Why Nobody’s Funding the HIV-Prevention Strategy Ten Times More Effective than PrEP

TasP – or Treatment as Prevention-aims to promote awareness that it’s incredibly difficult to get HIV from someone who’s undetectable. But that idea is proving a hard pill to swallow

“This is a world that is run mostly by HIV-negative people, and they’re focused on protecting their own interests,” Bruce Richman tells me. He’s the executive director of Prevention Access Campaign, a multi-agency initiative working to end HIV and HIV-related stigma, and he’s referring to the world of HIV prevention and treatment, where for the last few years, public attention has been fixed on pre-exposure prophylaxis (PrEP).

PrEP is an HIV prevention method where high risk, HIV-negative people take virus-fighting antiretroviral drugs and see up to a 99 percent decrease in their chances of getting HIV. It’s an exciting innovation, especially for the HIV-negative; CDC researchers have predicted that expanding the use of PrEP could prevent 17,000 new infections by 2020. As a result, HIV prevention programs across the country have gone all-in on pervasive public awareness campaigns and treatment access programs over the past few years. Which is fantastic, but as Richman warns, “I think it’s short sighted to think that PrEP is the best way to protect their own interests.”

Another treatment strategy exists that’s potentially ten times as effective as PrEP, but it’s getting much less of the limelight. Known as treatment as prevention (TasP), it involves HIV-positive patients getting their viral load (or the number of copies of HIV measurable in their blood) below levels detectable via testing. When that’s achieved, multiple studies have shown that it’s almost impossible to transmit HIV to uninfected sexual partners. The CDC predicts that if 80 percent of people living with HIV were to achieve an undetectable viral load through antiretroviral therapy (ART), it could prevent about 168,000 infections by 2020.

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