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Treatment as prevention in Canada proving successful
Expansion of highly active antiretroviral therapy (HAART) from 1996-2012 was directly related to a decline in new HIV infections and HIV- and AIDS-related mortality in Canada. The study, published in PLOS One, gives further evidence to support treatment as prevention (TasP) as a public health strategy that can be applied in both low resource and high resource settings.
Antiretroviral (ARV) treatment means that people living with HIV can lead long and healthy lives. They work by decreasing the amount of HIV virus in a person’s body, which in turn reduces the likelihood of developing an AIDS-related illness. The viral load of a person is also the single biggest risk factor in the transmission of HIV. Therefore taking and adhering to treatment has the added benefit of significantly reducing the risk of onward transmission of HIV. The idea of ‘treatment as prevention’ is to use treatment as a prevention strategy that individuals can engage to protect their sexual partners, or, on a large scale, reduce HIV transmission among a population – something that this study shows.
Over the time period of the study, coverage of HAART increased, as well as adherence to HAART – both were associated with a suppressed viral load and decreased drug resistance. In addition, new HIV diagnosis decreased by 66 percent and AIDS incidence and mortality each decreased by 80 percent.
The research aligns with other population-based evidence about the expansion of HAART that have emerged from Taiwan, China, the US and South Africa, to name but a few. The authors state: “Further monitoring of the population-level impact of HAART roll out efforts will help to validate the predictions of recent and further characterise the field impact of TasP in diverse epidemiological situations and settings.”