Almost four years ago I wrote a blog post titled “Advocating a treatment that may not help the treated?”, which was in response to the news that starting treatment with antiretroviral drugs immediately rather than waiting until the then standard of falling below a CD4+ count of 250 significantly reduced transmission of HIV among HIV-discordant couples. The study also reported effects on the health of the HIV-infected partner and found that the evidence for any beneficial effects for the person being treated were weak at best.
A new study presented at Conference on Retroviruses and Opportunistic Infections found that a community intervention (a package that improves take-up, provides community engagement, and post-test support)
If you are interested in HIV prevention, at some point you are likely to have heard “transactional sex” discussed as one of the issues. However, I find this discussion to usually be awkward and confused, especially among Western audiences: the user is feeling somewhat uncomfortable using the term and the audience is having trouble understanding what it is she exactly means. The frameworks we have in the U.S. are dating on one end and commercial sex work on the other.
With funds devoted to HIV/AIDS declining, there has not been a better time, at least in the past decade or so, to optimize the use of the limited resources between treatment and prevention.
For the World AIDS Day, there is a sign at the World Bank that states that taking ARVs reduces rate of HIV transmission by 96%. If this was last year, a sign somewhere may well have read “A cheap microbicidal gel that women can use up to 12 hours before sexual intercourse reduces HIV infection risk by more than half – when used consistently.” Well, sadly, it turns out, so much for that.
In this article in the NYT from a few weeks back, there is this quote from Dr. Stefano Bertozzi, director of H.I.V. and tuberculosis for the Bill and Melinda Gates Foundation:
An interesting, recently revised working paper by Duflo, Dupas and Kremer looks at the effects of providing school uniforms, teacher training on HIV education, and the two combined. This paper is useful in a number of dimensions – it gives us some sense of the longer term effects of these programs, the methodology is interesting (and informative), and finally, of course, the results are pretty intriguing and definitely food for thought.