Treating HIV Patients Protects Whole Community
Epidemiologists from Harvard University followed 17,000 HIV-negative South Africans for seven years in the province of KwaZulu-Natal. They found that, when more than 30 percent of HIV-positive people are on powerful anti-HIV drugs, it cuts the risk of contracting the virus by about 38 percent, compared to when less than 10 percent of those infected have treatment.
"The intention of this program [the South African government's antiretroviral drug program] is not treatment as prevention," Till Barnighausen, a health economist who contributed to the study, tells Shots. "The intention of this program is treatment for treatment, to save lives."
A true treatment-as-prevention model, Barnighausen says, would offer antiretroviral therapy to everyone who is HIV positive. But the South African government is providing medications only to the sickest of the sick.
Nevertheless, Barnighausen and his colleagues saw a sharp reduction in new HIV infections when drugs were widely available to the community.
"It is a program with all the failures and challenges of a real-life, public-sector, nurse-led program in southern Africa," Barnighausen says. "And despite these challenges, we see a strong effect of HIV treatment on HIV incidence. And that's extremely encouraging."
Infectious disease specialist Dr. Myron Cohen at the University of North Carolina, who wasn't involved in this study, calls the findings "a home run."
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