May 4, 2012
There is good news, and there is complex news.
That’s the message that sex health researcher Graham Brown, a senior fellow at LaTrobe University, helped spread to Berlin conference goers at the ‘Improvement and Effectiveness in HIV Prevention’ seminar recently.
Experts from LaTrobe’s Australian Research Centre for Sex Health & Society shared ways to apply last year’s dramatic research findings on AIDS prevention to community treatment and prevention programs.
“One of the big challenges facing community organisations is actually how to respond to the great news that AIDS treatment can also prevent transmission,” Dr Brown said.
The US National Institute of Allergy and Infectious Diseases funded a 13-nation study of 1700 couples, and its findings were brought forward on the strength of its data results.
The study found that anti-retroviral treatments could maintain low viral levels among HIV positive people and keep them well, and were 96 per cent effective in preventing re-transmission of the virus to partners.
This effectiveness almost matches use of condoms, shown to offer 96 to 98 per cent protection.
In a statement, Michel Sidibe, Director of the UN’s HIV/AIDS Program, welcomed the findings as a “major game-changer” in preventing spread of the disease.
Strategies to treat a big portion of the world’s 33.3 million people with the disease will be affected, according to the AIDS Council of Australia.
Treatment effectiveness has already alleviated much stigma and discrimination caused by ignorance, fear and misconceptions about people with the disease, said Trish Langdon, Director of the WA AIDS Council.
Ms Langdon urges caution however in applying the present ‘population research’ to public messages on people’s personal decisions regarding their HIV status.
“This is the most complex and important area in the HIV world at the moment- no question, and it’s very, very much at the forefront in debating how to proceed,” Ms Langdon said.
She stressed the study findings were gleaned from many countries, including in Africa, where treatment had not existed before.
“This is not a panacea, and the message of ‘treatment as prevention’ could so easily mislead people to believe treatment is prevention,” she said.
Australia has more in common with Western Europe in terms of the sectors and levels of the community most affected by HIV, said Dr Brown.
He said this made the Berlin conference particularly important.
Dr Brown said the conference – with about 100 groups attending– was relatively small, designed around groups applying research in a practical context.
The next International AIDS conference in 2014 is expected to draw 25,000 attendees. It will be held in Melbourne, Australia.
Dr Brown concedes that not all health service providers agree on the best ways of advising people infected, or on community HIV prevention programs.
“Many argue that if the effectiveness in treatment is more widely known, it will remove the incentive for people to use condoms,” he said.
“It would be inaccurate for me to say that treatment was 100 per cent effective in preventing transmission.
“Condoms should always be part of the picture, but it’s not our business to restrict information.”
Dr Brown said treatments had improved in Australia over the past 10 years.
However, levels of new infections had remained largely the same, with people unaware of recently contracting HIV forming the biggest health risk to the community.
“In the 1980s, the message was easier – use a condom,” he said.
“But we should not ignore that this new research provides a great deal of hope to couples.
“Now, there are more options, better targeted treatments, but the message has gotten more complicated.”