By Dr. Gail Barouh
Although they were phrased in hundreds of different ways, most of the headlines that came out last month’s XIX (19th) International AIDS Conference contained the words “AIDS Cure.”
While some media outlets that put a spin on the phrase were cautiously optimistic, many were downright irresponsible. To be fair, scientists who gathered at the conference were committing to the goal of a cure for HIV, which just a few years ago did not seem possible. For the first time in the history of one of these conferences, they were framing their discussion of AIDS in the context of a cure. And the form that this cure was discussed in was in the context of treatment. This came out of the recently published study in the New England Journal of Medicine that patients who are optimally treated with the current anti-retroviral drugs used on AIDS, (such as Truvada, which was recently approved by the FDA for this purpose) are unlikely to transmit their infections to others and uninfected people who take the medications correctly are unlikely to acquire an infection if exposed. Another factor that influenced the discussion was the “Berlin Patient” who has been affectively “cured” of AIDS.
And the media outlets that were less responsible reported these advances as if they were part of a cure that was a done deal, when in fact they are just steps toward transmission reduction and better long term health for those with AIDS.
The high cost of these drugs is one of the biggest hurdles that needs to be addressed, not only in poorer countries, but here as well. The poor in America are more affected by AIDS and least able to afford adequate access to these medications. Also, “optimally treated” implies 100% commitment to taking these medications, when it is estimated that some 800,000 of the 1.1 million HIV infected people are not taking their medications consistently. This means the risk of transmission is returned, and the risk of creating drug resistant strains of the virus is a strong possibility.
And finally, conference participants who spoke of eradicating AIDS failed to recognize that the only way that two other viral infections, polio and smallpox were virtually eliminated was through a vaccine, not through treatment. Only a few media outlets made note of this.
When I think back to the early days of AIDS, when there was a sense of hopelessness while patients wasted away and died horrendous deaths, the idea that we could contemplate, however tentatively, the beginning of the end, is something that was difficult to imagine happening in my lifetime. But we must remain cautiously optimistic and recognize that the cure that is being discussed requires responsible behavior and a commitment of resources that our current health care system can currently not provide. It is by no means a guarantee and we need to remain diligent and encourage education and safe sex practices, caseworkers need to follow up with clients to make sure they are taking their medications, and get everyone tested so those that test positive can take advantage of the benefits early treatment has to offer. For more information on testing, education or help managing your care check out our Facebook page or call 1-877-864-4222.