by Cheryl Overs
The recent Lancet publication of the HPTN 052 study has shown unequivocally that initiation of anti-retroviral treatment (ART) by people with HIV substantially protects their HIV-uninfected sexual partners from acquiring HIV infection, with a 96 percent reduction in risk of HIV transmission.[1]
The announcement in June is a welcome confirmation of what many already suspected – that ART is prevention. The word ‘game-changer’ was, not surprisingly, all over the internet within hours of the publication of the announcement of the closure of the trial. But so were questions about where this leaves the existing approaches to HIV prevention and promotion of sexual and reproductive health. Sex worker advocates immediately recognised that this new evidence could have a significant effect on both the actual conduct of commercial sex and on the programmes, public health policy and legal frameworks around it.
Article in the Lancet, Volume 377, Issue 9779, Page 1719, 21 May 2011.
This article gives more detail on the recent trial of HIV treatment as a form of HIV prevention.
An article by Granich RM, Gilks CF, Dye C, et al in the Lancet 2009, 373: 48–57.
The news that people living wtih HIV who are on antiretoviral therapy will have a huge effect on HIV programming for sex workers. It suggests that ARV therapy rather than condom promotion may account for the huge reduction in HIV transmissions during commercial sex over recent years. It also raises the question of whether voluntary testing should be replaced by routine testing. What it definitely raises is the importance of free access to ARVs, nutrition and adherence support for all.
