How antiretroviral drugs can suppress HIV, one pill at a time

One afternoon last week, CDs, clothes, tools – as well as sex and drugs – were for sale on the sidewalks of Vancouver’s Downtown Eastside neighbourhood, the pungent scent of marijuana hanging in the air and stench of urine wafting out of alleys.

“It is the perfect opportunity to end the epidemic,” says Dr. Julio Montaner, former president of the International AIDS Society and director of the B.C. Centre for Excellence in HIV/AIDS.

He is spearheading a global campaign called 90-90-90, which has been embraced by UNAIDS and a growing list of countries and world leaders.

The aim is that by 2020, 90 per cent of people living with HIV will be diagnosed; 90 per cent of them will be on antiretroviral treatment; and 90 per cent will be virally suppressed, having such low levels of HIV in blood and body fluids that the chance of passing the virus to sex partners is greatly reduced.

The key is early detection and treatment, Montaner says, pointing to the success of B.C.’s Treatment as Prevention program that offers free access to HIV testing, treatment and care.

Rourke estimates that 40 to 50 per cent of Ontarians with HIV are not virally suppressed. And British Columbia’s 2014 data show that four out of 10 people with HIV are not suppressed. “Forty per cent still have the virus and are very likely passing the virus to others,” says Dr. Rolando Barrios, assistant director of the B.C. Centre for Excellence in HIV/AIDS.

Jonathan Postnikoff learned he was HIV-positive five years ago.

He was 26, finishing his degree at the University of B.C. and tending bar at a busy downtown restaurant at the time of his diagnosis. He was so afraid, he gave up sex and kept his HIV-positive status a secret for three years, confiding in just his closest friends and family.

“It was like being back in the closest all over again, being that scared young boy not able to talk to people,” he says.

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