Using antiretroviral drugs has been shown to decrease risk of transmission, according to a recent study at the University of North Carolina at Chapel Hill.
HIV/AIDS has been the 21st century’s version of the Black Plague. However, unlike the plague, it takes a lot more than a few antibiotics to kill this bugger.
A landmark new study has shown that the use of anti-retroviral drugs can actually prevent HIV transmission. Myron Cohen, director of the Institute of Global Health and Infectious Diseases UNC, led the project.
Over the course of six years, Cohen studied transmission rates among discordant couples—couples in which one partner is HIV positive and the other is not. Half of the infected partners were provided with anti-retroviral drugs. To maintain the standard of research ethics, all were provided with safe-sex counseling, free condoms, and regular check-ups.
The study found that only 28 out of over 1,700 previously HIV-free partners were infected.
While these results are monumental, it is important to note that Cohen’s study focused on preventing transmission only in discordant couples. So yes, the study was wildly successful, but only for a specific risk group. The HIV/AIDS epidemic targets many walks of life, often those that are weakest and least able to care for themselves or partake in one of these experimental studies.
Even though the study holds many implications for the future of treatment and prevention of HIV/AIDS, the battle is far from over. As Cohen stated in an email, “policy follows science.”
HIV/AIDS policy has been controversial to say the least. In a debate as notorious as the chicken-egg dilemma, politicians have been arguing for decades over whether to focus on prevention or treatment.
“In a world where we have limited funds, new opportunities mean more funding,” said Michael Miller, adjunct associate professor of global health and former deputy assistant administrator for global health at USAID. “You have to be very careful about what new things you fund versus what you already fund.”
According to The Economist, it would take about $25 billion a year to more effectively combat HIV/AIDS. Currently, only $17 billion is being spent.
So if we were to implement a prevention program based off of Cohen’s study, what would it cost? Cohen placed patients on ARV’s much earlier in the progress of the disease than usual, and ARV drugs are notorious for being spendy. Earlier treatment means more ARV’s, more ARV’s mean more money – and money, as we all know, does not grow on trees.
“Once you put somebody on treatment, if there’s no cure for AIDS, you’re obligated to keep that person on treatment forever,” Miller said.
So if we choose to fund such at treatment, we have to fully commit. We can’t pay for people’s drugs and then say 'just kidding, we need the money for something else now.'
“There are many challenges in broadly implementing [ARV] for all HIV-infected persons,” John Bartlett, director of the AIDS Research and Treatment Center at Duke, wrote in an email. “But even success in reaching a portion of them will result in decreased transmission and aversion of new cases.”
Despite innumerable setbacks and issues, progress is being made. New infection rates have decreased over the past decade – from 3.1 million infections annually to 2.6 million, according to The Economist.
Hopefully, with the help of more successful studies like Cohen’s, the trend will continue and we will finally someday eradicate this plague.
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