In this week's Scrubbing Up health column HIV expert Michael Carter argues that drugs used to treat HIV could have a significant effect on the spread of the virus.
The main focus for HIV prevention work is still encouraging people to use condoms. Michael Carter says increasing the numbers taking medication would reduce infections to the same degree. The impact of HIV treatment on infectiousness is so great that it might have the potential to stop the epidemic in its tracks if everyone took an HIV test each year and everyone diagnosed with HIV received treatment.
What do you think? Here are some of the comments you have been sending in to this week's Scrubbing up.
As a HIV+ individual I still find it crazy that people are still making such abig issue out of the "Swiss Statement"! Surely, the only hard and fast message that should be given is that safe sex decreases your chances of contracting HIV! The issue of other STD's was only slightly touched on in this article. They along with HIV can all be prevented by sticking with the safe sex message. The only REAL way to halt the epidemic is to ensure that education in sexual health is available to all no matter where they come from or what religion they follow.
What a refreshing change to discover HIV being discussed openly in such a positive manner. As someone living with HIV/AIDS for over 25 years, I can give personal testimony of the improvements in medication. Whilst I take more than one pill a day, I am happy with my current combination which has no apparent side effects...in stark contrast to some of the unpleasant and damaging effects of the old first-line treatments. Hopefully, the positive tone of Michael's article will encourage sexually active people to take up his call to get tested regularly. Well done Aunty Beeb!
Maurice, Stoke-on-Trent UK
Yet again the sweeping statement is made about people with HIV on meds having a 'normal' lifespan. This is not true because there is no evidence of say an 18 year old on meds living to be 90 which would be the normal lifespan in this day and age. The meds have huge side affects which impact on your life in all manner of ways that over time wear ones body down. As well as abstinence the message also has to mention the side effects of medication too.
Desmond FitzGerald, London
It doesn't matter that viral load in genital fluids isn't regularly monitored as it's directly correlated to viral load in blood. If viral load is undetectable in blood, it's almost certain it will be undetectable in genital secretions or at such low levels that it isn't infectious. It really is wonderful that treatment for AIDS can stop someone passing the virus on. The real challenge is going to be getting people tested and on treatment.
Chris Conlon, London, UK
Would there not be a risk that people taking the medication would think they're invincible and not bother with condoms at all, thinking the medication is enough? What if one forgets to take it? Hepatitis, warts and other STIs are easier to catch than HIV and condoms remain the best protection. Also, the expense of the medication: part of the debate is the cost and availability of these medicines in the developing world, such as sub-Saharan Africa, where they have a real crisis but can't get the drugs.
Yes and no. HIV drugs reduce the level of HIV in the blood, but the level of HIV in genital fluid is never measured. So while it will help, it there is no guarantee of not infecting a partner. Condoms are still the best form of protection.
It is so good to see a well-balanced and considered discussion about HIV and its treatment. I am so used to seeing the usual doom and gloom pieces which use scare tactics as a way of attempting to regulate behaviour that this article is a breath of fresh air! Thanks for opening discussion and reducing stigma the correct way - by reporting the facts, clearly and without hysteria.
Garry Brough, London, England
I think it isn't realistic to propose testing every person in the world and treating every infected person. How much would it cost? Individuals wouldn't want to pay. Some community leaders and religious leaders will boycott the tests. In some countries in Africa, western medicine is feared as a conspiracy of genocide. But what else is there to do? Vaccines seem to be impossible to make and condoms are rather madly rejected on religious grounds.
Robert Carnegie, Hamilton, Scotland
This article is very misleading. I was infected with HIV from someone who had been taking medication for over a year. They were classed as a 'zero' risk yet I still managed to get infected!
I think that this treatment is great. HIV drugs have come a long way. Anything that can maybe counteract to give the virus less of a chance of spreading or infecting someone is great news. My only concern is the cost effectiveness of the treatment. HIV drugs are expensive but the benefits for me out way the costs.
Chris Mitchell, Manchester
Are condoms really preventing the spread of HIV and STIs?
Sumit, Woking, Surrey
Preventing HIV is a complex issue. I think it is important that people living with HIV are not portrayed as vectors of infection and a threat. Understanding the science behind the transmission of HIV can help reduce the stigma linked to this virus. If there is less stigma around HIV it will be easier for people with HIV to be open about their status and negotiate condoms. The prevention message doesn't change: condoms are always the safest option. However, as a woman living with HIV, knowing that being on treatment reduces infectiousness makes me feel more relaxed that if an accident happened I wouldn't put my partner's life at risk.
It is so important for everyone to know their HIV status. Many people don't think about it and our sexual health services in the UK are not capable of providing widespread testing to the whole population, along with the necessary pre- and post-test counselling that everyone should have. WHO has said universal testing would end Aids in a generation. We know how to stop the epidemic and that means every person taking responsibility for their own sexual health; knowing their status and knowing the facts of HIV/Aids, not the fear.
Nick Henderson, Dundee, Scotland
What Michael Carter says in this piece makes absolute sense. Positive people on anti-HIV drugs who adhere to their regimes are probably the safest group within society. The level of HIV in their bodies is so low that transmission is indeed almost impossible. As their status is known and monitored they prevent no risk - whereas all other groups still do. I'd be in favour of universal HIV testing and everyone with a positive result to be given HIV treatment. It would certainly slow down the spread of the virus and could ultimately eradicate it.
Michael Ratsey, Martock, Somerset
To tackle HIV it is essential that all carriers are diagnosed. Providing free and widespread testing, and encouraging testing upon change of sexual partner would be helpful. Making HIV tests socially acceptable by advertising campaigns and widespread home testing will help infections be discovered quickly, and reduce the infected population over generations.
Having read this article I am encouraged that there is a lowered risk of transmission to those, who are monogamous, use condoms consistently & correctly and whose partners are on HIV treatment... However, what about those who aren't aware they are HIV+? This report also focuses mainly on those in W & C Europe/ North America, where access to HIV drug treatment is higher... Without large scale sexual behaviour change, reduction of stigma, access to free medical treatment and adherence to anti retrovirals, the impact of these findings on the majority of those who are at risk of infection is still incredibly limited.
L., Herts, U.K.
The problem is that regardless of the intent of this article, the message is that those who are treated can very well go out and have unprotected sex - which is something we do not want to advocate to anyone in this day and age. People are complacent enough as it is and the wording of this article seems to encourage irresponsible behaviour.
Cecile, Tunbridge Wells
i think that this is great news, because it could halt the spread of HIV making Aids a thing of the past. However many people with HIV cannot afford the drugs especially those in Africa. So if we aught to see a major reduction in the spread of HIV then there needs to be a significant improvement in the social status of the world's poor.
Latoya Hall, Kingston, Jamaica