The following was written by Dr. Julio Montaner during the AIDS 2012 Conference.
Over the next week, world leaders, delegates and community advocates from around the world will meet in Washington D.C. for the XIX International AIDS Conference. There, they’ll define and create a roadmap that will determine the direction of the global AIDS response over the next two years. We know that the strategy of Treatment as Prevention (TasP) will play a key role in conference discussions – with over 8 million people around the world now accessing HIV treatment, there’s no question that the rapid expansion of treatment coverage can play a critical role in further decreasing morbidity and mortality, as well as in markedly curbing the spread of HIV.
How? Well, while a vaccine and a cure remain elusive, HIV treatment plays an essential role in reducing AIDS incidence and HIV and AIDS related deaths. Given that treatment markedly decreases HIV presence in biological fluids, it also lowers the likelihood of HIV transmission. This means that for people living with HIV, HIV treatments stop the virus from eroding their immune system and stop disease progression to AIDS, therefore extending their life expectancy, and decreasing the likelihood of HIV transmission.
Since 1996 in British Columbia, we have been able to carefully document the impact of progressive expansions of HIV treatment coverage. Our experience serves as a witness of the power of TasP in preventing morbidity, mortality and transmission. In brief, we have found that by expanding access to HIV testing and treatment we have driven new AIDS diagnoses to a record low, currently over 85% lower than in 1996. Similarly, all cause mortality among people living with HIV has decreased by over 90% over the same period. And, new HIV diagnoses have also gone down by over 60%. In the early 90’s we used to have about 900 new HIV cases diagnosed every year. Since then the numbers have decreased steadily until in 2011, when we documented less than 300 new HIV cases diagnosed, despite expanded HIV testing efforts and increasing rates of other STIs.