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Treatment as Prevention of HIV Transmission


July 27, 2012 (Washington, DC) — "The paradigm for use of antiretroviral therapy has shifted; treatment and prevention have converged," a panel from the International Association of Physicians in AIDS Care (IAPAC) announced here at AIDS 2012: XIX International AIDS Conference.
The foundation of the approach requires treatment as soon as HIV-positivity is established and the use of preexposure prophylaxis, said José M. Zuniga, PhD, MPH, a member of the IAPAC from Washington, DC.
"Successful treatment as prevention will require higher levels of HIV testing, enhanced linkage to and retention in care, access to quality treatment, adherence support, and new ways to monitor coverage and treatment," reports the IAPAC panel in its consensus statement.
Julio Montaner, MD, director of the British Columbia Center for Excellence in HIV/AIDS, chair in AIDS research and head of division of AIDS at the University of British Columbia in Vancouver, Canada, and past-president of the International AIDS Society, told meeting attendees that this should put to rest any discussion: "Treating the individual helps them but also helps reduce transmission of the virus.... Early treatment reduces morbidity, mortality, and transmission."
"It is no longer a matter of whether we want to treat or if we can; now we know we have to," Dr. Montaner explained.
"I think we can curb the AIDS epidemic," copanelist Kenneth Brayer, MD, professor of medicine and of epidemiology at Brown University in Providence, Rhode Island, told Medscape Medical News. "There are compelling data that these efforts work."
"We need to decriminalize treatment," Dr. Montaner added. Efforts at HIV detection and treatment directed at prison populations and sex workers are well underway in Canada, he said. Convincing politicians that early access to affordable treatment decreases morbidity and mortality and reduces HIV transmission is something that needs to be tackled, he noted.
"Our challenge is how to convey hope...that ending AIDS is more than a cliché," Dr. Zuniga said.
The speakers have disclosed no relevant financial relationships.

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