Esther García Almodóvar likes infectious diseases. “Finding the micro-organism, the treatment and curing them”, explains this internist at the Can Misses Hospital, an expert in this type of illness, among which HIV stands out, the fight against which is being recognised today as World AIDS Day. “It seemed to me to be the global infectious disease: systemic, affecting many organs and with a field in which there was much to investigate,” says the internist, who studied medicine in Cordoba and completed her residency at Son Espases, from where she arrived at Can Misses .
You are moderating the talk ‘Detecting neuropsychiatric and cognitive toxicity’ in Malaga. What is it?
The mental and social health of people with HIV are two of the areas that still need to be improved. Many studies show a higher prevalence of psychopathological disorders in people with HIV infection. Psychopathological disorders increase the risk of psychiatric illness, which in turn is a risk factor for people with HIV. This issue is not addressed, although many studies have found that 47% of people with HIV infection have anxiety and that depression is the most prevalent psychiatric disorder, ranging from 5% to 21%. The problem for these people who have depression and not being treated is that these pathologies are associated with poorer infection control, poorer adherence to treatment and more comorbidities because they are less aware of their health. The factor that is most associated with anxiety and depression is stigma. This is another field that we almost never work on.
Years ago this was not even considered, everything was focused on preventing death for those affected. Has much progress been made or less than it should be?
Much progress has been made. The viral load in the blood has been controlled and the patients have quality of life, they are not immunosuppressed. The infection has been controlled at a physical level, but there is still a lot to do, first of all, to cure the infection, and then to make progress in mental and social health. Patients still have a lot of social stigma and self-stigma. Many do not live freely, they do not share it with their family or friends and at a social level the infection is still not very normalized.
Why does this happen?
Because of the beginnings of the virus. It was not known, people died, because its transmission was basically sexual and because of the groups in which the infection occurred. It has remained in the DNA of society. Sometimes they ask you surprising questions like “aren’t you afraid to be in the consulting room”. It is an irrational fear.
But there are other sexually transmitted diseases that are talked about more naturally.
Sure, but they weren’t a pandemic and they didn’t cause the havoc and physical deterioration in people that HIV did. They are not deadly and they are treatable. There is still a lack of knowledge, many people may not know that if the virus is undetectable in blood it is not transmitted.
The covid vaccines have come out quickly, but there is still no vaccine for HIV. Does that mean that the pharmaceutical companies are not interested?
No. There are independent research groups, which are not funded by industry, that have been working on it for a long time. They are different viruses with a different way of replication. HIV has mutations, it stays hidden in reservoirs…
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