Saturday, Dec. 1, marks the 30th anniversary of World AIDS Day. Times have changed drastically since the annual observance was launched by the World Health Organization, thanks to breakthrough treatment options, widespread education, and well-designed prevention efforts. However, there are still an estimated 37 million people living with HIV around the world, and one in four individuals with HIV are not aware of their positive status. 

Young people in their late teens and twenties are increasingly becoming the face of new HIV infection. This is not surprising when you consider that this demographic has little to no recollection of the days when people hesitated to touch an AIDS patient and when receiving news of a positive HIV test was regarded as a death sentence. 

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Thirty years later, a positive HIV test result is no longer viewed that way. There are more avenues than ever to link newly diagnosed patients with care.

These realities – available treatments in the face of ongoing disease transmission – are why this year’s World AIDS Day theme “Know Your Status” resonates. Thanks to the emergence of rapid HIV self-test kits, there has never been a more convenient, faster, or more private way to know. In the face of infectious disease, knowledge is power, especially when people with HIV are living longer lives.

East and Southern Africa have the largest number of people living with HIV, anywhere. A number of public-private partnerships aimed at lowering new infection rates have remained steadfast in their efforts to educate and promote testing; self-test kits that assure privacy and confidentiality have been game changing for this model.  

Here in the United States about 40,000 people received an HIV diagnosis in 2016. While that number was down 5 percent from the preceding years, there is still much work to be done. Many in the U.S. have become complacent to HIV as deaths from gun violence and opioid overdoses are more common than deaths from AIDS complications.

But we must remain vigilant, particularly since HIV is re-emerging amongst injection drug users; until 2016, the incidence of HIV in this population had been declining. Needle sharing has unfortunately re-emerged as a high-risk behavior by those dealing with opiate addiction. (The opioid crisis is also fueling another epidemic that is responsible for more deaths in the U.S. than AIDS – Hepatitis C, for which there is a rapid test and a cure.) While it might be easy to point to a widely publicized outbreak of HIV across 215 injectable drug users in Indiana earlier this decade as an isolated incident, the CDC cautions that over 200 other counties in the United States today are at risk of a similar crisis stemming specifically from injectable opioid use. 2018 has already seen clusters of new HIV infection in Ohio, Kentucky, West Virginia and Massachusetts.

Simply put, we must change the testing paradigm if we want to permanently reverse the course of this disease. If high-risk populations aren’t coming into clinics to engage in testing, let’s take self HIV-tests directly to those at high-risk who may be too scared, unaware, or acutely ill to test outside of their home.

On this 30th anniversary of World AIDS Day, I am reminded of how things once were, when the AIDS crisis prompted protests, die-ins and fear. I am thankful that innovative ideas, successful technology commercialization, and effective partnerships have changed the AIDS narrative. Let’s work together to write the end of the story.   

Stephen S. Tang, Ph.D., is the President & CEO of OraSure Technologies, a leader in the development, manufacture and distribution of point of care diagnostic and collection devices and other technologies designed to detect or diagnose critical medical conditions.