The Context That Makes This Conversation Necessary
In Venezuela, approximately 100,000 people live with HIV, of whom only 73,000 have access to antiretroviral treatment. The shortage of reagents for viral load tests in public health centers, low coverage of rapid diagnostic testing, and the persistence of social stigma are the main barriers to epidemic control in the country.
100.000
people living with HIV in Venezuela
ONUSIDA 2024
73.000
access antiretroviral treatment
ONUSIDA 2024
7 / 10
new infections affect men
ONUSIDA 2024
+13.000
combined prevention packages distributed
PNUD 2024
+9.000
rapid diagnostic tests performed
PNUD 2024
Added to this is that 7 out of 10 new infections in Venezuela affect men, and key populations — men who have sex with men, trans women, and sex workers — continue to be the most exposed to misinformation, discrimination, and unequal access to services. In this scenario, speaking about HIV with rigor, empathy, and without taboos is not just an educational act. It is a public health act.
HIV and AIDS: The Distinction That Changes Everything
One of the most frequent errors in public conversation about sexual health is using HIV and AIDS as if they were synonyms. Dr. Salazar addresses this directly:
VIH
Human Immunodeficiency Virus
It is the microorganism that enters the body and attacks the immune system. One can live with HIV without developing disease, especially with timely treatment.
SIDA
Acquired Immunodeficiency Syndrome
It is the advanced stage of the infection, where the immune system is severely weakened and opportunistic diseases appear. This condition is reversible through appropriate antiretroviral treatment.
Terminology note
Science is moving toward using 'advanced stages of HIV infection' instead of 'AIDS'. This terminology seeks to remove the pejorative weight of the term and emphasize that this condition is reversible through appropriate antiretroviral treatment.
Dismantling Transmission Myths
Dr. Salazar points out that, according to studies conducted over two consecutive years with students, the myth that HIV is transmitted by mosquito bites remains the most persistent misconception in the population. The reality is clear:
Mosquitoes and insect bites. HIV is not transmitted through mosquitoes or any insect.
Casual contact. Sharing cups, cutlery, plates, hugs, or superficial physical contact does not transmit the virus. HIV requires specific routes of biological fluid exchange.
A note on correct language
The correct term is infection or transmission — never 'contagion'. 'Contagion' is associated with viruses that spread easily through the environment (like influenza or COVID-19). HIV requires specific routes of biological fluid exchange for its transmission. Using correct language reduces stigma.
Key Populations: Vulnerability, Not Identity
Modern epidemiology has replaced the concept of 'risk groups' with 'key populations'. The focus is placed on social vulnerability rather than people's identity. Key populations vary by regional context: in Africa, the most affected group is heterosexual women.
In Venezuela, incidence is higher among men who have sex with men (MSM), trans women, sex workers, indigenous populations, and people deprived of liberty. However, Dr. Salazar's central message is unambiguous: regardless of sexual orientation, every sexually active person is at risk if they do not implement preventive measures.
Every person who knows their HIV status holds the power to protect themselves and those they love.
Combined Prevention: A Menu of Options
Prevention no longer depends on a single method. Dr. Salazar describes it as a 'menu' of biomedical and behavioral options that can be adapted to each person and life context.
Condom and lubricant.
Condoms are essential, but should always be used with lubricant to avoid micro-trauma. Dr. Salazar specifically warns about the risk of anal douching, as this procedure generates micro-injuries that significantly facilitate viral entry.
PrEP: Pre-Exposure Prophylaxis
Aimed at HIV-negative individuals, PrEP is a medication that prevents infection before exposure. Dr. Salazar describes two modalities:
Daily Modality
Recommended for those with frequent or daily sexual activity.
2-1-1 Scheme (On-demand)
2 pills between 2 and 24 hours before sex
1 pill at 24 hours after the initial dose
1 pill at 48 hours
PEP: Post-Exposure Prophylaxis.
The 'HIV morning-after pill'. It is an emergency intervention for risk situations (condom breakage, sexual assault) with a critical 72-hour post-exposure window. Its effectiveness is highest when started immediately.
Diagnosis and Treatment Access in Venezuela
HIV symptoms can take 3 to 5 years to appear. For this reason, Dr. Salazar recommends testing annually for the general population and every 3 to 6 months for key populations. Knowing your serological status is the first step in personal and collective care.
In Venezuela, antiretroviral treatment is free and state-of-the-art, guaranteed by the National Program and international cooperation. Treatment regimens have evolved from 13 daily pills to a single daily dose with minimal side effects.
Receiving an HIV diagnosis today is not a death sentence — it is, in Dr. Salazar's words, 'the beginning of a new season' of life that requires a commitment to health and self-care. With current treatments, life expectancy is comparable to that of any other person.
What Is U=U and Why Does It Matter?
U=U means Undetectable = Untransmittable. It is the scientifically validated principle established by international consensus: a person living with HIV who maintains strict adherence to antiretroviral therapy and achieves an undetectable viral load cannot transmit the virus to their sexual partners.
This finding radically transforms what it means to live with HIV today: with timely diagnosis and sustained treatment, it is possible to live a full, healthy life with a life expectancy comparable to the general population.
Internationally validated reference studies
Stigma: The Most Lethal Barrier
Dr. Salazar is unambiguous: social barriers are often more lethal than the virus itself. Stigma encompasses internal misconceptions — fear of diagnosis, prejudices about the morality of infection. Discrimination refers to external acts of exclusion that occur in the daily lives of people living with HIV.
Dr. Salazar cites documented examples that occur in healthcare settings: the unnecessary use of triple gloves when treating a patient with undetectable HIV, refusal to perform surgery on patients who pose no transmission risk, or explicit moral judgments that blame the person for their diagnosis.
These acts drive people away from the health system, delaying diagnosis and increasing preventable mortality. Eliminating judgment is not just an ethical imperative: it is a public health strategy with a direct impact on epidemic figures.
Education is the only antidote against the stigma that stands in the way of ending the epidemic. — Dr. Freddy Salazar
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