Breakthrough of the Year: HIV Treatment as Prevention
Until 2011, the prevention of HIV/AIDS transmission using anti-retroviral drugs (ARVs) was considered to be a myth. Government and health organizations, including the WHO, stresses that the use of barrier contraception methods, such as condoms, was the essential component in preventing HIV transmission. The main reason for such misconception was that there were no conclusive and reliable studies showing the effectiveness of ARVs in preventing HIV transmission. However, in 2011, researchers presented results of a clinical trial that confirmed the 96% reduction in transmission following the use of ART. Thus, the research became the breakthrough of the year as it shifted the previous misconceptions about HIV/AIDS prevention by proving the effectiveness of ARVs in reducing transmission.
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Consequently, the breakthrough also affected the global fight against AIDS in at least two aspects. First of all, it offered sound evidence for the use of ARVs in HIV/AIDS prevention. Reducing the rates of HIV transmission on a global level, in turn, could lead to the reduction of HIV/AIDS prevalence, thus helping to eliminate AIDS. Secondly, the discovery helped to reduce the stigmatization of HIV and AIDS in society by showing that transmission can be controlled with adequate treatment. The reduced stigma associated with HIV and AIDS can help to improve testing rates among the general population, thus contributing to the effect of prevention and treatment efforts.
The WHO guidelines on the use of ARVs have changed since the breakthrough in response to the evidence in favor of the earlier initiation of ART. Until 2011, the guidelines stipulated that the start of therapy should be based on CD4 cell count and the clinical stage; today, however, the WHO recommends ART for all HIV-positive adults, regardless of their clinical stage and CD4 cell count. The change in recommendations was largely due to the proven effectiveness of ART in reducing transmission rates among homosexual and heterosexual couples.