A 6-year study sponsored by the US National Institute of Allergy and Infectious Diseases determined that early administration of antiretroviral treatment (ARV) to HIV-infected people can reduce the risk of viral transmission to heterosexual partners by 96%. The study included 1763 couples in 9 countries, with 97% of the participants identified as heterosexual. Only 1 partner in each couple was infected with the AIDS virus at the beginning of the study. Half of the participants diagnosed with HIV received immediate ARV treatment. The other half did not start ARV therapy until their CD4 count dropped to 250 or they developed an AIDS-related symptom. All of the participants were given free condoms and received safe-sex counseling, along with treatment for any other sexually transmitted diseases.
HIV developed in only 28 partners of the participants, and all but 1 had a partner in the study who waited to start ARV treatment. The study conclusively supports the efficacy of ARVs in a randomized, controlled clinical trial. Michel Sidibe (head of the Joint United Nations Programme on HIV/AIDS) hopes that the results of this study will end debates about the worthiness of spending funds on ARVs to prevent the spread of the disease. Sidibe emphasizes that the benefits of ARV treatment increase with evidence that treatment effectively prevents the spread of HIV.
Current WHO guidelines recommend ARV treatment to persons with CD4 counts of 350 or less. The new results support an increased demand for ARVs early in the course of HIV and will hopefully lead to an increased use of the drugs and a subsequent decline in price. However, funding to provide the ARVs continues to be less than needed on a worldwide basis and slow to respond to the new findings. Nurses, nursing students, and nurse educators can advocate for increased funding for ARVs as an effective strategy to prevent further spread of this global epidemic.
Source: Cohen J. HIV treatment dramatically prevents heterosexual transmission. May 12, 2011. ScienceInsider. Available athttp://news.sciencemag.org/scienceinsider/2011/05/hiv-treatment-dramatically-pre. Accessed May 15, 2011.
Submitted by: Robin E. Pattillo, PhD, RN, CNL, News Editor at [email protected].