When “Treatment as Prevention” was named Science magazine’s Breakthrough of the Year in 2011, there was optimism that we were closing in on AIDS. Results published from the HPTN 052 trial that year showed that in discordant couples, giving antiretroviral treatment (ART) to people with HIV not only was good for their own health, but also lowered the levels of HIV in their blood to undetectable levels, making the chance of infecting their partners extremely unlikely. Continue reading →
Dr. Virginia “Ginny” Bond is a Social Anthropologist and Associate Professor at the London School of Hygiene & Tropical Medicine. Based in Zambia, she heads the social science unit at Zambart. She is the lead social scientist for PopART (Population Effects of Antiretroviral Therapy to Reduce HIV Transmission) a large community-randomized trial being carried out in 21 communities in South Africa and Zambia. The trial is designed to evaluate the impact of a universal test-and-treat intervention on population-level HIV incidence. Similar to HAI’s Botswana Combination Prevention Project, the goal of PopART is to dramatically reduce the number of new HIV infections.
Martha Henry, Executive Director of HAI, spoke over Skype with Dr. Bond in Zambia.
(Eton spent a gap year working with HAI in Boston and Botswana. He’s now a freshman at Harvard. This article originally appeared in the Fall 2015 issue of Harvard Science Review.)
The target is 2030. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has ambitiously set 2030 as the year by which we should achieve the end of the HIV/AIDS epidemic, which has claimed the lives of 39 million people globally since the first cases were reported in 1981.1 This past year, to help drive united progress and accountability towards the goal, UNAIDS articulated the 90-90-90 targets. If these goals are reached by 2020, UNAIDS predicts, then the AIDS epidemic could come to an end by 2030:
Goal 1: “By 2020, 90% of all people living with HIV will know their HIV status.”
Goal 2: “By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.”
Goal 3: “By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.”2
With no cure or vaccine in sight, HIV/AIDS remains a devastating epidemic, particularly in sub-Saharan Africa where nearly 70% of new HIV infections occur. To curb HIV/AIDS, researchers have proposed a strategy to use drug treatment to decrease new transmissions so much that the epidemic eventually dies out. The concept requires changes in standards of when anti-retroviral therapy begins and who receives it. Could “treatment as prevention” prove to be the strategy to finally end the AIDS epidemic?
How do your define ‘household’ in a culture where extended families split time between town, the farm, and a cattle post? Who else has had trouble enrolling men? What happens if several large, expensive clinical trials deliver completely different results several years from now?
“We strongly believe that with this project we have the chance to make history in the fight against AIDS,” said Michelle Gavin, U.S. Ambassador to Botswana, at the November 8th press conference in Gaborone announcing the launch of the Botswana Combination Prevention Project. Continue reading →
Researchers involved in a large multinational study recently announced that men and women with HIV who take antiretroviral drugs have a 96% lower risk of transmitting the virus to their sexual partners. The study results, just published in The New England Journal of Medicine, were hailed by AIDS experts as a game-changer. Continue reading →