As an HIV test counselor in 1985, I never imagined that I would be working on HIV 30 years later. Over this period, my partner John and numerous friends died, I was diagnosed with HIV, and I witnessed two major revolutions in HIV treatment that changed the epidemic’s course. One was in the 1990s. The other is unfolding now, and is key to getting closer to ending HIV.
Treatment saves lives
The first revolution started in 1995 when new medications brought many people living with HIV/AIDS back from the brink of death, enabling them to regain their health. These medications stopped the virus from destroying the immune system and kept people healthy. In two years, deaths among people with AIDS were cut in half.
In the past 22 years, HIV treatments have improved to be more durable, safer and have fewer side effects. Today, someone who is diagnosed shortly after infection and starts HIV treatment, continues taking it daily and maintains an undetectable viral load can expect to live nearly as long as a peer without HIV.
Treatment stops transmission
We are now experiencing the second revolution, thanks to major scientific advances in our understanding of the prevention power of today’s HIV treatments.
We have known since 1994 that HIV medications significantly reduce mother-to-child transmission. In 2010, research started to show that medicines used to treat HIV, when taken daily by people without HIV as pre-exposure prophylaxis or “PrEP,”) could reduce the risk of getting HIV by more than 90 percent.
Last year, an HIV prevention study provided the data needed to definitely show that current HIV treatment that reduces viral load to undetectable prevents sexual transmission. These results were confirmed by two other studies. Together, these three studies involved thousands of couples and found zero HIV infections that were transmitted by a partner with an undetectable viral load.
This means that someone who takes HIV medicine as prescribed and maintains an undetectable viral load has effectively no risk of sexually transmitting HIV. Treatment protects the health of the person living with HIV and prevents new infections.
Tool to end new infections
The use of HIV treatment to prevent transmission is game-changing. It is redefining prevention and what it means to have HIV. I have had HIV for 22 years and this news has taken a weight off my shoulders and those of many peers. HIV treatment and PrEP are powerful tools that can help us get to the end of HIV.
Richard Wolitski, Ph.D., Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services, [email protected]