30 Nov 2010
Without treatment, no prevention say people living with HIV
In 2001 the United Nations General Assembly committed to achieve universal access to HIV treatment, prevention, care and services by 2010. Today increasing access to treatment has saved millions of lives, and substantial increases in HIV prevention and treatment efforts are making an impact on the epidemic in many countries[i].
However, still only 36 percent of people living with HIV in need of treatment are receiving it[ii]. To really change the global epidemic the scale up of treatment access, in combination with other prevention methods, must be sustained.
HIV treatment enables people living with HIV to better manage their personal physical and mental health and wellbeing. Antiretroviral treatment also provides people living with HIV with choices in their relationships and in their desire to have children, as treatment makes them less infectious to their partners. This empowers people living with HIV to assert their sexual and reproductive health and rights.
“Ensuring that all people living with HIV who need antiretroviral treatment have access to it is fundamental,” says Kevin Moody, International Coordinator and CEO of the Global Network of People living with HIV. “With the rate of new infections still twice as high as the rate of new people accessing HIV treatment, the focus must be on increasing treatment for treatment’s sake, recognizing also its preventative benefits.”
Using HIV treatment to stop onward transmission is not new. Advances in the prevention of mother to child transmission for example have led to nearly 100 percent effectiveness in preventing new infections amongst children. Similarly post-exposure prophylaxis has also proven to be a ‘treatment as prevention’ option following exposure to HIV.
Clinical trials testing other ‘treatment as prevention’ approaches must be in line with WHO ART guidelines and recognize the significance of a supportive legal and policy environments. Not recognizing these conditions can lead to oversimplified and medicalised HIV prevention efforts that ignore the full spectrum of challenges shaping the prevention needs of people living with HIV.
Kevin Moody states: “Human rights are an integral part of public health approaches and this is especially true with a chronic disease such as HIV. At the end of the day, the choice to get tested and the choice to start treatment must rest with the person, not the system or the state. Otherwise, public health approaches to universal access will alienate those who need the services the most.”
GNP+ supports the scale up of existing evidence informed treatment and prevention strategies and looks toward innovative ways to expedite access and coverage of HIV treatment, prevention, care and support. These however must be approached from a rights-based perspective if they are to meet the needs of people living with HIV – especially members of key populations – many of whom confront stigma and discrimination on a regular basis when accessing services.
[ii] Recently the rate of people living with HIV receiving treatment has gone down relatively. This is because 2009 WHO guidelines for ART treatment advise to provide treatment to people living with HIV earlier, essentially increasing the absolute number of people in need of treatment.