This is a companion article to the feature, “Battling the STD and HIV Epidemic.”
Despite the daunting number of people infected with the human immunodeficiency virus (HIV) worldwide, the outlook for state-of-the-science treatment, prevention, and cure continues to improve.
“New evidence from the Strategic Timing of Antiretroviral Treatment (START) study demonstrates that initiation of antiretroviral therapy early in the course of infection is beneficial to individuals infected with HIV,” observes Joe Medeiros, director of North American marketing for virology solutions at Alere Inc, Waltham, Mass.1 “In addition, individuals who are considered at high risk for HIV infection now have access to pre-exposure prophylaxis, a combination of medicines that has been shown to reduce the rate of HIV transmission to those who are not infected.”2
Meanwhile, progress toward achieving the goals of the US National HIV/AIDS Strategy has been steady, but slow and somewhat inconsistent.3 Released in 2010, the national strategy established three goals with measurable targets to be achieved in 2015, including:
- Reduce the number of people who become infected with HIV.
- Increase access to care and optimize health outcomes for people living with HIV.
- Reduce HIV-related health disparities.
In its progress report for 2013, CDC reported that 12 of the 21 objectives associated with the national strategy’s goals (62%) had been met or exceeded. But progress toward five objectives (24%) showed no change or moved away from the annual target, and progress on three objectives (14%) could not be compared with the annual target.4
Since the 2009 publication of findings from the RV 144 HIV vaccine trial conducted in Thailand, the global scientific community has significantly increased its concentration on developing a vaccine to cure HIV.5 “The findings of this study provided the first supporting evidence of any vaccine’s potential effectiveness in preventing HIV transmission,” notes Medeiros.
Speaking at a recent conference, Carl W. Dieffenbach, PhD, director of the division of AIDS at the National Institute of Allergy and Infectious Diseases, observed that more than 70 HIV vaccines are currently undergoing research and development.6 Current approaches to vaccine development include the use of broadly neutralizing antibodies that prevent the transmission of HIV. With the development of a successful HIV vaccine within our grasp, Dieffenbach asserted, the time is coming when healthcare providers will have all the tools necessary to bring the HIV pandemic under control.
- The START HIV treatment study. [Online Questions and Answers.] Bethesda, Md: National Institute of Allergy and Infectious Diseases, 2015. Available at: www.niaid.nih.gov/news/QA/Pages/STARTqa.aspx. Accessed June 29, 2015.
- Pre-Exposure Prophylaxis (PrEP). [CDC Fact Sheet.] Atlanta: Centers for Disease Control and Prevention, 2015. Available at: www.cdc.gov/hiv/prevention/research/prep. Accessed June 29, 2015.
- National HIV/AIDS strategy for the United States. Washington, DC: The White House Office of National AIDS Policy, 2010. Available at: www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf. Accessed June 29, 2015.
- National HIV Prevention Progress Report, 2013. Atlanta: Centers for Disease Control and Prevention, 2013. Available at: www.cdc.gov/hiv/pdf/policies_NationalProgressReport.pdf. Accessed June 29, 2015.
- Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S, et al. Vaccination with Alvac and Aidsvax to prevent HIV-1 infection in Thailand. N Engl J Med. 2009;361(23):2209–2220; doi: 10.1056/NEJMoa0908492.
- Dieffenbach CW. Prevention, where are we headed? [Presentation slides.] Presented at the 2015 National Summit on HCV and HIV Diagnosis, Prevention and Access to Care. Arlington, Va: 4–6 June 2015. Available at: www.hivforum.org/storage/documents/2015/Summit/Plenary/PL3_07_Dieffenbach.pdf. Accessed June 29, 2015.