Archives
New research finds gay and bisexual men who use HIV prevention pill ‘PrEP’ have lower anxiety
November 21, 2019 A new study from the Kirby Institute at UNSW Sydney published today shows that gay and bisexual men who are taking the HIV prevention medication PrEP (pre-exposure prophylaxis) also have significantly lower levels of HIV-related anxiety. HIV transmission anxiety has affected sexual behaviours of gay and bisexual men for more than 30 years, but ... Read MoreScientists discover new HIV strain
November 7, 2019 Scientists have discovered a new subtype of HIV with an Australian expert saying there was no cause for alarm. The subtype of the virus was discovered in 2001, but new DNA sequencing technology helped scientists confirm the new strain. The sequence discovery was published on Thursday in the Journal of Acquired Immune ... Read MoreA blue pill a day can help prevent HIV, but people most at risk are not taking it
November 7, 2019 Transgender women—people born male who identify as women—are the population most at risk for HIV. They are also the most understudied population. “We need to find out who they are, how old they are, where they live, where they work, what’s their lifestyle,” says Dr. Cheryl Holder, an HIV specialist and associate ... Read MoreMedicare ineligible PLHIV in Australia An analysis of new data with recommendations for systemic improvements
October 2019 This NAPWHA report is an analysis drawing together several years’ worth of data from the main pharmaceutical industry suppliers of compassionate access antiretroviral (ARV) therapy in Australia and combines this with, for the first time, data from the State and Territory jurisdictions to produce the most accurate estimate ... Read MoreTrial of HIV prevention implant hailed as boost in fight against disease
July 24, 2019 An implant containing an HIV-prevention drug has been trialed in humans, in a step experts have hailed as an exciting development in curtailing infections. Pre-exposure prophylaxis, or PrEP, with antiretroviral drugs has become a hot topic in recent years, with the drugs shown to substantially reduce the risk of contracting HIV from ... Read More
August 12, 2019
A bottle of Atripla, the first once-daily regimen for treatment of the HIV-1 infection in adults, sits on the podium at the conclusion of a press conference announcing the drug’s approval by the Food and Drug Administration, at the National Press Club, Wednesday, July 12, 2006 in Washington, D.C. Since the introduction of azidothymidine in 1987 there have been major improvements in the treatment of HIV. In a recently published study, Forsythe and colleagues demonstrate that the advent of antiretroviral therapy (ART) in the mid 1990s has yielded significant achievements in global public health. Between 1995 and 2015, 9.5 million deaths have been averted worldwide, and global economic benefits are estimated at over $1 trillion.
In 2014, the United Nations Program on HIV/AIDS established the 90-90-90 treatment targets for the year 2020. These targets aim to have 90% of people living with HIV know their HIV status; 90% of those who are diagnosed receive continuous treatment; and 90% have viral suppression. The year 2020 is around the corner. Denmark appears to have been the first country to have achieved all three 90-90-90 targets. But, other countries have not achieved this kind of success. To illustrate, the percentage of HIV-infected people who have viral suppression is 61% in the U.K, and only 30% in the U.S.
If treatment scale-up of ART achieves the global 90-90-90 targets of the Joint United Nations Program on HIV/AIDS, a total of nearly 35 million deaths are projected to be averted between 1995 and 2030. Moreover, approximately 40 million new HIV infections could also be prevented by ART, and economic gains could reach over $4 trillion by 2030. However, both in terms of prevention of HIV transmission and treatment of the disease significant challenges remain. In 2017 there were 1.8 million new HIV infections and almost 40 million people living with HIV worldwide. Also, there were one million AIDS-related deaths. And, of people living with HIV, 41% were not receiving treatment.
It’s agreed that continued expansion of treatment scale-up to reach the 90-90-90 targets constitutes good value for money for government authorities and payers in every global region. However, different jurisdictions must overcome different sets of barriers to realize these gains. In Europe, the main issue has been getting people to test for HIV. In the U.S., the persistent problem has been linkage with and retention in care: That is, a high proportion of people living with HIV knows their status but has not started or stayed on treatment.
And, invariably, a limiting factor is health budget constraints worldwide. This applies to all aspects of HIV treatment, from diagnostics, to the logistics of supply and storage of medicines, to treatment and follow-up. And, as transmitted and acquired resistance increases worldwide, individual patient viral load monitoring will be critical, as well as judicious use and reimbursement of second- and third-line ART medications.
Joshua Cohen