Monday, September 16, 2019

We must embrace new prevention efforts to reduce HIV/AIDS infection

There were approximately 37.9 million people across the globe with HIV/AIDS in 2018. Of these, 36.2 million were adults and 1.7 million were children (15 years old). HIV, the virus that causes AIDS, is one of the world’s most serious public health challenges. But there is a global commitment to stopping new HIV infections and ensuring that everyone with HIV has access to HIV treatment.

As the third decade since AIDS was first recognized comes to an end, extraordinary advances have occurred in the understanding, treatment, and prevention of HIV infection and AIDS. As a result of these successes, it is now time to focus on future challenges. Paramount among these is reaching the goal of truly controlling and ultimately ending the HIV and AIDS pandemic.

To that end, AIDS researchers and public health personnel worldwide are aggressively pursuing 3 key areas of scientific research. Given the availability of highly effective therapeutic regimens for HIV infection, the first challenge is efficiently identifying a maximum number of HIV-infected persons through voluntary HIV testing and initiating antiretroviral therapy (ART).

Second, scientists are trying to develop a cure for HIV infection, which would alleviate the need for lifelong ART. Finally, preventing new cases of HIV infection, which currently number approximately 2.6 million per year globally, is critical to any attempt to end this pandemic.

What can governments do to prevent the spread of HIV?
To prevent the spread of HIV, governments can develop guidelines for healthcare providers on testing and medical care, educate healthcare providers and the public about the importance of HIV testing and medical care, and fund programs that support effective HIV prevention services and medical care.

National governments can also identify and track differences in medical care, illness, and death across different groups of people and help meet the goals of the National HIV/AIDS Strategy, including getting all people with HIV into care.

Governments and local health departments can fund programs that support effective HIV prevention services and medical care, create programs and policies to test people at risk for HIV early and often, provide information about where people can get an HIV test, and educate people about the benefits of HIV testing, regular care, and treatment.

Governments and local health departments can also get people who have HIV connected to HIV medical care, promote HIV prevention counseling and services as a regular part of care, support community actions to prevent new HIV infections and help people with HIV, and help meet the goals of the National HIV/AIDS Strategy, including getting all people with HIV into care.

Preventing HIV Infection
The most compelling goal of the HIV research agenda in the coming years is more effective HIV prevention. Preventing HIV infection is critical to the long-term goal of controlling and ultimately ending the HIV epidemic.

Many prevention methods with a strong evidence base already exist, such as behavioral and educational approaches, proper use of condoms, needle exchange programs, adult male circumcision, and ART for prevention of mother–child transmission of HIV. Yet worldwide, these proven prevention strategies, alone or in combination, are accessible to only a fraction of persons who would benefit from their implementation.

Devising ways of “scaling up” proven, integrated prevention methods would have an important effect on slowing the growth of the HIV epidemic. Implementation of proven HIV prevention strategies needs to be bolstered with the development and validation of additional, effective prevention tools, such as ART-based prevention methods and a safe and effective HIV vaccine.

Conclusion
HIV, the virus that causes AIDS, is one of the world’s most serious public health challenges. These pandemic won't be defeated with existing tools.  ARVs are the only option we now have to prolong life. Innovative strategies to provide ARVs more efficiently to patients who need them have to be developed.

ARV treatment is possible even in the poorest and most difficult settings, despite the challenges. We must be more ambitious and invest resources into vaccine research, immunotherapy and other easy-to-use therapeutic approaches too.

Governments, International donors and health care providers, including medical NGOs must mobilize the necessary financial and human resources to make ARVs available to those who need them. At the same time we need to boost efforts to simplify current treatment and monitoring tools

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