Optimum implementations of treatment and prevention tools require ending HIV: Study

In a new study, the researchers from the National Institutes of Health Experts highlighted the best implementation of HIV prevention and treatment tools along with new interventions to end the pandemic.

The study was published in the journal, 'Clinical Infectious Diseases.'

Today, many highly effective HIV treatment and prevention interventions are available and such is an example of Antiretroviral therapy (ART) which not only improves health and prolongs the lives of people with HIV but also plays an important role in its prevention.

People suffering from HIV whose virus is durably suppressed to undetectable levels by ART, cannot sexually transmit HIV to others, a concept known as Undetectable=Untransmittable, or U=U. Antiretroviral drugs taken by people without HIV as pre-exposure prophylaxis (PrEP) are highly effective at preventing the acquisition of HIV.

Theoretically, the widespread provision of ART and PrEP could end the HIV pandemic. However, according to Anthony S. Fauci, M.D., director of NIH's National Institute of Allergy and Infectious Diseases, a gap exists between theory and reality.

Implementation gaps exist at all stages of the HIV care continuum. Progress in cities like San Francisco, which has dramatically reduced new HIV cases by deploying ART, PrEP and other tools, Anthony suggests that these gaps can be overcome. Such examples offer lessons for optimizing implementation strategies.

Even with the availability of simplified HIV drug regimens, medication adherence remains a challenge for many. Thus, there is a need to develop new treatment and prevention strategies and products that can be efficiently taken up by people from diverse communities. Potentially, these new tools will have improved efficacy and broader uptake due to better acceptability and usability.

Researchers are trying to reach out to multiple approaches to achieve durable control of HIV without daily ART, including pursuing a cure that would eradicate HIV from the body or keep it at very low levels, and developing long-acting ART and broadly neutralizing antibodies (bNAbs) that could be dosed once every few months or less often. Approaches to optimizing HIV prevention include long-acting injectables and implants, bNAbs, multi-purpose tools for HIV prevention and contraception, and other innovative strategies. Scientists also are working toward the development of a safe and effective preventive HIV vaccine. Currently, three large HIV vaccine efficacy clinical trials are underway globally.