The Rural Challenge of HIV

published on May 3, 2017 by Jason Socrates Bardi, in Inside Science

New study identifies obstacles for UN strategy of treatment as prevention in sub-Saharan Africa.

(Inside Science) -- A new map developed by researchers at UCLA in California calls into question whether a U.N. strategy for eliminating AIDS will succeed in parts of sub-Saharan Africa, where the majority of people living with HIV reside.

The map models where people infected with HIV live among the mountains and high plains of Lesotho, a small, landlocked nation in South Africa about the size of Maryland. And in a new study, the UCLA researchers use the data from this model as a roadmap to design an optimal strategy for eliminating HIV.

Their elimination strategy is based on a concept known as "treatment as prevention," which is built on evidence that treating people with antiretroviral drugs makes them less likely to transmit the virus to others. Many experts now believe the HIV/AIDS pandemic could be ended within a generation if treatment as prevention and other existing means of stopping the virus were fully implemented.

This conviction is enshrined in the "90-90-90 goal" of the Joint United Nations Programme on HIV/AIDS (UNAIDS), which seeks to diagnose 90 percent of people living with HIV, treat 90 percent of those diagnosed and successfully control the virus in 90 percent of those treated, all by 2020.

However, the new research calls into question whether the 90-90-90 strategy as envisioned by the U.N. will succeed. "It won't in the very rural countries," said Sally Blower, a professor at UCLA's David Geffen School of Medicine, who led the study.

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