By Adam, January 14th, 2016 in
Why does this global pandemic continue to rage?
It is not that we lack the medical advances and interventions to end the pandemic. It is that our proven tools have not been implemented adequately or uniformly.
1. Treatment as Prevention
In the past 4 years studies show that treating HIV-infected individuals sooner rather than later dramatically diminished the likelihood that they would infect their sexual partners. The public-health benefit of treatment for the prevention of further transmission is clear. But, many argued that the health benefit of HIV medications to the infected person was unproven. This notion was laid to rest – in a study published last year – that showed that treating a person as soon as possible after diagnosis was much more beneficial than waiting until the person’s immune system showed damage. There is now no excuse for delay; every person infected with HIV should be offered antiviral drugs upon diagnosis.
But doing so requires seeking out those at risk for infection and testing them; linking infected individuals to medical care; working to keep them in care; and providing anti-HIV drugs. It also requires careful attention to barriers to care such as poverty, substance abuse, and housing and food insecurity. Globally and domestically, we have not yet achieved this.
2. HIV Testing
Of the approximately 1.2 million people living with HIV in the United States, the 13 percent who do not know they are infected are responsible for transmitting about 30 percent of new infections per year. Even more striking, more than 60 percent of new HIV infections are transmitted by people who are aware they have HIV but who are not receiving appropriate care. Thus, if we identified all the infected people in the country and got them into continuous, effective care, including anti-HIV treatment, we could prevent more than 90 percent of new infections each year.
3. HIV Prevention
For uninfected, at-risk individuals, several modalities of prevention are available: Condoms, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), abstinence & circumcision
The latest (and most exciting) HIV prevention tool, PrEP, was born out of a series of clinical trials that convincingly demonstrated that regularly taking a single pill (Truvada) containing two anti-HIV drugs can reduce an individual’s risk of contracting HIV by more than 90 percent. However, it is not yet recognized/blessed by Pubic Health bodies in most countries including Canada. Also in the US, where PrEP is approved by the FDA for HIV prevention, ess than 5 percent of these people are taking it. To make matters worse, one- third of primary- care doctors and nurses are unaware of PrEP and its potential health advantages. This must change.
We have the tools to end the HIV/AIDS epidemic in the United States and globally. We can save the lives of infected individuals and prevent them from infecting others by getting them into treatment programs and maintaining them there. In addition, we can effectively prevent HIV infection in at-risk populations by a number of means, including the use of the highly effective PrEP. Today, we have the tools to end this modern-day plague. We must not squander the opportunity. History will judge us harshly if we do.
Original Source: The Washington Post