D Gregory Smith

Study: Early HIV Treatment Could Sharply Cut Infection Rate

Filed By D Gregory Smith | April 16, 2011 12:00 PM | comments

Filed in: Living
Tags: HIV/AIDS, medication, MSM, reducing HIV infection, reducing HIV transmission, starting HIV meds, testing, UCSF

Science Daily reports a new study finds that starting antiretroviral treatment soon after HIV diagnosis could cut mission-uganda.jpgthe rate of infection by almost 60 percent over five years.

Recent evidence suggests that, in addition to benefiting the individual, HIV treatment can reduce the likelihood of HIV transmission to other persons. We found that, just by changing the strategy of when to start treatment in individuals already in care, our model predicts significant reductions in new HIV infections among men who have sex with men in San Francisco.

Experts still don't agree about when exactly to start antiretroviral therapy. Some argue that the virus does a lot of damage, even before it becomes "active" and reduces the CD4 count significantly enough to warrant treatment. For them, it is important to suppress the virus as soon as possible. Others say that the medications themselves are damaging and a person with HIV shouldn't take them until absolutely necessary.

I tend to gravitate toward the first camp. Here's why:

  • If the virus is suppressed, it is less likely to do damage to the body - we know it's in there, and it may be hiding, but most experts agree it's doing some kind of damage. Microscopically, maybe, but it's still damage. And I wouldn't recommend it. I was diagnosed late, and there are things cropping up that can be linked to the virus running rampant through my body for far too long. I don't want anyone else to go through that - it seems cruel. More cruel than medication side-effects have ever been.
  • If the virus is suppressed, it is less likely to be transmitted to someone else. And if every HIV+ person were taking antiretrovirals, the amount of the virus available to be spread would be greatly reduced. And the infection rate would just as likely be reduced.
  • If the virus is suppressed, the health of our community would be greatly increased. The risks of medication for me are not as great as the risk of HIV doing a number on my body in ways I may not discover until it's too late. The effects of medication on the body can be monitored, and are, frequently, if you're in care.

The problem is testing.

We don't do it. Well, not as often as we could, anyway. But maybe this will give us a better reason to.

Read the full article here. Then go get tested. It's an investment in your long-term health- and the health of our community.

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One of the reaons people avoid testing is the massive healthcare and other discrimination that can come along with diagnosis. A decent healthcare system and enforcing non-discrimination policies would be a good step there. Also, actually making meds available to low income people is a big issue, obviously.

As to whether the side effects are worth it for early treatment, that could vary a lot between patients. As with any drug, some people will have harsher side effects than others and some people will have other conditions or medications to consider. Leaning towards early treatment where the person does not have other contraidicatoins and responds well sounds like a decent idea.

I'm glad you mentioned drugs for low income people, cat. With adap underfunded in most states & obamas budget cutting HIV/AIDS funding, what do we think are the chances that aspect will get overlooked?

The issue of funding an epidemic, vs funding a reduction of infection seems a no-brainer.
But, you're right, stigma, fear and just plain ignorance will probably keep this from happening.

Denial is a powerful thing.

The re:solve AIDS project is raising money to get a promising AIDS vaccine through human testing so that it can be produced and made available to the public. Check it out http://ResolveFromCDF.org