By Paul Kawata, executive director, National Minority AIDS Council
Thirty years ago, the Centers for Disease Control and Prevention first reported on what would come to be known as Acquired Immune Deficiency Syndrome, or AIDS. Since then, advances in research and treatment have revolutionized the global response to the epidemic. From the first HIV diagnostic tests to the development of protease inhibitors and combination therapies, each step forward in science and medicine has spurred a transformation of both the epidemic as well as the services that are put in place to respond to it.
Today, the HIV/AIDS community finds itself in another transformative moment, but this one is unlike any other. This time, science and policy have combined to provide a pathway to end the epidemic altogether.
Thousands of clinicians, care providers, activists and advocates will gather at the U.S. Conference on AIDS in Chicago this week to discuss this very real possibility. Decades of investment in research are paying off in huge and unexpected ways, resulting in a series of exciting new weapons in the fight against HIV/AIDS. A recent study funded by the National Institute of Allergy and Infectious Diseases ( NIAID ) found that prescribing HIV medications to individuals at high risk for infection, including gay and bisexual men and transgender women, could reduce infections by as much as 73 percent when those individuals consistently took their medications. This method of prevention is known as pre-exposure prophylaxis or PrEP.
Another study, conducted by the HIV Prevention Trials Network, produced even more impressive findings, this time related to the concept of treatment as prevention. The study, 052, found that among sero-discordant heterosexual couples—meaning couples in which one individual is HIV-positive and the other HIV-negative—when an individual's viral load is reduced to undetectable levels through highly active anti-retroviral therapy ( HAART ) , the risk of transmitting the virus to one's partner was cut by as much as 96 percent. The importance of this study cannot be overstated. By routinely offering HIV testing to sexually active persons and providing universal access to care and early treatment for people who are diagnosed with HIV, we could reduce the number of infections by an astounding number.
Combined with traditional methods of prevention, including condoms, syringe-exchange and comprehensive sex education, treatment as prevention and PrEP could revolutionize how we fight the spread of HIV. At the same time, a series of public health initiatives have laid the groundwork for ensuring that these interventions can be put to use in the most effective ways possible. The National HIV/AIDS Strategy, released last year, set ambitious goals for reducing infections, increasing access to care and minimizing health disparities. And the Patient Protection and Affordable Care Act will increase access to care through its insurance exchanges and Medicaid expansion. This combination of policy and new prevention strategies has placed us in the best position to end the HIV/AIDS epidemic in more than 30 years.
But to fulfill the promise of this moment, we must work to ensure that the resources necessary to accomplish this are available. The U.S. economy continues to struggle and Congress is working to negotiate over $1 trillion in spending cuts to reduce our deficit. But now is not the time to relent. Each HIV infection that is prevented saves more than $350,000 in lifetime medical costs. Currently, 50,000 Americans are infected with HIV each year. Preventing all those infections would save billions of dollars, and thousands of lives. For the first time in 30 years, we have a pathway to ending this epidemic. Now is the time. Each of us must do our part to make this change real.
Paul Kawata is executive director of the National Minority AIDS Council ( NMAC ) based in Washington, D.C. NMAC is hosting the U.S. Conference on AIDS, the largest annual AIDS-related gathering in the country, in Chicago from Nov. 10-13, 2011.
This story is part of the Local Reporting Initiative, supported in part by The Chicago Community Trust.
