“It’s time” was the unofficial theme, or perhaps subtext, of the International Treatment as Prevention Workshop held last week in Vancouver, a gathering of policy and decision makers, researchers and community from around the world. Altogether 250 delegates came from 41 countries to review progress and plan next steps. PositiveLite.com was there.
Next steps do not necessarily call for gathering yet further evidence to prove that treatment as prevention works. “There is no need for further discussions. The main discussion is how to implement treatment as prevention” said Dr Luiz Loures, Deputy Executive Director, UNAIDS in an opening address. And that is indeed where the ensuing three days focussed, as delegates from countries around the world reported in on their results, their challenges and how they intended to end the epidemic back home.
Dr. Julio Montaner, conference chair and director of the B.C. Centre for Excellence in HIV/AIDS and internationally recognized as one of the world’s leading TasP proponents (left, photo by Bob Leahy) , said it best. “We are at a critical time where finally there is a voice of consensus emerging-that treatment is highly effective at stopping HIV transmission.” While it may be unrealistic to suggest that consensus is universal – the conference was as notable for who was NOT there as for who attended (more on that later) – Montaner noted that the evidence has firmed up appreciably even in the last year. He cited the recent release of the PARTNER study results at CROI 2014 where there were no new infections in a large cohort of people with undetectable viral load, heterosexual or homosexual, conforming in effect the results of HPTN 052 and the often dismissed Swiss Cohort Study before that. While not feeling they went far enough, Montaner is nevertheless buoyed by last year’s revision of WHO recommendations on when to start treatment. The suggestion now stands at a CD4 count of 500 but we seem to be trending upwards towards a recommendation of treatment on diagnosis, a key element, along with ramped up testing initiatives and retaining people in care, of most treatment as prevention strategies.
Bob Leahy
Positive Lite.com
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