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Treatment

To save lives, HIV treatment alone isn’t enough. Suppressing HIV is what matters.

In 2011, a landmark clinical trial showed that early initiation of anti-retroviral therapy (ART) for people who are HIV-infected cuts the risk of HIV transmission by a stunning 96 percent. The trial provided powerful new momentum to global efforts to expand treatment access — both for the health of individuals living with HIV and for the potential to prevent millions of new infections.

Getting people onto treatment, though, is only half the story. To save lives and slow the HIV epidemic, treatment needs to achieve long-term virologic suppression — meaning the level of HIV in a person’s body is essentially undetectable. In most countries, only a minority of people with HIV have their virus in check. To make viral suppression the norm, better adherence programs, viral load monitoring and other steps are urgently needed.

What We're Reading

Imagine that 90 percent of all people living with HIV were diagnosed and treated with drugs. Would that be sufficient to end the AIDS epidemic? Scientists tried to answer the question in three enormous studies published on Wednesday in the New England Journal of Medicine. Instead of simply urging people to get testing and treatment for HIV, health workers in five African countries went door to door, or set up mobile sites, offering tests for HIV, tuberculosis and other diseases to everyone in certain communities.

July 17, 2019
New York Times

Universal test-and-treat strategies resulted in "modest to no reductions" in new HIV transmissions in three large population-based studies, writes Salim Abdool-Karim, MD, ChB, PhD, of the Centre for the AIDS Programme of Research in South Africa, in a commentary published online today in the New England Journal of Medicine. But that doesn't necessarily mean that expanding diagnoses and offering immediate access to HIV medicines is ineffective at stopping HIV transmission, said Myron Cohen, MD, of the University of North Carolina School of Medicine in Chapel Hill.

July 17, 2019
Medscape

The Opposites Attract and the PARTNER studies, provided the evidence that people with HIV who had an undetectable viral load were not infectious. A new analysis has now delved deeper into the actual sex and prevention behaviour of those who took part in Opposites Attract and found that couples were by no means just relying on the positive partner’s undetectable viral load to avoid the negative partner becoming infected.

May 1, 2019
aidsmap
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