0:00:02 > 0:00:06There is now a danger that has become a threat to us all.
0:00:06 > 0:00:10It is a deadly disease, and there is no known cure.
0:00:10 > 0:00:13It was just 30 years ago that the biggest public health campaign in
0:00:13 > 0:00:18British history shocked us all into accepting a new epidemic.
0:00:20 > 0:00:22Everyone was petrified.
0:00:22 > 0:00:27And a lot of people that I knew died very, very quickly.
0:00:27 > 0:00:29And a lot of people I knew died in the '80s.
0:00:29 > 0:00:33I mean, it was one after the other.
0:00:33 > 0:00:36But whilst it's easy to think that AIDS is a thing of the past,
0:00:36 > 0:00:38here in the UK, the number of people
0:00:38 > 0:00:40with the virus which actually causes it
0:00:40 > 0:00:42still remains worrying.
0:00:42 > 0:00:44My name is Chris van Tulleken.
0:00:44 > 0:00:49These days, I spend most of my time in this lab at University College in London.
0:00:49 > 0:00:54And I study HIV - a virus that's infected 76 million people
0:00:54 > 0:00:57and killed 35 million of them.
0:00:57 > 0:01:00The good news? The NHS in England and Wales have just announced trials
0:01:00 > 0:01:05for a new drug that can prevent HIV, and in Scotland it's available now.
0:01:05 > 0:01:08The bad news? There's still no cure.
0:01:08 > 0:01:12So I'm getting out of the lab to meet people living with HIV.
0:01:13 > 0:01:17He'd sort of spent the weekend in bed with what I thought was man flu
0:01:17 > 0:01:21and then it was three days later that he died.
0:01:21 > 0:01:24And I'll be questioning the scientists fighting the virus.
0:01:24 > 0:01:26Will we cure it?
0:01:26 > 0:01:29We're going to try, you know, and there's a real possibility.
0:01:29 > 0:01:33There are billions of pounds of research money being invested
0:01:33 > 0:01:35in labs like this all around the world.
0:01:35 > 0:01:39We now have powerful anti-retroviral drugs that mean HIV
0:01:39 > 0:01:43doesn't have to be a death sentence.
0:01:43 > 0:01:45And PrEP, the new drug combination
0:01:45 > 0:01:47that has been on all over the headlines recently,
0:01:47 > 0:01:50can prevent you catching it in the first place.
0:01:50 > 0:01:52But the battle is not over yet.
0:01:52 > 0:01:56I'll travel to the front line of the AIDS epidemic...
0:01:56 > 0:01:57She has lost six children.
0:01:57 > 0:01:58Yes.
0:01:59 > 0:02:02..to discover how science is racing to stop
0:02:02 > 0:02:04over a million deaths a year.
0:02:04 > 0:02:06We were able to, in our trial,
0:02:06 > 0:02:12- diagnose 92%...- Really?- ..of those individuals who are infected.
0:02:12 > 0:02:16And I'll meet those dedicated to beating this disease.
0:02:16 > 0:02:20We have a responsibility, all of us, to de-stigmatise,
0:02:20 > 0:02:22to normalise the testing
0:02:22 > 0:02:24and encourage more and more people to get tested,
0:02:24 > 0:02:26so that every six months, every year, whatever it be,
0:02:26 > 0:02:29you go and get tested for HIV just like you do everything else.
0:02:38 > 0:02:40Despite what many of us might think,
0:02:40 > 0:02:43HIV is still a problem in this country.
0:02:44 > 0:02:47There are over 6,000 new infections every year.
0:02:48 > 0:02:51And the risks are now being taught to a whole new generation.
0:02:53 > 0:02:57When you think about HIV right now, what pops into your head?
0:02:57 > 0:02:59What do you think about?
0:02:59 > 0:03:02- Dirty things, don't you? - Is it frightening?
0:03:02 > 0:03:03In a way, yes.
0:03:03 > 0:03:05I've heard some stuff that, like, the government made AIDS.
0:03:05 > 0:03:07Write it down. Government conspiracy.
0:03:07 > 0:03:10And then obviously it spread through needles.
0:03:10 > 0:03:12- Drugs.- Drugs.
0:03:12 > 0:03:16People who are gay, they get blamed for the spread of it.
0:03:16 > 0:03:19That's Freddie Mercury because he died of HIV.
0:03:20 > 0:03:23I've come to William Farr School in Lincolnshire
0:03:23 > 0:03:26and a special class on a unique virus.
0:03:26 > 0:03:30So we're going to talk about how that virus actually gets passed on.
0:03:30 > 0:03:32So which bodily fluids are we talking about?
0:03:35 > 0:03:38- Like, blood.- Yes, infected blood.
0:03:38 > 0:03:40Anything else?
0:03:40 > 0:03:41- Semen.- Semen.
0:03:41 > 0:03:43Yes. Any other body fluids that you guys know of?
0:03:45 > 0:03:49It's OK. We've got vaginal fluids and rectal secretions.
0:03:49 > 0:03:52But you know what? We're talking about them here today.
0:03:52 > 0:03:55Do you think you could spot somebody with HIV?
0:03:56 > 0:03:58No? No?
0:03:58 > 0:04:00So would you have any idea that I have HIV?
0:04:00 > 0:04:02- STUDENTS:- No.
0:04:02 > 0:04:04No? OK, so I'm HIV positive.
0:04:04 > 0:04:07I was diagnosed over ten years ago.
0:04:08 > 0:04:11You've all spent this time with me and couldn't tell.
0:04:11 > 0:04:14And actually, anyone else you meet, you may not be able to tell.
0:04:16 > 0:04:18- Come in.- Thank you.
0:04:18 > 0:04:22Lizzie Jordan now works to educate young people about the virus.
0:04:24 > 0:04:27She found out she was HIV-positive after her partner, Benji,
0:04:27 > 0:04:29suddenly fell ill.
0:04:29 > 0:04:31He went to work on a Friday.
0:04:31 > 0:04:35Came home complaining of what he thought was a sinus infection.
0:04:35 > 0:04:40He'd sort of spent the weekend in bed with what I thought was man flu.
0:04:40 > 0:04:43And, you know, "Have some Lucozade and you'll be fine."
0:04:43 > 0:04:46And then... So, it was three days later that he died.
0:04:48 > 0:04:50Doctors broke the news that Benji
0:04:50 > 0:04:53had died from an AIDS-related illness...
0:04:53 > 0:04:56without ever even knowing that he was HIV positive.
0:04:56 > 0:04:59I mean, that was probably six weeks before.
0:04:59 > 0:05:02Seeing those pictures, even I find that amazing.
0:05:02 > 0:05:06Come on. Yeah. Yeah. Yeah.
0:05:06 > 0:05:10No-one knows when or how Benji contracted the disease,
0:05:10 > 0:05:15but people can live for ten years or more without any symptoms at all.
0:05:15 > 0:05:16SHE LAUGHS SOFTLY
0:05:16 > 0:05:18Is it hard to watch that?
0:05:19 > 0:05:20It's bittersweet because
0:05:20 > 0:05:23that's the last piece of footage we have of him.
0:05:23 > 0:05:25Um...
0:05:26 > 0:05:27Yeah.
0:05:34 > 0:05:35Yeah.
0:05:40 > 0:05:44You must have been in...total shock.
0:05:44 > 0:05:46It just didn't make sense.
0:05:46 > 0:05:49How you can be so fit and well...
0:05:50 > 0:05:52..and then die. You know, literally die and drop dead.
0:05:52 > 0:05:54HIV, it never popped into your head?
0:05:54 > 0:05:59- You never thought...?- Not once, and it wasn't even on my radar.
0:05:59 > 0:06:01It wasn't even something I considered.
0:06:02 > 0:06:06When Lizzie discovered she was also HIV-positive, her next thought was,
0:06:06 > 0:06:10had she unknowingly passed the virus to their baby?
0:06:10 > 0:06:14Joe was 18 months old and had been breast-fed for 18 months.
0:06:14 > 0:06:15Natural delivery.
0:06:15 > 0:06:20All the things that I knew a HIV-positive mother wouldn't do.
0:06:20 > 0:06:24Despite a one in four chance of infecting her child,
0:06:24 > 0:06:25they were lucky.
0:06:25 > 0:06:27The test came back negative.
0:06:27 > 0:06:30I mean, the only reason your story is listenable to is cos you're
0:06:30 > 0:06:35standing here kind of fit and well and looking amazing.
0:06:35 > 0:06:38That fires me up even more to make people get tested.
0:06:38 > 0:06:40You know.
0:06:40 > 0:06:41You cannot tell.
0:06:44 > 0:06:46Yeah.
0:06:46 > 0:06:51Lizzie is one of over 100,000 people in the UK living with HIV,
0:06:51 > 0:06:56and it's estimated around 13,000 of those are undiagnosed,
0:06:56 > 0:07:00because for many years there are often no outward signs
0:07:00 > 0:07:02that anything is wrong.
0:07:02 > 0:07:04It's what helps the virus silently spread.
0:07:09 > 0:07:11OK, so a quick lesson.
0:07:11 > 0:07:12This is a quick biology lesson.
0:07:13 > 0:07:17HIV is a virus and it specifically infects
0:07:17 > 0:07:19the cells of your immune system.
0:07:19 > 0:07:22So this is a white blood cell.
0:07:23 > 0:07:27And on the surface, these little things that almost look like pollen,
0:07:27 > 0:07:30those are HIV particles.
0:07:31 > 0:07:34Like all viruses, in order to survive,
0:07:34 > 0:07:37HIV needs to get inside the cell,
0:07:37 > 0:07:39but then it does a very special thing.
0:07:41 > 0:07:48It unstitches your DNA and it inserts its DNA into the gap.
0:07:48 > 0:07:51The virus literally becomes a part of you.
0:07:52 > 0:07:56That is why it's so hard to cure it.
0:07:56 > 0:08:00You can live for years, even decades without any symptoms at all.
0:08:00 > 0:08:03But all that time, the virus is replicating in your cells
0:08:03 > 0:08:06so that your immune system will reach a point
0:08:06 > 0:08:08where you can no longer defend yourself
0:08:08 > 0:08:10against really minor infections.
0:08:10 > 0:08:14And that's when you develop the syndrome of AIDS -
0:08:14 > 0:08:16Acquired Immune Deficiency Syndrome.
0:08:16 > 0:08:22The virus is HIV, the disease in the final stages is AIDS.
0:08:24 > 0:08:26These days, I worry we've become complacent,
0:08:26 > 0:08:29even ignorant of the risks.
0:08:29 > 0:08:32So I want to find out how many of us have even taken a test?
0:08:38 > 0:08:39Have you ever had an HIV test?
0:08:39 > 0:08:41- I haven't, no.- Why?
0:08:42 > 0:08:44Just because I've never felt the need to do it, really.
0:08:44 > 0:08:46And actually, I'm pretty...
0:08:46 > 0:08:49You know, I'm not that... What's the word?
0:08:49 > 0:08:50I don't get involved with that many people,
0:08:50 > 0:08:52partners and that kind of thing.
0:08:52 > 0:08:53If you have a new partner...
0:08:53 > 0:08:56- Yeah.- Do you always insist on an HIV test?
0:08:56 > 0:08:58I insist on a full test.
0:08:58 > 0:09:00- A full test. OK, so the whole lot. - I'm a bit paranoid.
0:09:00 > 0:09:04- Have you been tested? - I have been tested.- OK.
0:09:04 > 0:09:08Hopefully my mum doesn't watch this!
0:09:08 > 0:09:09Your mum will be so happy to know
0:09:09 > 0:09:13that her daughter is being responsible and having HIV tests.
0:09:13 > 0:09:15Yeah, I mean, I think you can't be complacent.
0:09:15 > 0:09:17- Have you ever had an HIV test?- No.
0:09:17 > 0:09:21- Why?- I've always had protected sex.
0:09:21 > 0:09:24- Always?- Always, yeah.- OK, wow. - As a general rule.
0:09:24 > 0:09:28- As a general rule.- You may be the only man on the planet
0:09:28 > 0:09:30- who has always done it. - Actually, that's a lie.
0:09:30 > 0:09:32You're going to keep getting tested regularly?
0:09:32 > 0:09:34Yeah, of course. Like, even if, like...
0:09:34 > 0:09:36Sometimes even if I haven't had sex with anyone,
0:09:36 > 0:09:37I'll go and get tested anyway.
0:09:37 > 0:09:42- Do you think you'll go and have one now?- Um... You know what,
0:09:42 > 0:09:45I think that there is such a stigma around it that the thought
0:09:45 > 0:09:48of going into a doctor and asking for one would actually be, like,
0:09:48 > 0:09:49quite embarrassing.
0:09:49 > 0:09:51- Really?- Personally, yeah.
0:09:51 > 0:09:53I would find it really uncomfortable doing that.
0:09:53 > 0:09:56It's a bit of a mixed bag, and if I'm honest,
0:09:56 > 0:09:59us blokes don't come out of it all that well.
0:10:01 > 0:10:04And that's why it's all the more extraordinary that last year
0:10:04 > 0:10:09a member of the British royal family did something almost unthinkable.
0:10:09 > 0:10:12What I was going to do there... Your hands are quite cold.
0:10:12 > 0:10:14July 14th, 2016,
0:10:14 > 0:10:19and Prince Harry is taking an HIV test live on the internet.
0:10:20 > 0:10:21Weirdly that didn't even hurt.
0:10:21 > 0:10:23There you go.
0:10:23 > 0:10:28I can tell you here, you have an HIV non-reactive result here.
0:10:28 > 0:10:31- All right.- So everything is fine.
0:10:31 > 0:10:34Was that your first HIV test that you'd ever had?
0:10:34 > 0:10:37- It was my first HIV test. - First ever, in your 30s?
0:10:37 > 0:10:41Yeah, in my 30s. This is something that, from a guy's point of view,
0:10:41 > 0:10:44is... It's nerve-racking.
0:10:44 > 0:10:46I think it's nerve-racking regardless of who you are
0:10:46 > 0:10:48or what you've been up to.
0:10:48 > 0:10:51And all the media are sitting on this...standing on the other side
0:10:51 > 0:10:54of this mirror. And I know exactly what they're thinking, like,
0:10:54 > 0:10:56as I'm sure you know as well. And they're thinking,
0:10:56 > 0:10:58"Oh, imagine if, imagine if. What if? What if?"
0:10:58 > 0:11:00And I'm sitting there going, "Jeez, what if?"
0:11:00 > 0:11:03Yes, I could have done it in private, what's the point in that?
0:11:03 > 0:11:06I mean, for everyone else, go and get it done in private.
0:11:06 > 0:11:09I don't suggest everyone else does it live, but, you know,
0:11:09 > 0:11:11it's the responsible thing to do,
0:11:11 > 0:11:14from my point of view, to get the message out there.
0:11:14 > 0:11:18And what are the things that stop us all getting tested regularly?
0:11:18 > 0:11:19It's the fear, isn't it?
0:11:19 > 0:11:21It's the stigma.
0:11:21 > 0:11:23The word AIDS.
0:11:23 > 0:11:26I mean, just when you say that, it just gives me...
0:11:26 > 0:11:30gives me goose bumps. And I think there's so much stigma
0:11:30 > 0:11:32simply around a name.
0:11:38 > 0:11:39When AIDS came along,
0:11:39 > 0:11:41everyone was petrified.
0:11:41 > 0:11:42And...
0:11:42 > 0:11:46a lot of people that I knew died very, very quickly.
0:11:46 > 0:11:48And a lot of people I knew died in the '80s.
0:11:48 > 0:11:51I mean, it was one after the other.
0:11:53 > 0:11:55And everyone was so frightened.
0:11:55 > 0:11:57You know, when you went for your annual blood test
0:11:57 > 0:11:59or you had a cold or you had anything, you thought,
0:11:59 > 0:12:01"Have I got HIV? Have I got AIDS?"
0:12:03 > 0:12:06I was delivering meals to people who were so ashamed, they wouldn't come
0:12:06 > 0:12:08out their front door.
0:12:08 > 0:12:11We'd put the meal on the doorstep and then you'd walk down the
0:12:11 > 0:12:13garden path and you'd hear the door open and slam very quickly.
0:12:13 > 0:12:16Because they were so ashamed to be seen.
0:12:18 > 0:12:21At the time, Caroline Bradbeer was a junior doctor
0:12:21 > 0:12:26at St Thomas's Hospital in London, trying to cope as best she could.
0:12:26 > 0:12:28We didn't really know what was happening.
0:12:28 > 0:12:31We did know that statistically, at that stage,
0:12:31 > 0:12:33once somebody had developed AIDS,
0:12:33 > 0:12:37the average survival was less than two years.
0:12:37 > 0:12:39I think it was about 18 months.
0:12:40 > 0:12:43There was nothing really we could do.
0:12:43 > 0:12:48And I felt so helpless, really.
0:12:48 > 0:12:50I made them a little bit better for a while,
0:12:50 > 0:12:52and that's what buoyed me up.
0:12:53 > 0:12:55Sometimes when they died, you were glad for them.
0:12:58 > 0:13:00The virus was a complete mystery to doctors.
0:13:02 > 0:13:04And scientists didn't have a clue where it had come from.
0:13:06 > 0:13:08But as we've learned more about HIV,
0:13:08 > 0:13:12researchers have been able to trace the epidemic all the way back to
0:13:12 > 0:13:13its very beginning.
0:13:13 > 0:13:14Very nice to see you.
0:13:14 > 0:13:17I've come to meet my friend and colleague Dr Stephane Hue,
0:13:17 > 0:13:22who uses genetic analysis to track the spread of the virus.
0:13:22 > 0:13:23Here you can see,
0:13:23 > 0:13:25let's say a family tree
0:13:25 > 0:13:29of the HIV strains that are circulating across the world.
0:13:29 > 0:13:33This family tree goes down to a single point here,
0:13:33 > 0:13:35to a single ancestor, right?
0:13:35 > 0:13:39Hold on. So, to a single...person.
0:13:39 > 0:13:42The first person who was infected with HIV.
0:13:42 > 0:13:43That's right.
0:13:43 > 0:13:48So we believe that this jump has occurred between 1910, 1930.
0:13:48 > 0:13:51Quite a lot before the virus was first identified.
0:13:51 > 0:13:55So the virus that has infected 60 million people
0:13:55 > 0:13:59- and killed half of them came from one person?- Yes.
0:13:59 > 0:14:03So, naturally, we want to know not who that person was, right,
0:14:03 > 0:14:06but we want to know, where did that virus come from?
0:14:06 > 0:14:10We realised very early on that this virus belongs to a family of viruses
0:14:10 > 0:14:14that mainly infects primates, OK?
0:14:14 > 0:14:16- So there's been a long... - Monkeys and apes.
0:14:16 > 0:14:18Exactly, monkeys and apes.
0:14:18 > 0:14:23And it turns out, we inherited HIV from chimpanzees.
0:14:23 > 0:14:25So in other words, in the world,
0:14:25 > 0:14:30the virus that is most closely related to HIV is SIVcpZ,
0:14:30 > 0:14:32which is a virus that infects chimpanzees.
0:14:32 > 0:14:34The question that I get asked is,
0:14:34 > 0:14:36did someone have sex with a chimpanzee?
0:14:36 > 0:14:40If you see and watch chimpanzees in their habitat, right?
0:14:40 > 0:14:44Their aggressivity, their teeth, right? Their strength.
0:14:44 > 0:14:47Realistically, you know, that's not what's happened.
0:14:47 > 0:14:49It's believed the virus made the jump to humans
0:14:49 > 0:14:53in Central Africa where chimps are sometimes butchered for their meat.
0:14:53 > 0:14:57- You know that I have lived in this part of the world.- Mm-hm.
0:14:57 > 0:15:00And... So I brought some photographs.
0:15:00 > 0:15:04This is a man butchering...
0:15:04 > 0:15:06- OK.- ..a small monkey.
0:15:06 > 0:15:09But I think you get a very good idea that this is not an environment
0:15:09 > 0:15:13where it's possible to avoid contact with the monkey blood.
0:15:13 > 0:15:17- Exactly.- And we think this is how the virus was introduced
0:15:17 > 0:15:18into the human population.
0:15:20 > 0:15:21For more than 50 years,
0:15:21 > 0:15:25the virus had such a small impact it wasn't noticed.
0:15:25 > 0:15:29But by the early 1980s, the world was facing a new and deadly disease.
0:15:31 > 0:15:33Without any effective drugs to treat it,
0:15:33 > 0:15:36doctors like Caroline Bradbeer were delivering what amounted
0:15:36 > 0:15:40to a death sentence to an increasing number of patients.
0:15:41 > 0:15:45One of those was Jerry Patterson, who's managed to survive against
0:15:45 > 0:15:47extraordinary odds.
0:15:47 > 0:15:49Oh, my God!
0:15:49 > 0:15:52- This is an absolute delight! - Come round here.
0:15:52 > 0:15:53Sorry, I'm a bit welled up.
0:15:53 > 0:15:56- Oh, sweetie!- They haven't seen each other for years, but the memories
0:15:56 > 0:15:57are still vivid.
0:15:57 > 0:16:00It really is. You look wonderful.
0:16:00 > 0:16:01So do you.
0:16:01 > 0:16:04Well, I was ushered straight into a cubicle.
0:16:04 > 0:16:07And the curtain went back and in you walked.
0:16:07 > 0:16:11And you'd got the result back, and it was an HIV-positive result,
0:16:11 > 0:16:14and you said that I was being admitted.
0:16:14 > 0:16:16I knew I could talk to you.
0:16:18 > 0:16:21A spade is a spade. I said, "Give it how it is."
0:16:21 > 0:16:24You said, two years.
0:16:24 > 0:16:28And here we are 28 years later, and we're having afternoon tea!
0:16:28 > 0:16:33It's wonderful, isn't it? I mean, it's just such an incredible thing.
0:16:33 > 0:16:35I'm so glad you came through it.
0:16:36 > 0:16:39Gosh! Golly.
0:16:39 > 0:16:41So young. How old were you?
0:16:41 > 0:16:4328.
0:16:43 > 0:16:47For young men like Jerry, the symptoms were devastating.
0:16:47 > 0:16:50The immune system was just crashing.
0:16:50 > 0:16:54The Kaposi's sarcoma, which was a form of cancer on the skin,
0:16:54 > 0:16:56would be these lesions appearing.
0:16:56 > 0:17:01- The banes of my existence were warts on my fingers, molluscum...- Yes.
0:17:01 > 0:17:05Which of course looks horrible because it looks like awful acne.
0:17:05 > 0:17:07Yes. And of course the gauntness was the other thing,
0:17:07 > 0:17:09the atrophy in the face.
0:17:09 > 0:17:13Yes, yes. They shrunk down to a level where you think,
0:17:13 > 0:17:15"Why are they still alive?"
0:17:15 > 0:17:16Which was taken...
0:17:16 > 0:17:20But by the late 1990s, everything was about to change.
0:17:20 > 0:17:25Scientists had discovered the first effective treatments against HIV.
0:17:25 > 0:17:29And Jerry had held on long enough to become one of the first to try them.
0:17:30 > 0:17:34It was amazing when we suddenly had treatments that worked.
0:17:34 > 0:17:37It took a while...
0:17:37 > 0:17:41to believe it. It took a while to persuade both the clinicians
0:17:41 > 0:17:45and the patients to take the medication
0:17:45 > 0:17:47because we'd had so many false starts,
0:17:47 > 0:17:51and there was always the worry that the side-effects would be worse than
0:17:51 > 0:17:52the benefits.
0:17:52 > 0:17:58But once it became clear that people could get better,
0:17:58 > 0:18:00you saw the most amazing things.
0:18:00 > 0:18:03I had the warts, I had the molluscum,
0:18:03 > 0:18:06and within weeks, I looked at my hand,
0:18:06 > 0:18:07the warts had gone.
0:18:07 > 0:18:11He's very lucky, but it would have been even better if he hadn't been
0:18:11 > 0:18:13infected in the first place.
0:18:13 > 0:18:15Nowadays, if people are taking their medication properly,
0:18:15 > 0:18:17actually the consultation goes along the lines of,
0:18:17 > 0:18:19"Where are you going on your holidays?"
0:18:19 > 0:18:22It's a bit like going to the hairdresser. It really is...
0:18:23 > 0:18:26..just carrying on giving the same prescription.
0:18:27 > 0:18:29Which is incredible.
0:18:31 > 0:18:32So, 30 years later,
0:18:32 > 0:18:36we now have drugs that can keep HIV under control.
0:18:37 > 0:18:39But there's still a long way to go.
0:18:41 > 0:18:45Whilst the diagnosis of HIV is not a death sentence in Britain any more,
0:18:45 > 0:18:49thousands of us don't know we carry the virus.
0:18:49 > 0:18:51I spoke to people in my lab about whether or not
0:18:51 > 0:18:54they would have regular tests since we all handle live virus,
0:18:54 > 0:18:55and they all said no!
0:18:55 > 0:18:57None of them have regular HIV tests.
0:18:58 > 0:18:59So why is that?
0:19:00 > 0:19:04Is it because they're too afraid to have a test?
0:19:04 > 0:19:05They don't want the information?
0:19:05 > 0:19:07Or is it because they're not afraid enough?
0:19:10 > 0:19:13It's been several years since my last test and, to be honest,
0:19:13 > 0:19:15I've left it longer than I should have.
0:19:17 > 0:19:20But these days, testing can be as simple as ordering
0:19:20 > 0:19:23a do-it-yourself kit over the internet.
0:19:23 > 0:19:26I think everyone should HIV test
0:19:26 > 0:19:30because there is almost no-one for whom the risk is zero.
0:19:31 > 0:19:32For me, it's much more than zero.
0:19:32 > 0:19:34You know, I've had more than one sexual partner,
0:19:34 > 0:19:36I've had unprotected sex previously,
0:19:36 > 0:19:39and I work in an HIV lab, mainly.
0:19:39 > 0:19:43I handle enormous quantities of live virus -
0:19:43 > 0:19:48so fluid that is hundreds or thousands of times
0:19:48 > 0:19:50more concentrated virus
0:19:50 > 0:19:53than you'd ever find in the sickest patient's body.
0:19:55 > 0:19:56Yeah, I'd be lying if I said
0:19:56 > 0:19:59I didn't have some butterflies about this.
0:19:59 > 0:20:02Your how-to test guide. HE CLEARS THROAT
0:20:02 > 0:20:06So there's a "If your result is positive..." The basics.
0:20:07 > 0:20:11If I test positive, I think I'm not comfortable,
0:20:11 > 0:20:16but I think I'm OK with saying I have HIV.
0:20:16 > 0:20:17Or at least...
0:20:20 > 0:20:21..I think I would be...
0:20:22 > 0:20:23..such a hypocrite if I didn't
0:20:23 > 0:20:26that I wouldn't be able to live with myself.
0:20:26 > 0:20:28So you need to remove the buffer part.
0:20:36 > 0:20:39Push the test device hard into the buffer box.
0:20:40 > 0:20:42So it's like a pregnancy test.
0:20:42 > 0:20:45If you get two lines, you're positive.
0:20:45 > 0:20:47OK. Let's make a cup of tea.
0:20:53 > 0:20:57As I wait, I'm running through all the ways I might have caught HIV.
0:20:59 > 0:21:00I've been careless in the lab.
0:21:01 > 0:21:04My wife's recently become positive and hasn't told me.
0:21:05 > 0:21:07This is a weird situation,
0:21:07 > 0:21:09and I think that the legacy of the public health campaign
0:21:09 > 0:21:12is it turns me about HIV, and I think many people...
0:21:12 > 0:21:15ALARM SOUNDS Oh, there we go. It turns...
0:21:16 > 0:21:21..people of my generation into HIV hypochondriacs.
0:21:33 > 0:21:35OK, so that is a negative result.
0:21:37 > 0:21:38HE EXHALES LOUDLY
0:21:38 > 0:21:41Gosh, I feel real... Honestly, my heart is really...
0:21:43 > 0:21:46..pounding. That is a load off, though.
0:21:48 > 0:21:50The unequivocal truth is it is better to know.
0:21:50 > 0:21:53It is better to know if you're negative, and it's better to know
0:21:53 > 0:21:55if you're positive. And it's better to understand if you are negative
0:21:55 > 0:21:57that you may not always be negative.
0:21:58 > 0:22:01That the next time you have unprotected sex
0:22:01 > 0:22:02warrants another HIV test.
0:22:06 > 0:22:11So what's it like nowadays for the 6,000 people who test positive
0:22:11 > 0:22:12in the UK each year?
0:22:16 > 0:22:18- Michael.- Hi, how you doing, Chris?
0:22:18 > 0:22:20I've come to Glasgow,
0:22:20 > 0:22:24where 31-year-old Michael is coming to terms with his recent news.
0:22:26 > 0:22:29Fourth of July, it was. I'd been on a...
0:22:29 > 0:22:32So, fourth of July, so two months ago?
0:22:32 > 0:22:34Two months ago, yep. Really recent.
0:22:34 > 0:22:36I was on a dating app.
0:22:36 > 0:22:40Now, while you're on it, you always get messages popping up
0:22:40 > 0:22:44saying to you, HIV tests, STI tests and things like that.
0:22:44 > 0:22:48And I thought, "HIV test, I'll get it done, tick it off my list.
0:22:48 > 0:22:49"Nothing to worry about."
0:22:49 > 0:22:51I was actually quite blase with it,
0:22:51 > 0:22:53assuming it was going to be negative.
0:22:53 > 0:22:58I went in and the gentleman that was passing me my results says to me,
0:22:58 > 0:23:02"We've got your results back, and they are HIV positive."
0:23:05 > 0:23:06Erm...
0:23:07 > 0:23:11Yeah, it's probably the worst words that you can hear
0:23:11 > 0:23:12getting told to you.
0:23:14 > 0:23:17I just went numb. Completely numb.
0:23:17 > 0:23:19I had no thought, I had no feeling.
0:23:22 > 0:23:23There was nothing.
0:23:23 > 0:23:25Pure blankness.
0:23:25 > 0:23:30As far as I was concerned, that was my death certificate written for me.
0:23:30 > 0:23:32- Really?- That was as much as I knew.
0:23:32 > 0:23:37You get HIV, it develops into AIDS, and unfortunately there's no cure.
0:23:37 > 0:23:40Obviously, cos I was crying, trying to take it in,
0:23:40 > 0:23:45he told me this does not mean that I'm going to die.
0:23:45 > 0:23:50It won't develop into AIDS because it doesn't happen any more.
0:23:50 > 0:23:53Worst-case scenario what will happen is I'll be on two meds a day.
0:23:53 > 0:23:56Two tablets that I'll need to take for the rest of my life.
0:23:58 > 0:24:02There are very few miracle drugs in modern medicine, but this really is,
0:24:02 > 0:24:04I would describe it as, a miracle drug.
0:24:04 > 0:24:06We always say, "This isn't a cure.
0:24:06 > 0:24:08"You're not cured. You still have HIV."
0:24:08 > 0:24:10So if you ever stop taking these,
0:24:10 > 0:24:14- you understand that the virus will come back.- Bounce back.
0:24:14 > 0:24:16But kind of the astounding thing to me is still that,
0:24:16 > 0:24:19if you do keep taking these every day at the same time,
0:24:19 > 0:24:22that your life expectancy is essentially unaffected.
0:24:22 > 0:24:23- Perfect.- Have you missed a day?
0:24:23 > 0:24:26- Nope.- Not a single one? - Not a single one.
0:24:28 > 0:24:31Anti-retroviral drugs, or ARVs,
0:24:31 > 0:24:35block the enzymes that HIV uses to infect immune cells.
0:24:36 > 0:24:40This stops the virus multiplying any further and brings HIV levels in the
0:24:40 > 0:24:42blood down to almost zero.
0:24:43 > 0:24:45As long as you keep taking the pills.
0:24:47 > 0:24:50Today, two months after starting treatment,
0:24:50 > 0:24:52Michael is going to find out
0:24:52 > 0:24:54how much virus is still present in his body,
0:24:54 > 0:24:58what doctors call his viral load.
0:24:58 > 0:25:00- Thank you. - We'll look at some of your results.
0:25:00 > 0:25:04It's been a few weeks now, I think, since you started treatment for HIV.
0:25:04 > 0:25:06Tell me how that has gone for you.
0:25:06 > 0:25:08- Really well, actually. - That's really good to hear.
0:25:08 > 0:25:11As you are aware, I was really concerned about side effects.
0:25:11 > 0:25:13- Mm-hm.- I've had none, absolutely none.
0:25:13 > 0:25:16- What else would you want to know about this?- My viral load.
0:25:16 > 0:25:19- Your viral load, I thought you'd be coming on to that.- That is the key one that I want to know.
0:25:19 > 0:25:21So I've seen people whose viral loads
0:25:21 > 0:25:23are more than a million copies,
0:25:23 > 0:25:26and that number is the amount of virus that you have
0:25:26 > 0:25:28in every millilitre of your blood.
0:25:28 > 0:25:30So this value was just reported a few weeks ago,
0:25:30 > 0:25:33and this value is not detected.
0:25:33 > 0:25:35Physically, we've switched off
0:25:35 > 0:25:37the virus making new copies of itself and
0:25:37 > 0:25:39now there's no copies in your blood at all.
0:25:43 > 0:25:44- I want a copy of that. - A copy of that?
0:25:44 > 0:25:47- I want that in black-and-white. - We'll print that out for you.
0:25:47 > 0:25:49I can get that framed. I'm amazed it can happen so quick.
0:25:49 > 0:25:52How do I ensure that always stays non-detectable?
0:25:52 > 0:25:55So, the virus is not cured.
0:25:55 > 0:25:59- Yes. Yes.- There are copies of the virus in your body, but they're all
0:25:59 > 0:26:00completely suppressed,
0:26:00 > 0:26:03and the reason of that is that you're taking your tablets.
0:26:03 > 0:26:05And just to clarify as well, that's...
0:26:05 > 0:26:08I am not infectious.
0:26:08 > 0:26:11There's no way even with unprotected sex, if that happens,
0:26:11 > 0:26:13that I can infect somebody?
0:26:13 > 0:26:16So if you're able to take your tablets, a pill every day,
0:26:16 > 0:26:21you'd have almost no risk of passing on HIV to anyone else.
0:26:22 > 0:26:24I can just get on with my normal life
0:26:24 > 0:26:26without actually having to think about HIV.
0:26:26 > 0:26:28I've got my life back.
0:26:28 > 0:26:30And it's great.
0:26:30 > 0:26:32Michael is one of the lucky ones.
0:26:34 > 0:26:38But the trouble is, you have to be diagnosed before you can benefit
0:26:38 > 0:26:40from the amazing treatments we now have.
0:26:41 > 0:26:44Nearly one in eight people who have the virus
0:26:44 > 0:26:45don't know they are infected.
0:26:47 > 0:26:49And one of them was 43-year-old Addie.
0:26:50 > 0:26:54SHE READS WITH SPEECH IMPAIRMENT
0:26:59 > 0:27:00Perfect. OK.
0:27:00 > 0:27:02This one is new to you, isn't it?
0:27:02 > 0:27:06- It's new to me as well.- She had no idea she had HIV until a brain
0:27:06 > 0:27:10infection caused by her depleted immune system left her struggling
0:27:10 > 0:27:12to walk and talk.
0:27:15 > 0:27:18Brain infections are common in patients
0:27:18 > 0:27:21where HIV has gone undiagnosed for many years.
0:27:23 > 0:27:25Hi. I'm here to see Addie.
0:27:25 > 0:27:28I've come to the Mildmay Hospital in East London,
0:27:28 > 0:27:31where they specialise in rehabilitating patients like Addie.
0:27:31 > 0:27:34- Hi, Addie, I'm Chris. - Welcome, Chris.
0:27:34 > 0:27:37- How are you?- Nice to meet you.
0:27:37 > 0:27:40- Very, very nice to meet you, Addie. - Nice to meet you.
0:27:40 > 0:27:42- Can I join in, Addie? - Yeah, yeah, yeah.
0:27:42 > 0:27:44- Is that all right?- Yeah. Yeah, yeah.
0:27:44 > 0:27:45We've done our warm-up now, Addie,
0:27:45 > 0:27:48so we might come across to the parallel bars.
0:27:48 > 0:27:50Oh, we're going to walk over there, are we?
0:27:50 > 0:27:54Addie is now on ARVs and her HIV is under control,
0:27:54 > 0:27:57but the damage to her brain may never be fully reversed.
0:28:04 > 0:28:05You can't just feel them?
0:28:05 > 0:28:07No, no.
0:28:07 > 0:28:09And it's worth saying, it's very obvious,
0:28:09 > 0:28:13simply standing here, I can feel your muscles flexing
0:28:13 > 0:28:15and you're sweating to do this, aren't you?
0:28:15 > 0:28:17Just standing here is quite hard work.
0:28:17 > 0:28:18Is that true?
0:28:20 > 0:28:21I shouldn't say sweating.
0:28:21 > 0:28:22You're glowing.
0:28:22 > 0:28:24You're perspiring gently.
0:28:24 > 0:28:28So Addie's been coming... Start in January 2015.
0:28:28 > 0:28:32And when you came in January, how good were you at the parallel bars?
0:28:32 > 0:28:33- Very bad, very bad.- Very bad?
0:28:33 > 0:28:36Nice and slowly. One hand at a time.
0:28:36 > 0:28:38It's very interesting for me as a doctor to try and work out
0:28:38 > 0:28:39where the problem is.
0:28:41 > 0:28:42What's happened here?
0:28:42 > 0:28:46This is quite similar to if someone's had a stroke,
0:28:46 > 0:28:49where there's been some damage to the brain and it's affecting...
0:28:51 > 0:28:54..I guess her ability to contract her muscles,
0:28:54 > 0:28:57with her strength and her co-ordination,
0:28:57 > 0:29:01which leads to problems with her balance,
0:29:01 > 0:29:05difficulty standing and also with your coordination in terms of your
0:29:05 > 0:29:10- speech as well.- It seems to me that you're working very hard to make the
0:29:10 > 0:29:12- words with your mouth and tongue. - Yeah, yeah.
0:29:12 > 0:29:15Is that a thing you've had to relearn to do?
0:29:15 > 0:29:16Yeah, yeah, yeah.
0:29:21 > 0:29:23Addie, are you always this cheerful?
0:29:27 > 0:29:30Has that always just been your nature?
0:29:30 > 0:29:31We're going to come and have a sit down.
0:29:31 > 0:29:33- Do you want to gave a seat? - Yeah, yeah, yeah.
0:29:33 > 0:29:36I'm conscious you are really working away here.
0:29:36 > 0:29:37Yeah, I bet you're getting tired.
0:29:37 > 0:29:42What was Addie's prognosis when she came here?
0:29:42 > 0:29:46It was very bad. She had just been given about three months to live.
0:29:46 > 0:29:49So she had virtually no functioning immune system?
0:29:49 > 0:29:51No, she didn't.
0:29:51 > 0:29:52So you were in a bad way.
0:29:53 > 0:29:55And you were given three months to live.
0:29:55 > 0:29:59It's remarkable, I think, to work with someone like you, Addie,
0:29:59 > 0:30:03where you've had this very severe brain damage, really.
0:30:03 > 0:30:04Let's call it what it is.
0:30:04 > 0:30:08But at your age, the brain is sufficiently plastic
0:30:08 > 0:30:10that you can retrain it and gain a lot of function.
0:30:10 > 0:30:14Exactly, and there has been quite remarkable improvement.
0:30:14 > 0:30:16THEY SING "Amazing Grace"
0:30:16 > 0:30:20Singing therapy is now helping Addie to rebuild her power of speech.
0:30:24 > 0:30:27And the Mildmay has been at the forefront
0:30:27 > 0:30:30of treating HIV and AIDS for the past 30 years.
0:30:34 > 0:30:37- REPORTER:- The Princess of Wales has been visiting AIDS sufferers
0:30:37 > 0:30:38in an East London hospital.
0:30:38 > 0:30:42This morning, she spent time with patients at the hospice wing
0:30:42 > 0:30:43of the Mildmay hospital.
0:30:45 > 0:30:48In 1989, in the full glare of the media,
0:30:48 > 0:30:52Princess Diana openly shook hands with patients who had AIDS.
0:30:52 > 0:30:55It was a landmark moment in challenging the stigma
0:30:55 > 0:30:58surrounding the disease.
0:30:58 > 0:31:00And her legacy continues to this day.
0:31:05 > 0:31:07Addie, I think you've got a visitor.
0:31:07 > 0:31:09Who? Prince Harry!
0:31:11 > 0:31:14- Prince Harry!- Hello.
0:31:14 > 0:31:16Stay, stay, stay. How are you?
0:31:16 > 0:31:18- I'm fine.- Nice to see you again.
0:31:18 > 0:31:20- Nice to see you too. - I heard you singing outside.
0:31:20 > 0:31:21Yeah. Yeah, yeah.
0:31:21 > 0:31:25- Amazing. Literally, Amazing Grace, wasn't it?- Yeah.- It was.
0:31:25 > 0:31:30Prince Harry has met Addie before, and she has made real progress.
0:31:31 > 0:31:35Understandably, there is huge frustrations for you
0:31:35 > 0:31:36because of your speech.
0:31:36 > 0:31:39People... People...
0:31:40 > 0:31:41Yeah.
0:31:44 > 0:31:47- Can I have a...?- Thank you, Prince. - We'll see you.- Yeah, yeah.
0:31:47 > 0:31:50Addie's story proves that when it comes to HIV,
0:31:50 > 0:31:52an early diagnosis is crucial.
0:31:52 > 0:31:57And the only way to be sure of that is regular testing.
0:31:57 > 0:31:59The key point of this is how easy it was,
0:31:59 > 0:32:01and how easy it was for you as well.
0:32:01 > 0:32:02You had a home-testing kit.
0:32:02 > 0:32:05I went in and the only reason I did it live was because I wanted to show
0:32:05 > 0:32:09to everybody how easy it is and how normal it is.
0:32:09 > 0:32:13Imagine if we could create a movement where everybody...
0:32:13 > 0:32:16everyone goes and gets tested. You know, if you're not going to get
0:32:16 > 0:32:18tested for yourself and you're not going to go
0:32:18 > 0:32:21and get tested for your loved ones that you could possibly infect,
0:32:21 > 0:32:24then - I don't know whether it's a selfish thing to say or not -
0:32:24 > 0:32:26but if you respect what my mother stood for,
0:32:26 > 0:32:27go and get tested for her.
0:32:27 > 0:32:31You know, you've got 20 years next year since she died,
0:32:31 > 0:32:32and 30 years ago,
0:32:32 > 0:32:35she was in the hospital and she did something that no-one else had ever
0:32:35 > 0:32:38done before, and she started this whole thing.
0:32:38 > 0:32:42Is that partly what is inspiring you to do this?
0:32:42 > 0:32:45Yes. You know, if she were still here today...
0:32:45 > 0:32:48she would... Well, she'd probably get tested every month
0:32:48 > 0:32:49just to prove the point.
0:32:49 > 0:32:55There's so much stigma simply around a name or an acronym that we need...
0:32:55 > 0:32:57we need...
0:32:57 > 0:32:59You know, it's 2016, for God's sake.
0:32:59 > 0:33:01I mean, we need to start rethinking
0:33:01 > 0:33:06the whole Acquired... What is it? Acquired Immune Deficiency Syndrome.
0:33:07 > 0:33:11When you actually lay it out and you spell it out, you suddenly go,
0:33:11 > 0:33:14"It's not actually that terrifying at all."
0:33:14 > 0:33:16Obviously, if you speak to someone who's suffering from it,
0:33:16 > 0:33:19of course it's terrifying because it can kill you.
0:33:19 > 0:33:21But the point I'm trying to make is,
0:33:21 > 0:33:24if you can't even say the word without cringing or worrying
0:33:24 > 0:33:26or freaking out about it,
0:33:26 > 0:33:29how the hell are we going to help everybody and solve this
0:33:29 > 0:33:30problem before it gets too big?
0:33:30 > 0:33:35I think most people would admit that they've had sex without a condom,
0:33:35 > 0:33:39and that is always a moment - the next day, probably -
0:33:39 > 0:33:40when you think to yourself,
0:33:40 > 0:33:42"You know what, Christ, I probably need to,
0:33:42 > 0:33:44"you know, go and get a checkup."
0:33:44 > 0:33:47Why did you want to take this on as a cause?
0:33:47 > 0:33:50The issue itself needs...
0:33:51 > 0:33:54..a straight guy, mid-30s, early 30s...
0:33:55 > 0:33:59..to come in and try and normalise it.
0:33:59 > 0:34:03And once again, I'm fortunate enough to be in this position to be able to
0:34:03 > 0:34:05make a difference. Let's start in the UK.
0:34:05 > 0:34:08Let's lead by example, and then help everybody else.
0:34:14 > 0:34:15In Britain, we've come a long,
0:34:15 > 0:34:19long way since Princess Diana extended the hand of compassion
0:34:19 > 0:34:21to people with AIDS.
0:34:23 > 0:34:26But huge challenges still remain.
0:34:27 > 0:34:31I'm off to a part of the world where the worst-case scenario
0:34:31 > 0:34:33the doctors feared for the UK
0:34:33 > 0:34:37has now become a catastrophe of unimaginable proportions.
0:34:42 > 0:34:47I've come to South Africa, the worst affected country in the world,
0:34:47 > 0:34:50where nearly 200,000 people still die every year.
0:34:54 > 0:34:59So South Africa is an example of what happens when you don't have
0:34:59 > 0:35:02a really effective public health campaign
0:35:02 > 0:35:05in the early stages of an HIV epidemic.
0:35:05 > 0:35:07So, in the UK, we did.
0:35:07 > 0:35:09In South Africa, they didn't.
0:35:09 > 0:35:13So today, there are 7 million people living here with HIV.
0:35:13 > 0:35:15It has one of the highest infection rates in the world.
0:35:18 > 0:35:21This is the front line of the war against the virus.
0:35:22 > 0:35:24In a bid to end the epidemic,
0:35:24 > 0:35:27the UN has now set an ambitious global target.
0:35:27 > 0:35:30They're calling it 90-90-90.
0:35:31 > 0:35:35Diagnosis of 90% of people with HIV,
0:35:35 > 0:35:38getting 90% of those onto medication,
0:35:38 > 0:35:42and suppressing the virus in 90% of those.
0:35:45 > 0:35:47The latest scientific models show
0:35:47 > 0:35:50that if the 90-90-90 goal is achieved,
0:35:50 > 0:35:53it could end the epidemic in less than 15 years.
0:35:56 > 0:35:59So I'm heading to a clinic in KwaZulu-Natal,
0:35:59 > 0:36:01the hardest-hit province in South Africa,
0:36:01 > 0:36:04to see how they're trying to reach that target.
0:36:08 > 0:36:12As I arrive, I take the opportunity to speak with some locals who are
0:36:12 > 0:36:14selling fruit outside the clinic.
0:36:14 > 0:36:16How are you guys? Do you mind talking to me?
0:36:16 > 0:36:19THEY SPEAK ZULU
0:36:19 > 0:36:23We're making a programme about HIV,
0:36:23 > 0:36:26and I wanted to know what you all thought about it.
0:36:26 > 0:36:29Oh!
0:36:29 > 0:36:32THEY SPEAK ZULU
0:36:36 > 0:36:38My Zulu is a bit rusty, I'm afraid.
0:36:41 > 0:36:43The lady, she's saying, basically,
0:36:43 > 0:36:46all the kids have passed away
0:36:46 > 0:36:49because of HIV.
0:36:49 > 0:36:51I hadn't understood how serious it was.
0:37:00 > 0:37:01She has lost six children?
0:37:01 > 0:37:03- Yeah.- Yes.- OK.
0:37:03 > 0:37:05I'm very sorry. I'm very sorry.
0:37:05 > 0:37:06Thank you.
0:37:06 > 0:37:10Is it a thing that young people understand?
0:37:24 > 0:37:26You get these from the clinic?
0:37:44 > 0:37:48Nothing can prepare you for hearing stories like these,
0:37:48 > 0:37:50but at the Macabuzela Clinic,
0:37:50 > 0:37:53this is what they're dealing with every single day.
0:37:53 > 0:37:56SINGING IN ZULU
0:37:56 > 0:38:00Which is why it's all the more amazing that they begin each morning
0:38:00 > 0:38:01with such an uplifting song.
0:38:15 > 0:38:18The clinic covers an area of 13,000 people,
0:38:18 > 0:38:21roughly the same as a busy GP practice in the UK.
0:38:25 > 0:38:27And many of the common conditions they treat are the same.
0:38:29 > 0:38:31High blood pressure, diabetes,
0:38:31 > 0:38:34mental health, epilepsy, diarrhoea, asthma.
0:38:34 > 0:38:37But strikingly, at the top of the list is the term
0:38:37 > 0:38:41"People living with HIV and AIDS".
0:38:41 > 0:38:46I really want to understand why HIV is so widespread in this part of the
0:38:46 > 0:38:47world.
0:38:48 > 0:38:51The first patient is a teenager.
0:38:51 > 0:38:54Diagnosed HIV-positive just two months ago,
0:38:54 > 0:38:55she prefers to stay anonymous.
0:38:58 > 0:39:00What was it like to find out you were positive?
0:39:03 > 0:39:04You told your mum?
0:39:06 > 0:39:08You told your brother, OK.
0:39:08 > 0:39:11So not your mum and your... So only one person knows?
0:39:11 > 0:39:14Do you know the person that you think you caught it off?
0:39:16 > 0:39:18Did you tell him?
0:39:18 > 0:39:19- No.- Why?
0:39:25 > 0:39:28He's 25 years older than you?
0:39:28 > 0:39:29He's in his mid-40s.
0:39:29 > 0:39:34OK. When you had sex, were you worried about HIV?
0:39:34 > 0:39:36Did you say, "We should use a condom"?
0:39:41 > 0:39:44And because she was in love with him,
0:39:44 > 0:39:48- just allowed him to do unprotected sex.- OK.- Yeah.
0:39:48 > 0:39:50They just dated for a week.
0:39:50 > 0:39:53He just slept with her, then dumped her.
0:39:54 > 0:39:56OK. Gosh.
0:40:10 > 0:40:12The girl collects her prescription,
0:40:12 > 0:40:16the same anti-retroviral drugs as in the UK,
0:40:16 > 0:40:17and heads to school.
0:40:19 > 0:40:22It's a desperate story, but not unusual.
0:40:22 > 0:40:27Teenage girls in this part of South Africa have an 80% chance
0:40:27 > 0:40:29of becoming HIV positive during their lifetime.
0:40:30 > 0:40:33How does this make you feel? Because you're a young woman.
0:40:33 > 0:40:35Does this make you mistrust men?
0:40:42 > 0:40:44So often by then it's too late.
0:40:44 > 0:40:46It's too late most of the time.
0:40:48 > 0:40:51It's not a shortage of drugs that is killing people here.
0:40:54 > 0:40:58South Africa now has the biggest anti-retroviral treatment programme
0:40:58 > 0:40:59anywhere in the world.
0:41:04 > 0:41:05For a doctor like me,
0:41:05 > 0:41:10it's baffling there are still nearly 200,000 AIDS-related deaths here
0:41:10 > 0:41:12every year.
0:41:12 > 0:41:15I think they have come to regard this as completely normal.
0:41:16 > 0:41:18There's the market. In that room,
0:41:18 > 0:41:22in that Portakabin, are all the drugs to completely...
0:41:23 > 0:41:29..end transmission and mean that no-one, almost no-one has to die.
0:41:30 > 0:41:32That's the thing I don't feel I've in any way
0:41:32 > 0:41:34really got under the skin of.
0:41:34 > 0:41:37What are all the complicated factors that mean that people
0:41:37 > 0:41:39don't go and seek treatment?
0:41:43 > 0:41:47On the way back to my hotel, I decide to drop in at a local bar.
0:41:50 > 0:41:53As a bloke, I want to hear what some of the men have to say.
0:41:58 > 0:42:00Can I get a beer? A bottle of beer?
0:42:03 > 0:42:05How are you, sir?
0:42:05 > 0:42:07- What's your name?- Zotani. - Zotani?- Yes, sir.
0:42:07 > 0:42:10We've discovered, out in the clinics,
0:42:10 > 0:42:13that the young men don't want to get testing
0:42:13 > 0:42:14and they don't want to get treated,
0:42:14 > 0:42:17and I'm trying to understand why.
0:42:17 > 0:42:18HE LAUGHS
0:42:23 > 0:42:27Why haven't you had an HIV test in three years?
0:42:30 > 0:42:32Do you have a girlfriend now?
0:42:32 > 0:42:34- Yeah, I have three. - You've got three girlfriends?
0:42:34 > 0:42:36In KwaZulu-Natal,
0:42:36 > 0:42:3930% of people have HIV.
0:42:39 > 0:42:41So there is a good chance that one
0:42:41 > 0:42:43of your three girlfriends will have HIV.
0:42:43 > 0:42:45You should go and get a test.
0:42:48 > 0:42:51- Go and do it tomorrow. Go and get tested.- My own time.
0:42:51 > 0:42:54But going to the clinic can be fraught with embarrassment
0:42:54 > 0:42:55and fear for these men.
0:43:12 > 0:43:16When you go and you test positive, at a clinic, people will know.
0:43:22 > 0:43:25It's so important for you to have some confidentiality.
0:43:27 > 0:43:31If I knew when I went and had an HIV test, and then went every month
0:43:31 > 0:43:34when I had to go and get my pills to be treated,
0:43:34 > 0:43:35everyone would know, you know what,
0:43:35 > 0:43:38honestly, I might not get tested.
0:43:38 > 0:43:43I hope I would, but I can't say hand on my heart that that wouldn't push
0:43:43 > 0:43:44me away from the clinic.
0:43:50 > 0:43:53So, if the men won't come to the clinic,
0:43:53 > 0:43:57a pioneering scientific trial is taking the clinic to the men,
0:43:57 > 0:44:01in a bid to diagnose 90% of people who have HIV.
0:44:03 > 0:44:04For the past four years,
0:44:04 > 0:44:07testing teams have been visiting every home
0:44:07 > 0:44:10in an area of 22,000 people.
0:44:11 > 0:44:12No-one is singled out,
0:44:12 > 0:44:16and people can avoid the stigma of their neighbours knowing.
0:44:24 > 0:44:26How are you, my friend?
0:44:26 > 0:44:28Themba, a 60-year-old widower,
0:44:28 > 0:44:30was one of those who tested positive
0:44:30 > 0:44:34when fieldworkers visited his home in 2014.
0:44:34 > 0:44:37- Can we see?- Yes, you can come in.
0:44:39 > 0:44:40Can I sit on the bed?
0:44:48 > 0:44:49Do you like taking the pills?
0:44:58 > 0:45:00- One pill at seven o'clock? - Yeah.- Every day.
0:45:00 > 0:45:03Do you know your viral level?
0:45:03 > 0:45:04Can we see the paper?
0:45:06 > 0:45:08First viral load was 18,000,
0:45:08 > 0:45:11and then, as soon as he started taking the drugs,
0:45:11 > 0:45:13so, what, August to November, LDL,
0:45:13 > 0:45:16which is lower than detectable limit.
0:45:16 > 0:45:20Undetectable, undetectable, undetectable, undetectable.
0:45:21 > 0:45:23So the pills are working very well.
0:45:23 > 0:45:27Do you think you will ever have a girlfriend or a wife in the future?
0:45:31 > 0:45:32He's thinking about it.
0:45:32 > 0:45:35This treatment, it helps you live
0:45:35 > 0:45:39a long time, but it also stops you
0:45:39 > 0:45:40passing the virus on.
0:45:40 > 0:45:42So that's the key thing.
0:45:42 > 0:45:44There are two benefits.
0:45:44 > 0:45:49It makes you live and it stops you giving the virus to anyone else.
0:45:49 > 0:45:51So as long as your viral level
0:45:51 > 0:45:54is undetectable, which yours is,
0:45:54 > 0:45:56you won't give the virus to anyone.
0:46:02 > 0:46:06Themba is just one small part of a much bigger plan
0:46:06 > 0:46:09to try and end the epidemic within ten years.
0:46:11 > 0:46:14But has the trial come anywhere close to reaching
0:46:14 > 0:46:17the UN's 90-90-90 target?
0:46:17 > 0:46:20To diagnose 90% of people with HIV,
0:46:20 > 0:46:24to get 90% of them onto medication,
0:46:24 > 0:46:27and suppress the virus in 90% of them.
0:46:28 > 0:46:31At the Africa Health Research Institute,
0:46:31 > 0:46:33I'm catching up with Professor Deenan Pillay,
0:46:33 > 0:46:37who wants to show me how well they've done.
0:46:37 > 0:46:39First up, diagnosis.
0:46:39 > 0:46:41We were able to, in our trial,
0:46:41 > 0:46:45- diagnose 92%...- Really? - ..of those individuals
0:46:45 > 0:46:47who are infected in this area.
0:46:47 > 0:46:49We achieved that target.
0:46:49 > 0:46:53So the next question is what proportion of these individuals
0:46:53 > 0:46:56come to clinics? And unfortunately,
0:46:56 > 0:47:00what we find is only 47% get into care.
0:47:00 > 0:47:04And that's too low to get anywhere near
0:47:04 > 0:47:06to start to reduce the epidemic.
0:47:06 > 0:47:10So you've managed to get less than half of people with HIV
0:47:10 > 0:47:13into treatment. Why?
0:47:13 > 0:47:16It's a tremendous success that we've been able
0:47:16 > 0:47:21to go into people's homes and convince them to be tested for HIV,
0:47:21 > 0:47:25- but the point of that is that they get onto treatment.- Right.
0:47:25 > 0:47:28I want to understand - that isn't because of a shortage of drugs
0:47:28 > 0:47:31or a lack of money. The resources are there
0:47:31 > 0:47:33if you can get people
0:47:33 > 0:47:36to use them. Is that right?
0:47:36 > 0:47:40We provided mobile clinics,
0:47:40 > 0:47:46we provided the care for their HIV infection with no shortage of drugs
0:47:46 > 0:47:49or diagnostics and always with sufficient staff.
0:47:49 > 0:47:53I think defeating this awful HIV epidemic
0:47:53 > 0:47:55requires an understanding of
0:47:55 > 0:47:57society, as well as individuals,
0:47:57 > 0:47:59as well as medicine.
0:47:59 > 0:48:02And without an understanding of all of those, we will never defeat it.
0:48:05 > 0:48:10I think, you know, 20 years ago, no-one...
0:48:10 > 0:48:12I don't think anyone thought we'd get to this point where,
0:48:12 > 0:48:14basically,
0:48:14 > 0:48:19we've overcome all those kind of scientific, medical obstacles.
0:48:19 > 0:48:21We have highly effective treatment
0:48:21 > 0:48:24that works with very few side effects,
0:48:24 > 0:48:28and it's cheap, and there's enough of it for everyone out there.
0:48:28 > 0:48:31At this point, we're batting up against the hardest problem of all,
0:48:31 > 0:48:33that feels so simple -
0:48:33 > 0:48:37just persuading human beings to be rational and do the right thing -
0:48:37 > 0:48:38and...
0:48:41 > 0:48:44I'm sure we will get there, but that...
0:48:44 > 0:48:48that, I guess... In any medical challenge, that is the hardest bit.
0:48:59 > 0:49:01Back here in the UK,
0:49:01 > 0:49:04it's easy to assume we are winning the battle against HIV.
0:49:06 > 0:49:09Sitting here feels so different to KwaZulu-Natal
0:49:09 > 0:49:11that it is hard to believe
0:49:11 > 0:49:17that there could be any epidemic of infection at all.
0:49:17 > 0:49:22But what can we do about the 6,000 new British infections every year?
0:49:23 > 0:49:26Although condoms have made a huge difference to safer sex,
0:49:26 > 0:49:29people still don't really like wearing them,
0:49:29 > 0:49:31and given the choice, I'd rather not wear one either.
0:49:34 > 0:49:38So what if there was a radical new way to prevent infection?
0:49:40 > 0:49:42This is Harry Dodd.
0:49:42 > 0:49:44As a sexually active young gay man,
0:49:44 > 0:49:47he doesn't want to take any chances.
0:49:47 > 0:49:49So he signed up to a clinical trial
0:49:49 > 0:49:53of a revolutionary new pill called PrEP.
0:49:53 > 0:49:56It contains two different anti-retroviral drugs
0:49:56 > 0:49:59and can prevent HIV being contracted.
0:49:59 > 0:50:01OK. Well done.
0:50:01 > 0:50:05And Harry has regular checkups to make sure it's working.
0:50:05 > 0:50:07What is PrEP?
0:50:07 > 0:50:10PrEP stands for pre-exposure prophylactic,
0:50:10 > 0:50:14so it's prevention that you take ahead of being exposed to a risk.
0:50:14 > 0:50:16- Do you mind if I have a look? - Go ahead.
0:50:16 > 0:50:20Are the drugs the same as the ones we use to treat HIV?
0:50:20 > 0:50:23They are. Cos they work brilliantly to control the virus,
0:50:23 > 0:50:24and that's what you're doing,
0:50:24 > 0:50:27whether you're preventing it or you're treating it,
0:50:27 > 0:50:30so the advantage of pre-exposure,
0:50:30 > 0:50:33if you think there's going to be an exposure in the future,
0:50:33 > 0:50:35is that the drug is there ready and waiting.
0:50:35 > 0:50:38If you take the pill properly, every day as instructed,
0:50:38 > 0:50:40the chances of contracting HIV are negligible.
0:50:41 > 0:50:46For Harry, it's removed a lifelong fear of contracting HIV.
0:50:47 > 0:50:49Growing up knowing you're gay,
0:50:49 > 0:50:53that fear haunts you from the first time you become sexually active.
0:50:53 > 0:50:57You have this guilt and fear and worry and concern
0:50:57 > 0:51:01with almost any sexual partner you have. Even with the condom,
0:51:01 > 0:51:04there's still the worry of the big one, which is HIV.
0:51:04 > 0:51:09And PrEP takes that fear and that anxiety away from that experience.
0:51:09 > 0:51:11OK, Harry.
0:51:11 > 0:51:13We look for that one spot for negative,
0:51:13 > 0:51:15two spots for positive.
0:51:17 > 0:51:19One spot, negative.
0:51:19 > 0:51:20Brilliant.
0:51:20 > 0:51:23How do you feel? Are you relieved that the test is negative?
0:51:23 > 0:51:25Of course I'm relieved that the result is negative,
0:51:25 > 0:51:27but I didn't have any anxiety beforehand either...
0:51:27 > 0:51:31- Really?- ..because I appreciated that I've been taking PrEP
0:51:31 > 0:51:35for three years and that the chances of me contracting HIV
0:51:35 > 0:51:38are pretty much non-existent.
0:51:38 > 0:51:42The thing that is amazing to me about this is, in this pot,
0:51:42 > 0:51:45is the power to end the epidemic.
0:51:45 > 0:51:47Yes. I mean, I completely agree with you.
0:51:47 > 0:51:48This is the thing we need.
0:51:48 > 0:51:51DRUMS AND MUSIC
0:51:56 > 0:51:58At last summer's London Pride Festival,
0:51:58 > 0:52:01Harry took to the streets with hundreds of others to campaign
0:52:01 > 0:52:04for PrEP to be made available on the NHS.
0:52:05 > 0:52:09- What do we want?- CROWD:- PrEP! - When do we want it?- Now!
0:52:09 > 0:52:13- What do we want?- PrEP! - When do we want it?- Now!
0:52:13 > 0:52:15Then, in December 2016,
0:52:15 > 0:52:18the National AIDS Trust won an Appeal Court ruling
0:52:18 > 0:52:21that NHS England and local authorities
0:52:21 > 0:52:25do have the power to fund the provision of anti-retroviral drugs
0:52:25 > 0:52:27for the prevention of HIV.
0:52:27 > 0:52:31And so, a £10 million trial over the next three years was announced in
0:52:31 > 0:52:33England, and then a further one in Wales,
0:52:33 > 0:52:37whilst NHS Scotland announced that PrEP will be available there
0:52:37 > 0:52:39this summer to those who need it.
0:52:39 > 0:52:41Cost is a big factor,
0:52:41 > 0:52:45and NHS England has challenged drug companies to supply at lower prices.
0:52:46 > 0:52:50Now 10,000 more people will take part in these clinical trials
0:52:50 > 0:52:54to answer what NHS England says are outstanding questions,
0:52:54 > 0:52:56paving the way for a full roll-out.
0:52:58 > 0:53:02But not all views on the subject were based on clinical concerns.
0:53:02 > 0:53:05So this is an article in the Daily Mail.
0:53:05 > 0:53:09Headline is, "NHS told to give out £5,000 a year
0:53:09 > 0:53:15"lifestyle drug to prevent HIV as vital cataract surgery is rationed.
0:53:15 > 0:53:18"What a skewed sense of values."
0:53:18 > 0:53:23Calling it a lifestyle drug, I think, totally misunderstands.
0:53:23 > 0:53:26Almost all the conditions we treat in the NHS
0:53:26 > 0:53:29could be largely prevented
0:53:29 > 0:53:30if people lived different lifestyles.
0:53:30 > 0:53:34We never have a discussion saying we should not give out
0:53:34 > 0:53:36blood pressure and cholesterol medication
0:53:36 > 0:53:38to people who are overweight and unfit.
0:53:38 > 0:53:44And to single out this particular highly effective pill as being a
0:53:44 > 0:53:46lifestyle drug...
0:53:46 > 0:53:48is really poisonous.
0:53:48 > 0:53:52But whatever our attitudes to sexual health, or even sexual morality,
0:53:52 > 0:53:55the use of PrEP has been all over the headlines recently,
0:53:55 > 0:53:58and it does raise interesting, difficult questions.
0:53:58 > 0:54:01I wanted to ask my own boss, Professor Greg Towers,
0:54:01 > 0:54:04a leading expert on HIV, what he thought.
0:54:04 > 0:54:07What you think about the idea that, for a lot of people, PrEP is a
0:54:07 > 0:54:11lifestyle drug? It allows them to have high-risk sex.
0:54:11 > 0:54:14Well, it allows them to not get HIV, which is the point.
0:54:14 > 0:54:15I mean, you know, it's not
0:54:15 > 0:54:18our business to be focusing on what people do,
0:54:18 > 0:54:20it's about making a decision based
0:54:20 > 0:54:23on how to improve the health of people in the UK,
0:54:23 > 0:54:25and how to do that in the most cost-effective way.
0:54:25 > 0:54:29Those people taking that drug will cost the NHS less
0:54:29 > 0:54:30if they don't get HIV.
0:54:30 > 0:54:33There is more money to treat patients if you save money
0:54:33 > 0:54:36through not having to treat people for their entire lives
0:54:36 > 0:54:38with very expensive drugs rather
0:54:38 > 0:54:41than for a period where they're at risk of getting HIV.
0:54:41 > 0:54:44Why aren't we rolling it out in England and Wales
0:54:44 > 0:54:46in the way they have in Scotland? We're doing another trial.
0:54:46 > 0:54:48We need to work out what drugs we're going to give,
0:54:48 > 0:54:50who we're going to give them to...
0:54:50 > 0:54:52Will everybody take it? Will the right people take it?
0:54:52 > 0:54:54Will the right people have access to it?
0:54:54 > 0:54:55You have to have due process,
0:54:55 > 0:54:58you have to make sure that this is going to be the appropriate thing to do,
0:54:58 > 0:55:00and to work out the appropriate way to do it.
0:55:00 > 0:55:03So it isn't like we're doing a little trial and testing it in a few
0:55:03 > 0:55:07hundred people. It is actually, in practice, going to be offered
0:55:07 > 0:55:11to quite a large proportion of the eligible population.
0:55:11 > 0:55:13Yeah. I don't know how big the eligible population is, but, yeah,
0:55:13 > 0:55:1710,000 people is a lot of people who won't be at risk.
0:55:17 > 0:55:21So why do you think that condoms and personal responsibility
0:55:21 > 0:55:23aren't enough to stop the spread of HIV?
0:55:23 > 0:55:26People just don't use them. You know, some people object to using them,
0:55:26 > 0:55:28they don't want to, so it just doesn't work.
0:55:28 > 0:55:32We know that now, and I don't think that's a realistic proposition for stopping the spread of HIV.
0:55:32 > 0:55:34Do you think a cure is on the horizon?
0:55:34 > 0:55:39A cure for HIV is, unfortunately, I think, a big ask at the moment,
0:55:39 > 0:55:41because we don't understand enough about the biology of the virus
0:55:41 > 0:55:44and its relationship with the immune system.
0:55:44 > 0:55:45A lot of people are working on it.
0:55:45 > 0:55:47It's certainly a possibility.
0:55:47 > 0:55:49Will we cure it?
0:55:49 > 0:55:50We're going to try.
0:55:53 > 0:55:57The truth about HIV is that its treatment has been
0:55:57 > 0:56:01one of the biggest breakthroughs in medical history,
0:56:01 > 0:56:04but it's a disease that's not going away.
0:56:06 > 0:56:09And many people are still diagnosed too late.
0:56:11 > 0:56:13We have a potential end in sight,
0:56:13 > 0:56:15but we have to get rid of the stigma
0:56:15 > 0:56:18and we have to get rid of the hate and the shame.
0:56:18 > 0:56:23Science has already given us the tools we need to defeat HIV.
0:56:23 > 0:56:26What a fantastic thing for humanity to be able to say,
0:56:26 > 0:56:29you know, "We've cured HIV."
0:56:29 > 0:56:32Let's start in the UK. Let's lead by example.
0:56:33 > 0:56:36We've got some of the most powerful drugs in medicine
0:56:36 > 0:56:39that mean people can live long, healthy lives with HIV,
0:56:39 > 0:56:42and crucially, they'll be uninfectious.
0:56:42 > 0:56:46We even have pills that you can take that prevent you catching the virus
0:56:46 > 0:56:50in the first place. Pills that are now available on the NHS,
0:56:50 > 0:56:52in Scotland at least.
0:56:52 > 0:56:54The money you spend on PrEP will save you all that treatment.
0:56:54 > 0:56:58I mean, it's like... It doesn't make any sense not to put it out there.
0:56:58 > 0:57:00It's just an economic no-brainer.
0:57:02 > 0:57:05So it seems to me that the remaining challenge is about harnessing social
0:57:05 > 0:57:06and political will
0:57:06 > 0:57:10to put these scientific breakthroughs to best use.
0:57:10 > 0:57:15Because if we can do that, I believe we can bring the epidemic to an end.