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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
HIV epidemiology and breakthroughs in prevention 30 years into the AIDS epidemic
1University of California San Francisco, San Francisco, CA, USA.
Abstract:
Thirty years after the first AIDS cases were reported in the United States, the HIV epidemic continues to be heavily concentrated among men who have sex with men (MSM) in the United States. MSM are heavily impacted throughout most of the world and are the predominant risk group throughout the Americas and Western Europe; heterosexuals are the predominant risk group in sub-Saharan Africa; and injection drug users predominate throughout Eastern Europe and Southeast Asia. In the United States, blacks and Latinos continue to be disproportionately affected, despite overall advances in HIV testing and care. The 2011 Conference on Retroviruses and Opportunistic Infections focused on populations heavily impacted throughout the world: adolescents, women, MSM, and serodiscordant couples. Several presentations focused on the unique relationship between herpes simplex virus type 2 (HSV-2) and HIV-1; although many opportunistic infections increase HIV acquisition risk, HSV-2 is likely the only one whose effective prevention or treatment could substantially influence HIV infection rates, because of the high prevalence and persistence of HSV-2. The 2011 conference also celebrated the substantial advances made in the use of antiretroviral drugs for prevention of HIV acquisition (eg, oral preexposure prophylaxis, topical microbicides) and transmission (eg, antiretroviral therapy). Further progress is also being made in evaluating other prevention strategies and their rollout, including male condoms, male circumcision, and HIV testing and linkage to care.
Insights
The HIV epidemic disproportionately affects men who have sex with men (MSM) globally. Advances in antiretroviral therapy and prevention strategies like pre-exposure prophylaxis (PrEP) offer hope, alongside managing herpes simplex virus type 2 (HSV-2) co-infections.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- The Human Immunodeficiency Virus (HIV) epidemic, thirty years post-initial reports, remains concentrated among men who have sex with men (MSM) in the United States.
- Global HIV impact varies, with MSM predominant in the Americas/Western Europe, heterosexuals in sub-Saharan Africa, and injection drug users in Eastern Europe/Southeast Asia.
- Disparities persist in the U.S., with Black and Latino populations disproportionately affected despite improved HIV testing and care.
Framework:
- The 2011 Conference on Retroviruses and Opportunistic Infections highlighted key populations: adolescents, women, MSM, and serodiscordant couples.
- A significant focus was the interplay between herpes simplex virus type 2 (HSV-2) and HIV-1, noting HSV-2's potential to substantially impact HIV rates due to its prevalence and persistence.
- Advances in antiretroviral drugs for both HIV prevention (oral pre-exposure prophylaxis, topical microbicides) and treatment (antiretroviral therapy) were celebrated.
Implementation:
- Ongoing evaluation of prevention strategies including male condoms, male circumcision, and HIV testing with linkage to care.
- Emphasis on comprehensive approaches addressing co-infections like HSV-2 to curb HIV transmission.
- Leveraging advancements in antiretroviral therapy (ART) for both treatment and prevention (TasP).
Implications:
- Effective prevention and treatment of HSV-2 could significantly reduce HIV-1 incidence.
- Continued focus on high-risk populations and tailored interventions is crucial for global HIV control.
- The integration of biomedical and behavioral prevention strategies is essential for comprehensive HIV/AIDS management.
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