Treating HIV to save lives and prevent new infections

About ten years ago, when HIV medication began to appear and international funds started financing mass distribution programs, two divergent philosophies emerged: some felt that the limited resources should be used to treat individuals who were already infected, while others wanted to concentrate on preventing new infections.

An estimated 18,000 Quebecers are living with the HIV virus, but about a quarter of them are unaware they are carriers. In 2009, men accounted for 83 percent of new diagnoses. While Quebec’s drug insurance plan covers medication to treat HIV, not everyone is so lucky.

About ten years ago, when HIV medication began to appear and international funds started financing mass distribution programs, two divergent philosophies emerged: some felt that the limited resources should be used to treat individuals who were already infected, while others wanted to concentrate on preventing new infections. Few considered the possibility that the two philosophies were compatible.

However, that is the conclusion of a study that has been stopped ahead of schedule, because its results were so decisive that it was considered immoral to continue it. The research involved 1,763 established couples (97 percent heterosexual and 3 percent male homosexual) in which only one partner was infected. The couples came from Africa, Asia and the Americas. The infected individuals were not “ill enough” according to existing medical guidelines to be given HIV drugs. Those guidelines were implemented to avoid having patients suffer unnecessary side-effects, but especially to prevent drug-resistant strains of the virus from developing. Among the participants who were infected, half were treated according to the existing guidelines (i.e. only if their level of white blood cells – immune-system cells – dropped below a certain threshold), while the other half were all treated.

The study began in 2005 and was stopped prematurely because of the 28 people who were infected during the study, 27 were in the untreated group and only one belonged to the group where everyone was treated with HIV drugs. In other words, the medication does not only treat those who already have the disease, it also prevents the transmission of the virus.

If you are concerned about the possibility of being infected by HIV, see a doctor to be tested if necessary. Ignoring the possibility will not help your health or that of your partners.