AIDS 2008 - XVII INTERNATIONAL AIDS CONFERENCE (MEXICO) - 2

CALL FOR A MULTI-PRONGED APPROACH TO HIV PREVENTION – ‘MARRYING PREVENTION AND TREATMENT’

(condensed from the official press release of AIDS 2008)

6 August 2008 - In light of promising evidence of the potential impact of antiretrovirals on HIV prevention, and recent setbacks in other biological interventions, HIV experts at the XVII International AIDS Conference today called for a reinvigorated commitment to prevention research and accelerated implementation of proven prevention strategies. In 2007, 2.7 million people were newly infected with HIV worldwide, nearly 7,400 each day.

“Today, there are many effective strategies to prevent HIV, and all nations of the world must commit fully to their implementation,” said Dr. Luís Soto Ramírez, Local Co-Chair of AIDS 2008. He pointed out that too often stigma and discrimination continue to fuel counterproductive laws and policies that undermine prevention and treatment. Changing these attitudes needs to be a central component of any HIV prevention strategy.

Pointing out that in the recent past there have been some setbacks in the areas of vaccine and microbicides research, Dr. Pedro Cahn, International Co-Chair of AIDS 2008, decried the tendency to abandon all efforts to find other means to prevent new infections. Other speakers provided insights into current prevention research and programming, while highlighting the harmful effects of oppressive attitudes and policies, which inhibit the implementation of effective prevention programs. We need to increase basic science and vaccine research so as to reverse the course of the epidemic.

Despite important increases in HIV treatment access worldwide, it will be impossible to “treat our way out of the epidemic,” according to Dr. Myron Cohen (United States). Citing the central role that clinical and other HIV treatment providers have played in averting mother-to-child transmission with antiretroviral drugs, he mooted a greater partnership between treatment providers and those working in public health campaigns to prevent HIV. Reflecting on the need for a multi-pronged approach to prevention, Cohen iterated the urgent need to develop combination primary prevention strategies; reinvigorate research on HIV vaccines, other immune-based strategies, and antiretroviral prevention; and encourage people to learn their HIV status for the own health and the benefit of their sexual partners and communities. Cohen urged that once and for all, the HIV community marry HIV treatment and prevention.

Dr. Adeeba Kamarulzaman (Malaysia) highlighted the sorry plight of injecting drug users (IDUs) who are disproportionately less likely to have access to antiretrovirals. They are often faced with stigma and discrimination, inadequate health infrastructure, as well as a lack of access to HIV treatments during incarceration or internment in detoxification centres. To address these obstacles, Kamarulzaman urged the development of care models located in non-traditional health care settings that integrate HIV services with substance abuse, psychiatric, and primary care services. She also pointed out the lack of access to harm reduction strategies such as needle exchange programs (NEP) which have proven value in arresting the epidemic. Widespread prejudice and moralistic criticisms are a major obstacle. This is also reflected in the implicit contradictions between the United Nation’s public health approach to HIV, and the punitive focus of its drug control policies which tend to undermine efforts to provide HIV services to IDUs.

As part of Tuesday’s plenary, Dr. Jorge Saavedra (Mexico) delivered the Jonathan Mann Memorial Lecture, named in memory of scientist Jonathan Mann, who is credited with building the WHO’s AIDS Programme from the ground up. Saavedra provided a multi-dimensional overview of the HIV epidemic in men who have sex with men (MSM), specifically highlighting hidden epidemics among MSM in low- and middle- income countries, and factors that increase HIV risk and vulnerability across cultures. He profiled current budget outlays for MSM prevention programs, and provided examples of effective prevention strategies, including community-based interventions. Saavedra called for some specific policy changes including greater involvement of MSM in the planning of national AIDS responses, and the inclusion of MSM prevention strategies in the strategic plans of low- and middle-income countries. There is a great need for donors to both fund MSM programs, and include measures of responsiveness to MSM needs in programme evaluation.

For additional information, including programme information, abstracts, rapporteur and scientific summaries, transcripts and presentations from key conference sessions, please visit http://www.aids2008.org/