Over the past decade, the District of Columbia has seen more than a 74% decrease in the number of new HIV infections, from 1,333 new cases in 2007 to 347 in 2016. Although a myriad of public health programs have contributed to this decline, the most impactful has been treatment as prevention, according to Michael Kharfen, senior deputy director of HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA), D.C. Department of Health.
Since 2007, the District has launched a number of campaigns, including on needle exchange, condom distribution and, more recently, pre-exposure prophylaxis (PrEP). Yet, the “leading driver in reducing new transmissions” has been treatment as prevention, or ensuring that HIV-positive people become aware of their status and start daily antiretroviral treatment, said Kharfen.
A growing body of research has demonstrated that people with HIV who take their medication every day can reduce the level of virus in their blood to an undetectable level, meaning they cannot transmit the virus to others through sex, needle sharing or from mother to child.
The enormous impact of this strategy is the reason Washington, D.C., now supports the Undetectable = Untransmittable, or U=U, campaign. Launched in early 2016 by the Prevention Access Campaign, U=U is a nationwide effort to spread the word about the effectiveness of treatment as prevention.