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18 July 2011
Roll-out HIV treatment as a preventative, say medicos
by George Atkinson

Medical journal The Lancet has called for highly active antiretroviral therapy (HAART) to be used as a preventative in the battle against HIV/AIDS, a strategy the authors call "Treatment as Prevention." The publication of this controversial editorial coincides with the opening of the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention taking place in Rome.

The editorial - by Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS and Past President of the International AIDS Society (IAS) - strongly invokes the view that the benefits of HAART extend beyond its remarkable effectiveness at preventing the onset of AIDS. Specifically, the treatment decreases the level of HIV in sexual fluids to undetectable levels, thereby reducing the likelihood of HIV transmission by over 90 percent.

Based on HAART's effectiveness in reducing transmission of the virus, Dr. Montaner is calling on the international community to support an immediate and expanded roll out of HAART under the Treatment as Prevention strategy. "Treatment as Prevention is one of the most important and promising additions to the range of prevention strategies available to us today," said Dr. Elly Katabira, President of the IAS. "Dr. Montaner's column is a rallying call for the universal endorsement and funding of this approach for the benefit of our future generations."

"The evidence is clear: treatment conclusively prevents morbidity, mortality and transmission," said Dr. Montaner. "We now have ample and compelling evidence that treatment prevents HIV transmission during pregnancy and breastfeeding, as well as in sexual and injection drug use settings." A recent study by the US National Institutes of Health reported that immediate use of HAART led to a 96 percent decrease in the risk of HIV transmission among heterosexual couples where one partner is HIV positive.

The Treatment as Prevention model has been embraced by UNAIDS and the World Health Organization within the Treatment 2.0 initiative, announced last year as a central pillar of the global strategy to respond to HIV.

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International AIDS Society

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