Feature story

Antiretroviral treatment for prevention

06 November 2009

People living with HIV who are following an effective antiretroviral therapy regimen can achieve undetectable viral loads – the amount of virus in a body fluid such s blood, semen or vaginal secretions – at certain stages of their treatment. Research suggests that when the viral load is undetectable in blood the risk of HIV transmission is significantly reduced. However, antiretroviral therapy for prevention has not proven to completely eliminate the risk of transmitting the virus.

To explore the issue WHO earlier this week convened a meeting to review the scientific data available on the use of ART for prevention and also explored the implications of this approach for individuals and communities as well as take into consideration human rights and ethical and public health implications.

Participating in the meeting, UNAIDS Deputy Executive Director, Dr Paul De Lay, provided closing reflections. Dr De Lay said the meeting had raised the hard fact that many people living with HIV - including many who need treatment today - are unable to access HIV testing and counseling and to initiate timely treatment, as a result of a range of social, cultural and economic barriers.

These are exciting and challenging times. The diverse perspectives heard in this meeting reflect the best of the AIDS response, and continuing this dialogue - this committed questioning and the research agenda coming from this meeting - will undoubtedly lead to more lives saved and fewer new infections.

Dr Paul De Lay, UNAIDS Deputy Executive Director

Dr De Lay congratulated the participants in their effort to identifying scientifically sound and innovative ways to accelerate progress toward universal access to HIV prevention, treatment, care and support, and maximizing the effects of ART both for extending full and productive life for people with HIV, and also for primary prevention.

"These are exciting and challenging times. The diverse perspectives heard in this meeting reflect the best of the AIDS response, and continuing this dialogue - this committed questioning and the research agenda coming from this meeting - will undoubtedly lead to more lives saved and fewer new infections" continued Dr De Lay.

UNAIDS strongly recommend a comprehensive approach to HIV prevention that plans and delivers an evidence informed and human rights based combination of programmes and policies, tailored to meet the needs of those most at risk, and including practical programmes to reduce underlying causes of vulnerability, such as gender inequality and HIV related stigma and discrimination. 

Antiretroviral therapy will play several roles in combination prevention strategies, along with other key strategies including, but not limited to, social and behavioral change communication to delay sexual debut, promote mutual fidelity and reduction of the number of sexual partners, promote safer sex including correct and consistent male and female condom use, harm reduction programmes for people who use drugs, prevention of vertical transmission, and other biomedical, behavioural and structural prevention programmes. 

The WHO hosted antiretroviral treatment (ART) for Prevention was held in Geneva from the 2 to the 4 of November, 2009.