3 June 2011
June 5 is 30 years since the day a US medical publication reported that a group of gay men in Los Angeles were showing symptoms of pneumonia that normally only occur as a result of failing immune systems. What in subsequent diagnosis became known as Acquired immune deficiency syndrome has killed over 30 million people world wide according to UNAIDS. Efforts by medical researchers to find a cure have led to dozens of anti-HIV drugs being licensed but none have so far been successful in fully neutralizing its effects.
However, the world has much to be positive about in the fight against AIDS. According to UNAIDS, the world spent $16 billion on the epidemic last year. In that year, deaths from AIDS were at a new low of 1.8m in the years since 2005 when the all time high of 2.1 million deaths started to dip. Currently, as a result of renewed international efforts, 6.6m people in lower-income countries are on anti-retroviral drugs. In many of the world's poorest countries the rate of new HIV infections has fallen by as much as a quarter, and even more in some cases. This achievement is part of a 16-fold increase in people reached by the drugs since 2003.
Despite this positive news, enormous challenges remain. Current estimates are that around 9 million people who desperately need the drugs in those low-income and middle-income countries are not getting them. There are still two new people infected with the disease for every new person that receives anti-retroviral drugs. 2.6 million people became infected last year.
While a cure or vaccine remains undiscovered, the role for preventative treatments must therefore be given continued development and investment. AIDS workers, medical programs, NGOs and governments can learn a great deal from further collaboration with social scientists in prevention programs. Many research discoveries have already been used to improve communication and understanding of AIDS, and to improve the effectiveness of the delivery and success rates of medicine, and there is great potential for more.
Some important questions in this area have been identified by the U.S. based HIV Prevention Trials Network (HPTN), and are listed below. More about their current work of the HPTN Behavioral Science Working Group can be read here.
Alex Ingrams
SPSSI Policy Coordinator
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1. Can a behavioral intervention implemented at the community-level have an effect on HIV incidence?
2. What effect does saturation of voluntary counseling and testing have on community transmission rates?
3. Under what circumstances is an associated increase in disclosure and/or decrease in stigma associated with reduction in HIV incidence, and what implications does this have for the nature of interventions that would be able to effect further reductions in HIV incidence?
4. Under what conditions do behavioral interventions that have shown efficacy in reducing self-reported risk behaviors or surrogate STDs have a similar effect on HIV incidence?
5. What is the most effective way to reach HIV infected individuals to reduce the transmission of HIV to their sex partner(s)?
6. What is the best way to communicate the concept of “partial effectiveness” of clinical HIV prevention strategies to study participants and the general population?
