Earlier this week, three announcements about HIV/AIDS lent an optimistic view towards the regression of this nearly-30-year-old world-wide pandemic.
The first was a report issued by UNAIDS (The Joint United Nations Programme on HIV/AIDS). In just six years, global death rates from HIV/AIDS have fallen by 20% – largely due to the increase of new and more available treatments. It also recognized that “ virtual elimination of mother-to-child transmission of HIV is possible.” If true, this feat would have an exponential effect in preventing transmission by eliminating an entire generation of HIV patients that are capable of transmitting the virus their entire life.
The second glimmer of hope was an article, published in the New England Journal of Medicine, which announced the success of a pre-exposure prophylaxis (PrEP) against prevention transmission of the HIV virus. This large international clinical trail, conducted specifically among men who have sex with other men, concluded that using a daily oral antiretroviral drug (currently in use to treat infection) reduced the risk of HIV infection by an average of 43.8%. Even better – the men who dutifully followed the daily dose regime (rather than falling out of the pattern, like some patients inevitably do) experienced a 72.8% rate of effectiveness. The next step of this trial is to extrapolate it to other populations, like women and heterosexual men.
Figure 3. HIV Incidence among Subjects Receiving FTC–TDF, According to Subgroup from "Preexposure chemophylaxis for HIV prevention in men who have sex with men." The efficacy of emtricitabine and tenofovir disoproxil fumarate (FTC–TDF) is 1 minus the hazard ratio. Hazard ratios of less than 1 indicate efficacy, and 95% confidence intervals (shown by horizontal lines) that do not cross 1 indicate significant evidence of efficacy. All subgroup analyses were prespecified except for testing for herpes simplex virus type 2 (HSV-2) at screening and pill use at the rate of 90%. P values for the intention-to-treat analysis and the modified intention-to-treat analysis apply to the hypothesis of any evidence of efficacy; P values for other comparisons refer to the hypothesis that efficacy differed between the two strata. NA denotes not applicable, and URAI unprotected receptive anal intercourse.
Finally, against the chagrin of devote Roman Catholics, it looks like the Vatican is suggesting that condoms are a lesser evil than transmitting HIV. Some ambiguity remains as religious conservatives adamantly maintains that condom use is immoral – preventing child birth – and the church is NOT endorsing condoms as a method of birth control of means of AIDS prevention. Let’s be reminded that not even a year ago, the pope had told reporters AIDS was not going to be relieved by using condom and that “on the contrary, it [condoms] increases the problem.”
This post was written by melissa.frick
Tags: aids, clinical trials, condoms, hiv, mother-to-child, prevention, prophylaxis, risk, UNAIDS
