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Treatment IS Prevention

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Gus Cairns
Member
Posts: 257
Treatment IS Prevention
Posted on: June 8 2011, 05:43 pm

I want you to sign on to this (there's the smack of authority): http://www.avac.org/ht/d/sp/i/34301/pid/34301

For the non-HIV policy wonks, this statement is in rather technical language but basically it says "This study [ACTG 5202] has proved that if you stick people on HIV drugs it makes them 20 times less infectious, so let's stop messing around with ideologically-driven HIV prevention and get as many people on treatment as we can. We need to fund other stuff too, including safer-sex support and condoms, but only if it's been shown beyond all shadow of doubt to work".

It's in cautious language but that's because it was got together by a really disparate coalition of people involved in HIV ranging from ankle-biting activists (including me) through respected scientists to US government reps. HIV infections are starting to go down and if we build a really strong coalition behind evidence-based and rational prevention, they will go down a lot faster.

Best, Gus
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john@tcell.org.uk
Member
Posts: 136
Re: Treatment IS Prevention
Reply #1 on: June 8 2011, 06:00 pm

What no "Please"? (LOL)

"For the first time in the 30 years of the AIDS epidemic, there is now conclusive evidence showing that earlier initiation of highly active combination antiretroviral therapy (ART) at 350-550 CD4 cells/mm3 is a highly powerful tool for preventing transmission to sexual partners and has clinical benefit for HIV-positive people."

Was enough, signed.  Though I have argued that starting treatment above current guidelines should be considered carefully because if a patient want to commit to therapy, earlier, than it seems to me they are likely to be more adherent and have a better treatment outcome.
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kevinkelleher
Guest
Re: Treatment IS Prevention
Reply #2 on: June 8 2011, 07:48 pm

Given the toxity and side effects, if you get the treatment right in the first place, at a current cost to the NHS of about £5K pa, what is spend on prevention first before be go down this route?
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Mark Platt
Member
Posts: 290
Re: Treatment IS Prevention
Reply #3 on: June 9 2011, 05:46 pm

Done.
Of course, this research has major implications not only for the future of HIV prevention work, but for the drugs budgets of major metropolises, such as London... As I heard Peter Scott say earlier this week, too little HIV prevention money is actually spent on effective measures and interventions.
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Gus Cairns
Member
Posts: 257
Re: Treatment IS Prevention
Reply #4 on: June 10 2011, 01:17 pm

Good question, Kevin, which is why we need good cost-effectiveness studies. It may look daft to spend £5000 a year on ARVs when you could spend £50 on condoms but if it is true that most people with HIV would benefit from ARV treatment anyway (in these days of much reduced side effects) AND if all that money spent on condom provision and prevention ads hasn't curbed HIV infections, then that may turn out to be £5000 well spent.
Gus

Quote from: Kevin Kelleher on June  8 2011, 07:48 pm
Given the toxity and side effects, if you get the treatment right in the first place, at a current cost to the NHS of about £5K pa, what is spend on prevention first before be go down this route?
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Ben Cromarty
Member
Posts: 451
Re: Treatment IS Prevention
Reply #5 on: June 10 2011, 01:56 pm

We surely know by now that relying on condom use has not been effective - the number of new infections in the UK, for those infected in the UK as opposed to overseas, has been increasing steadily for both MSM and heterosexual infection for the past 10 years and more. Another (perhaps complementary) approach seems to be needed. As for side effects and toxicities, without in any way belittling them - for those of us who have experienced some of the older drugs, we know how difficult side effects can be - it does seem that the most recent drugs have fewer problems with side effects than the drugs of even 10 years ago. I guess we won't know about long-term toxicities for a while, though...but so far things look good.
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