British scientists think they can end HIV epidemic in 40 years

British scientists think they can end the HIV epidemic within 40 years by identifying and treating those infected with HIV with anti-retroviral medications, or ARVs.

In an article in the Independent, scientists argue that by implementing widespread testing and treatment of HIV, they will drop the incidence of HIV transmission to nearly zero. That, they say, will end the epidemic.

A study published in 2008 showed that it is theoretically possible to cut new HIV cases by 95 per cent, from a prevalence of 20 per 1,000 to 1 per 1,000, within 10 years of implementing a programme of universal testing and prescription of ART drugs.

“Each person with HIV infects, on average, one person every one or two years. Since people with HIV, and without treatment, live for an average of 10 years after infection, each person with HIV infects about five to 10 people,” Dr Williams said. “Treating people with ART within about one year of becoming infected would reduce transmission by about 10 times. Each person with HIV would infect, on average, less than one other person and the epidemic would die out.”

The article also notes that a study is starting in South Africa to see if this strategy works, and programs are already underway in Washington D.C. and Brooklyn New York to see if aggressive identification and treatment will reduce the incident of HIV infections in those cities.

Meanwhile, Detroit, in which over 50 percent of the zip codes have an HIV prevalence rate of three percent or higher (with one zip code ringing in with a six percent prevalence), has not made the national panic press, but Motor City leaders have called it a “crisis” and an “emergency.”

This move also ties into the use of ARVs in post exposure prophylaxis, in both occupational (medical) and non-medical exposures. Studies have shown the use of the medications can prevent a person exposed to HIV from being infected, if the medications are administered within 72 hours and for a total of 28 consecutive days following the exposure.

But as Michigan Messenger reported, the state does not have a cohesive policy when it comes to advising local health departments on the use of the medications in non-occupational exposure situations. A top ranking official for MDCH assured Michigan Messenger a new policy would be in place “early” in 2010. MDCH spokesman James McCurtis did not return a phone call seeking a status update on that promise by press time.

Incidentally, documents from the MDCH show that the state spends $25,706,072 for the state’s AIDS Drug Assistance Program (ADAP). Of that, $4.6 million is in from state coffers, and $6.5 million comes in rebates from AIDS drug manufacturers. The remainder comes from the federal government.

The ADAP program provides assistance to just under 2,800 people in the state, at an average per month cost to the program of $11,000 per person. The cost of ARV treatment is between $13,000 and $15,000 per year.

The state is also grappling with how to implement widespread HIV testing. A bill currently in the Senate Health Policy Committee would eliminate the necessity for those being tested for HIV to sign an in-depth consent form. That consent is mandated by state law. The MDCH supports the change, as do some medical groups. But HIV activists say the change is dangerous because people could unwittingly be diagnosed with HIV and be unprepared for the consequences of such a diagnosis.