The HIV epidemic can be stopped

published on July 7, 2015 in nature

Mounting evidence that rapid treatment with antiretroviral drugs dramatically reduces HIV transmission must be acted on fast if a target date for curbing the epidemic is to be met.

As scientists prepare to meet in Vancouver, Canada, for the annual meeting of the International AIDS Society (IAS) on 19–22 July, many argue that the end of the AIDS epidemic could be in sight. A mass of convincing data, they say, shows that the universal roll-out of antiretroviral treatment provides a means to stop HIV — but only if the world acts fast.

The optimism is due to the apparent success of the ‘treatment as prevention’ approach. Treating people with antiretroviral drugs as soon as possible after their diagnosis, it seems, not only prevents death and disability due to the disease but also prevents virus transmission. In 2014, the United Nations Joint Programme on AIDS (UNAIDS) drew on this concept to set the ‘90-90-90’ goals, which envisage diagnosing and effectively treating 90% of people infected with HIV to eliminate the disease as a public-health threat by 2030.

In a report last month by a UNAIDS–Lancet commission, experts estimate that there is a five-year window of opportunity to make or break the 90-90-90 goals (see go.nature.com/ztqoj1). They note that the number of new infections is now declining year on year as more and more people receive antiretroviral treatment. As of 2013, nearly 13 million people were receiving antiretroviral drugs, a roughly tenfold increase over the previous decade. Should this trend continue, the Millennium Development Goal set in 2011, to get 15 million people on treatment by the end of 2015, will be exceeded.

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The HIV epidemic can be stopped

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