Roll Out Treatment as Prevention Now to Stop HIV and AIDS

Roll Out Treatment as Prevention
Now to Stop HIV and AIDS

Lancet column calls for immediate,
collaborative expansion of global HIV strategy
Vancouver, British Columbia and Rome (July 15, 2011): The Lancet, a leading global medical journal, published an editorial comment today that emphasizes the critical role of expanding access to HIV treatment under a “Treatment as Prevention” strategy to stop the HIV pandemic.

The publication of the editorial comment coincides with the opening of the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011) taking place in Rome, Italy from July 17-20. The conference, the biggest open scientific AIDS conference in the world, will feature numerous presentations on Treatment as Prevention.

The commentary – by Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS (BC-CfE) and Past President of the International AIDS Society (IAS) – strongly reinforces the view that the benefits of highly active antiretroviral therapy (HAART) extend beyond the remarkable effectiveness of the treatment to prevent the onset of AIDS and prolong life, to dramatically reduce HIV transmission.

Based on HAART’s effectiveness in reducing transmission, Dr. Montaner is calling on the international community to support an immediate and expanded roll out of HAART under the Treatment as Prevention strategy, as pioneered by the BC-CfE in British Columbia, Canada.

“Treatment as Prevention is one of the most important and promising additions to the range of prevention strategies available to us today,” said Dr. Elly Katabira, President of the IAS and Chair of IAS 2011. “Dr. Montaner’s column is a rallying call for the universal endorsement and funding of this approach for the benefit of our future generations.”

The Treatment as Prevention strategy advocates for widespread HIV testing and facilitated access to free HIV treatment for all medically eligible HIV-positive individuals. Current HIV treatment reduces the level of HIV in the blood to undetectable levels, thus improving the health of HIV-positive individuals. At the same time, the treatment decreases the level of HIV in sexual fluids to undetectable levels, thereby reducing the likelihood of HIV transmission by over 90 per cent.

“The evidence is clear: treatment conclusively prevents morbidity, mortality and transmission,” said Dr. Montaner. “We now have ample and compelling evidence that treatment prevents HIV transmission during pregnancy and breastfeeding, as well as in sexual and injection drug use settings. The challenge remains to optimize the impact of this valuable intervention. Failure to do so is not an option.”

A recent study by the US National Institutes of Health (NIH) reported that immediate use of HAART led to a 96% decrease in the risk of HIV transmission among heterosexual couples where one partner is HIV positive.

“These results are a real scientific breakthrough and a game changer in the response to HIV,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “We must embrace Treatment as Prevention as part of a combination prevention strategy to achieve our collective vision of zero new infections and zero AIDS-related deaths.”
The Treatment as Prevention model has been embraced by UNAIDS and the World Health Organization within the Treatment 2.0 initiative, announced last year as a central pillar of the global strategy to respond to HIV.
In February 2011, in consultation with the BC-CfE and the Chinese Centre for Disease Control and Prevention (China CDC), China became the first country to incorporate Treatment as Prevention as part of its national HIV/AIDS strategy to control HIV/AIDS over the next five years.
For a free abstract of this paper, please use the following link, which will go live at the time the embargo lifts:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60821-0/abstract

About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. It is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including Health Authorities, health care providers, academics from other institutions, and the community to improve the health of British Columbians living with HIV through developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses.
Starting in the early 2000s, the BC-CfE-pioneered the "Treatment as Prevention" strategy, which promotes increased testing and facilitated access to antiretroviral treatment for all medically eligible HIV-positive people in order to stop the progression of HIV infection to AIDS or death, and simultaneously halt the spread of HIV and AIDS. Treatment as Prevention is recognized and supported internationally by organizations including the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). Additionally, China has implemented a national HIV and AIDS policy based on the BC-CfE’s Treatment as Prevention strategy.
In February 2010, the B.C. government funded and launched a $48-million pilot project called Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) to further capitalize on the early gains associated with the BC-CfE’s Treatment as Prevention strategy. Led by the BC-CfE, this four-year initiative will be implemented in collaboration with provincial stakeholders to improve access to HIV testing, treatment, and support services in designated areas within British Columbia.
About the International AIDS Society www.iasociety.org
The International AIDS Society (IAS) is the world's leading independent association of HIV professionals, with 16,000 members from 190 countries working at all levels of the global response to AIDS. Our members include researchers from all disciplines, clinicians, public health and community practitioners on the frontlines of the epidemic, as well as policy and programme planners. The IAS is the host of the IAS Conference on HIV Pathogenesis, Treatment and Prevention. The 6th edition is to be held in Rome July 17-20, 2011. www.ias2011.org The IAS is also the custodian of the biennial International AIDS Conference, which will be held in Washington, USA, from 22 to 27 July 2012. www.aids2012.org

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