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Getting the treatment-as-prevention
(TasP) strategy to work as well in the real world as it has in trials may be
difficult, experts suggest in a series of articles published Tuesday. Many
barriers, including capacities and cost-effectiveness, could hamper the success
of using antiretroviral therapy (ARVs) to stop new HIV infections, the experts
wrote.
“The field is split about whether
it’s really the best thing and it’s going to stop transmission, or if it’s a
small part of the puzzle,” said Timothy Hallett, an epidemiologist at Imperial
College London and co-author of one of the articles.
Early treatment “can have an impact,
but it’s not going to eradicate HIV,” said David Wilson, a University of New
South Wales epidemiologist whose study appears in the collection. He looked to
four places where testing and treatment linkage were already emphasized:
British Columbia, San Francisco, France, and Australia. In best-case Australia,
treatment is freely available and about 70 percent of people with HIV are on
it. Nonetheless, new HIV diagnoses there grew from 700 per year in 1999 to
1,000 annually in 2011, Wilson said.
People need to get tested regularly;
start ARVs once they test HIV-positive; and adhere to ARVs for their whole
lives to control the virus, said Wilson. Failure on any of these points reduces
TasP’s potential, he said.
However, one important implication
from TasP efforts has been that treatment and prevention do not have to compete
for resources, said Dr. Anthony Fauci, director of the National Institute of
Allergy and Infectious Diseases. A critical goal now is reaching and treating
those people who do not know they are infected with HIV, he said.
[PNU editor’s note: To access the
collection of 10 articles about TasP, published Tuesday in Public Library of
Science (PLoS) Medicine, visit: http://www.ploscollections.org/TasP2012.]
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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