Posted by: blog4globalhealth | 07/22/2011

TREATMENT FOR PREVENTION: THE LONG AWAITED SILVER BULLET?

Dr. Gitau Mburu shows importance of targeting at risk populations

The just concluded IAS conference in Rome this week has seen an unprecedented call for treatment as prevention for HIV. This comes in the wake of new data from the HPTN 052 trial results showing that HIV positive people who take combination antiretroviral therapy can reduce the risk of transmitting the virus to their HIV negative partners by more than 96 percent. This is a significant study which adds to the growing evidence on benefits of treatment not only for individual health but for prevention.

In the face of limited resources, key will be whether to provide antiretroviral therapy for someone who needs it for their own health or to someone else who wants to protect their HIV negative partner. In many ways this study highlights the need for universal access to HIV treatment for anyone who needs it.

It’s also worth reminding ourselves that even in the unlikely event that full implementation of treatment for all eligible individuals is achieved, combination prevention still remains a cornerstone principle for prevention of HIV.

In other words, this is not a silver bullet and a variety of approaches will still be required to achieve prevention of HIV transmission.

In the meantime, low access to HIV care and treatment continues to be a sad reality for many people living with HIV. Today, more than 9 million people who desperately need antiretroviral treatment to stay alive do not have access to it. Unless we dramatically increase access to HIV care and treatment, more people, including children living with HIV will continue to face ill health and death.

Thus the announcement by the Drugs for Neglected Diseases Initiative at the IAS conference to launch new drug development program to address the unmet treatment needs of children with HIV is a welcome step towards universal access to antiretroviral therapy.

The number of children and adolescents living with HIV is growing, particularly in low-income countries with high HIV prevalence, with an estimated 120,000 infected children and adolescents living with HIV at the end of 2009. Yet the needs of these young people are frequently left out of national HIV responses in poor countries.

In a study by the Alliance in Zambia, many of the adolescent respondents were determined not to let HIV alter their lives but they often had limited knowledge about sexual and reproductive health which adversely affects their ability to practice safer sex and prevent HIV.

We need stronger health systems that can ensure that such adolescents can access appropriate services and can transition seamlessly into adult care. This is one example that once again clearly demonstrates the need for the global AIDS response to be carefully tailored not only to geographic patterns of the disease, but also to particular populations at risk. It is a reminder that while the current treatment as prevention agenda is naturally exciting, the reality on the ground is somewhat different, and calls for a more comprehensive approach.

Dr Gitau, Mburu, Senior Adviser, International HIV/AIDS Alliance



Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories

%d bloggers like this: