On June 30, the WHO called for earlier treatment of HIV with antiretroviral therapy (ART), saying the move could save the lives of 3 million people and prevent 3.5 million more new HIV infections between now and 2025. But are these goals realistically attainable through biomedical means alone?
If everything went smoothly along the so-called cascade of HIV care, a purely biomedical strategy might work. But anyone involved in the HIV fight knows that things rarely go smoothly – from the very beginning of the cascade with testing to the end stage with adherence. Public health efforts must include communication as part of any comprehensive strategy to make a significant impact on this epidemic.
According to an article published online June 30 in the Journal of Therapy and Management in HIV Infections, “communication is an essential part of any comprehensive program that includes both services (medical, social, psychological and spiritual) and commodities (condoms, needles and syringes).”
Rupali Limaye, lead author and Director of the HIV/AIDS Global Program at Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU·CCP), argues that treatment as prevention presents a number of challenges, such as resource constraints, logistical hurdles, emergence of drug-resistant viral strains, adherence and risk compensation.
“We urge the public health community to think about treatment drugs not as the magic bullet for prevention, but rather as a key component that, when combined with sound communication practices, can play a significant role in reducing new infections,” she said.
HC3 plans to hold a global expert consultation later this month in Baltimore to further explore the important role communication plays in HIV prevention efforts, in particular biomedical interventions.
Photo © 2009 David Snyder, Courtesy of Photoshare