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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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Speaking at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention on Monday, U.S. Global AIDS Coordinator Eric Goosby outlined President Obama’s global AIDS policy agenda, Plus News/IRIN reports. The news service writes, “Goosby began by reassuring delegates - many of whom are implementers of programmes funded by … PEPFAR … — that fighting AIDS would remain a central component of Obama’s foreign policy. However, there would be a renewed focus on other priorities such as maternal and child health, and tropical diseases.”

Goosby noted, “Each government ultimately holds responsibility for the health of its citizens,” and that U.S. policies would seek to support country programs and encourage more national government buy-in and leadership. “The end goal is for each country to control its responses both strategically and, eventually, financially,” he said. “Goosby also made it clear that scientific evidence rather than moral concerns would drive intensified efforts to reach high-risk groups - men who have sex with men, injecting drug users and sex workers - with HIV prevention and care,” Plus News/IRIN writes.

“The economic crisis has made countries look at what they can and can’t afford with a new lens,” he said. “We are trying to maximize our ability to ensure that everyone who is on ARVs [antiretrovirals] stays on them, and that we expand access to those who are not yet on them.”

National Institute of Allergy and Infectious Diseases Director Anthony Fauci “told delegates that a bill to lift the ban on funding needle exchange programmes was working its way through Congress, and restrictions on HIV-infected people entering the U.S. were also almost certain to be lifted in the near future.” Facui added, “With regard to science and policy, we will stay on the right path” (7/20).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.


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