OK, so now we know for sure that being on ARV's provides a protective benefit to those we have sex with. This is great news! It is very nice to know that those of us on Antiretroviral therapy are not very infectious and the chances of us spreading HIV to those we are intimate with is low. Makes me feel great!
But what else does this knowledge actually do? The very large majority of newly diagnosed positive people in wealthier nations go on ARV's immediately any way now a days as research has determined that this is the best course of action. And for the developing world, this has been the goal for some time. Yes, it gives us more ammunition as we now know financially that this makes sense, but hadn't we already decided that everyone should be on ARV's – remember 'access for all'? Was that all just a crock?
Meanwhile 10's if not 100's of millions of dollars were spent by the National Institute of Allergies and Infectious Diseases (NIAID) on very large clinical trials that could have been redirected to cure research or to, I don't know, clear up the ADAP waiting lists or go to the Global Fund or PEPFAR to provide ARV's to those who need them? In the U.S. the state of Florida, a state with 3558 people on the ADAP waiting list, more then double the next highest state number, is now being forced to stop providing ARV's to people with HIV. Not only do those on the waiting list not get medication, but now no one will. And Obama has stated he cannot guarantee next months social security checks.
How much more will now be spent on additional clinical trials to determine the best strategies to implement treatment as prevention and fund organizations and clinics to carry out these strategies? How about this for a strategy? - Lets just work to provide everyone who needs them ARV's as we do the research that is really going to make a difference – cure research.
I mean really, does any of this actually make sense? Spend huge amounts of money to determine that there is an extra benefit to doing what we are already trying to do - give everyone ARV's. Then lets spend more money to justify that we need to give everyone ARV's and how it should be done when calling it prevention as well as treatment. I think we are losing the plot!Treatment as Prevention – Have we lost the Plot?