As one approaches December, and with it a day that in the past signified a flurry of TV interviews , lots of media coverage, key note speakers,  training, extensive blogs all which centred around 'waking' the world up today: World Aids Day.

Internationally there would be yearly themes that we celebrated like "Getting to Zero" in 2015, and "Leadership. Commitment. Impact" in 2016.

We have come such a long way...

I always describe how in early training days at Standard Bank with peer educators (another overdone concept), one of our biggest challenges was convincing the trainees that ARVs were the only effective way to stay alive when your CD4 level dropped to 200. We need to unpack this to show how far we really have come;

15 years ago, taking ARVs meant a very tight and tedious process: 3 tablets were the norm taken 3 times a day. The correct treatment terminology that we used to describe this regime was HAART. Now, it is a single tablet taken once a day. This is called Single Dose Therapy.

Imagine the relief to take a single tablet as opposed to one 3 times a day which had to be taken at the same time to be effective.

The second aspect of the medication that has changed is that before if one started to take ARVs, one could not stop. Once again, years ago, the government here followed internationally standards that believed your CD4 count should be at 200 or lower to start ARVs. Today, it is recommended that when your CD4 count is 500 or lower, it is advisable to start the ARVs. This means that the virus in your blood is controlled much earlier and it prevents the person from suffering from many ailments that they could experience when the body starts going into the stages of AIDS.

It must be mentioned that today, in South Africa, the CD4 count is irrelevant in pregnant mothers and, any mother who has HIV is put onto ARVs that will protect her child in vitro, during labor and whilst being breastfed. The catch here is that the mother has to stay on her medication throughout the pregnancy, labour and breast feeding. As a result, mother-to-child transmission rates are down to almost less than 1 per cent.

We would in our earlier training sessions stress that everyone had the right to choose whatever medical path they wanted to use but that a western made product (ARVs) would be the only way to hold back the virus and delay the body from deteriorating. So, we discussed traditional healers and methods: herbs etc. and many people who believed this was the right choice for them, were encouraged to use them but to be aware of the other medical options.

And today, we have over 3 million people living with HIV on ARVs, patients who accept that this is the only way to recover and live longer than with traditional healers and medicines.

It is now seen as another medical condition similar to 'diabetes' and 'high cholesterol', diseases  that mean taking life long medication to survive and live for another 20 years or more.

This has been the biggest break through for me to witness firsthand. Life expectancy as a result has increased and it is true that we are now living longer with the help of ARVs.

We all know that once people accepted the virus as a medical condition and that ARVs improve your quality of life, the dreaded stigma dissipated in many communities. We do still have a long way to go, but there is no comparison to the problems we faced in the past with stigma and denialism.

In training now, people openly discuss their status with more confidence.

There is one more area that has become endorsed by WHO that was always a grey area- the access to self testing. This is now called HIVST. This will mean access to HomeKits and self testing.

Times have changed for the better.

Should you require anything further please go to my website www.appelbaum.co.za to access a copy of my award winning book titled HIV & AIDS.