The Washington, D.C., Health Department and NIH are preparing to launch a study to determine whether aggressive treatment of all adults living with HIV could stop the spread of the virus and prevent AIDS, the Washington Post reports. The study’s premise is based on a mathematical theory presented in 2008 by doctors at the World Health Organization, who said that global universal HIV treatment with antiretroviral drugs could reduce the virus’ transmission rate to one case per 1,000 by 2016.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the purpose of the study is “to get the … level (of HIV in the blood) down so that people will not infect anyone because their viral load is so low.” He added, “When you follow couples — one who’s infected, the other who’s not — the probability of infection diminishes when the viral load is very low. The philosophy is if you test everybody, and treat everybody who has HIV, you could use treatment as prevention.” However, Fauci also cautioned that the WHO theory is “so far in the hypothetical stage that I wouldn’t even rank it” with proven prevention methods, such as condoms and needle-exchange programs. A similar study will be conducted in the Bronx, N.Y.

NIH will provide the health department with experts who will help modernize patient record-keeping at clinics to better track people living with HIV. The experts will show social workers how to monitor patients to ensure compliance with drug regimens, the Post reports.

The Post reports that researchers face major challenges to the study, including whether testing every adult for HIV is feasible. Researchers also must determine if people who test positive for HIV will opt for treatment.

The study is scheduled to begin around Dec. 1, which is World AIDS Day. According to the Post, Fauci would not say how much money or other resources would go toward the study. He and other officials also declined to say which areas of the District would be included in the study, aside from the area of Anacostia. Currently, about 50% of people who test positive for HIV in the district and other cities wait for treatment for an average of six months, during which time they risk spreading the virus (Fears, Washington Post, 11/13).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

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