious disease specialist Jesús Tapia García, based in Barranquilla.
Sexual transmission remains the primary mode of infection, accounting for over 92% of new cases. The epidemic is disproportionately affecting young men aged 20 to 34, with over 80% of cases concentrated in this age group. This trend underscores the need for targeted prevention efforts among young adults.
“More than 92% of cases were through sexual transmission. Regarding gender, more than 80% of patients are men, and the epidemic is concentrated in the community of men who have sex with men, where the highest number of cases occur,” Tapia García stated.
Regional Hotspot: Barranquilla Faces Elevated HIV Rates
The city of Barranquilla is currently the third-highest in Colombia for reported HIV cases, with over 480 cases reported so far in 2024. The surrounding Atlántico department is also experiencing a significant number of infections.
“In the latest reports from the National Institute of Health, there are more than 480 cases reported in the city of Barranquilla so far this year, placing it as the third city in the country with the most cases. And the department of Atlántico is also among those with a large number of cases,” Tapia García noted.
While sexual transmission is dominant, HIV can also spread through blood transfusions, shared needles, unsafe surgical procedures, and unsterile tattoos or piercings. These alternative routes of transmission highlight the importance of safe practices and regulated healthcare settings.
Early symptoms of HIV can be nonspecific, making early detection challenging. Individuals experiencing prolonged diarrhea (lasting more than two weeks), recurrent flu-like symptoms, unexplained fever, significant weight loss (over 5-10 kilograms in a short period), or oral lesions should seek medical attention and get tested.
“The main symptom is diarrhea. A patient or someone who has diarrhea for more than two weeks should consult a doctor and request an HIV test, as well as if they experience recurrent colds or respiratory syndromes, unexplained fever, weight loss of more than 5 or 10 kilos in more than 15 days, a month or two months, lesions in the mouth, whitish lesions called oral candidiasis,” the specialist explained.
HIV progression is typically categorized into clinical stages based on CD4 lymphocyte counts – a type of white blood cell crucial for immune function. While the term AIDS is used less frequently due to its stigmatizing nature, it still refers to the most advanced stage of the infection, characterized by severe immune compromise.
“Currently there are several stages. Today, the patient is classified into stage 1, 2 and 3 and that will depend on the count of TCD4 lymphocytes. And there is also another old classification in which the patient is in other stages A, B and C depending on how the patient debuts. The term AIDS, we have thrown it a little into oblivion because it is a term that stigmatizes the patient. But there are patients who we say are in an AIDS phase or in an AIDS stage because they are the patients who have a greater general commitment,” Tapia García said.
Treatment Advances: From Multiple Pills to Simplified Regimens
Significant progress has been made in HIV treatment over the past few decades. What once required patients to take up to 20 pills daily has been streamlined to a single daily dose. This evolution in treatment has dramatically improved adherence and quality of life for people living with HIV.
“There are treatments of one pill a day, which is highly effective and adequately controls the virus. In some Latin American countries, injectables are already available. There is a medication called cabotegravir + rilpivirina that is injected every two months and has the advantage that the patient does not have to take a pill daily, but that ampoule is placed and in two months they return again and the new dose is placed,” Tapia García explained.
Several injectable medications are currently under study for potential availability in Colombia in the coming years, though high costs currently pose a barrier to access.
Prevention Strategies: PrEP and Beyond
Pre-exposure prophylaxis (PrEP), a medication taken to prevent HIV infection, is a key prevention strategy. Individuals at high risk, including sex workers and men who have sex with men, particularly those engaging in chemsex (sex combined with drug use), can significantly reduce their risk of infection by taking PrEP.
“If a person takes a pill every day, they will prevent HIV infection. Who should do PrEP? Sex workers, men who have sex with men, who have a disordered life, people who practice Chemsex, which is the exchange of partners without a condom, combined with the use of drugs, the use of sexual desire stimulants such as Sildenafil, Tardalafilu. In those types of people, it is ideal to do PrEP,” Tapia García stated.
A new injectable medication, lenacapavir, is also showing promise in preventing HIV infection, offering protection for up to six months with a single injection.
“This injection is given every 6 months and has shown that a patient who receives this injection does not become infected with the HIV virus,” he added.
The Search for a Cure Continues
Despite advancements in treatment and prevention, a cure for HIV remains elusive. While a few cases of apparent cure have been achieved through hematopoietic stem cell transplants, this approach is complex and not widely applicable.
“Today there is no cure for the virus. There have been 3 to 4 cases in the world with hematopoietic transplants, but it is very difficult,” Tapia García confirmed.
The virus’s RNA-based genetic structure presents significant challenges to both cure development and vaccine creation. Research efforts are ongoing, but a viable vaccine remains a distant goal.
“Curing the HIV virus is very difficult, why? Because of its genetic composition. It is a difficult virus, it is an RNA virus, which has also hindered the development of a vaccine. There have been advanced studies regarding the vaccine for the cure of the HIV virus, but these studies have not had a happy ending. But yes, there are many studies that we hope will lead to the cure of the virus and soon to be able to stop this epidemic.”
Global Impact and Prevention Recommendations
In 2024, over 630,000 deaths worldwide were linked to HIV. In Colombia, mortality rates are around 4%, while in Atlántico, they exceed 5.6%.
Tapia García emphasized the importance of consistent condom use and responsible sexual behavior. “The main prevention is the use of a condom. Limit promiscuity, avoid combining alcohol, drugs and sexuality, because it is an explosive combination.”
