[afro-nets] HAART alone not enough to stop spread of HIV in South Africa

[A Odutola <chpss_abo@yahoo.com>]

HAART alone not enough to stop spread of HIV in South Africa
------------------------------------------------------------

http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2667


The investigators of a recently reported study on the impact of
HAART on the transmission of HIV/AIDS in South Africa using WHO
guidelines compared to using US DHHS guidelines have concluded
that "the provision of HAART using WHO guidelines would have
only a limited impact on HIV transmission". They also emphasise
that even if the more cautious US guidelines were used, HIV
transmission was still likely to occur as not all eligible indi-
viduals would access treatment, levels of adherence would be
sub-optimal in some individuals, and in view of the high co-
occurrence of Sexually Transmitted Infections (STIs), HIV trans-
mission can still occur even if an individual has an undetect-
able viral load.

The authors urge that "the budget allocated for [HIV] prevention
should not be in competition with the budget allocated for
treatment and should not be reduced and that the prevention of
HIV should be based on established cost-effective prevention
strategies such as condom distribution, blood and injection
safety measures, treatment of STIs, and changes of sexual behav-
iour."

Coming in the wake of WHO's much publicized 3 x 5 Aids drug ini-
tiative in Africa especially, this study report puts the policy
efficacy of this initiative in question.

Reference:
Auvert B et al. Can highly active antiretroviral therapy reduce
the spread of HIV: A study from a township in South Africa.
JAIDS 36: 613-621, 2004

--
A. Odutola
Centre for Health Policy & Strategic Studies
Lagos, Nigeria
mailto:chpss_abo@yahoo.com