“Treatment as prevention,” a cutting-edge approach to HIV drug therapy developed by BC-CfE director Dr. Julio Montaner, served as a major theme of the AIDS 2010 conference and was hailed by delegates as a “game-changing” strategy to curb the spread of HIV.

Based on the idea that highly active antiretroviral therapy (HAART) can suppress HIV to undetectable levels, treatment as prevention calls for the expansion of access to these drugs. This has the dual benefit of improving patient outcomes and reducing the probability of HIV transmission.

As Dr. Montaner and his team outlined in a Lancet paper published on the eve of the conference, the steady scale-up of antiretroviral therapy in B.C. has reduced new HIV diagnoses by more than 50 per cent since 1996. Treatment as prevention, already implemented in B.C. through the Seek and Treat pilot project, has been endorsed and adopted by the United Nations under the title “Treatment 2.0” as the basis of its strategy to avert 10 million deaths by 2025.

AIDS 2010 also marked the launch of the Vienna Declaration, an official conference statement championed by the BC-CfE’s Dr. Evan Wood, calling for an end to the global war on drugs and the adoption of evidence-based drug policies.

The declaration states that criminalizing drug abuse drives addicts towards unsafe practices, such as needle sharing, that promote the spread of HIV and other blood-borne infections. Prohibition and law enforcement have also been associated with increased levels of drug-market violence while failing to restrict the drug supply significantly.

Since its launch, the Vienna Declaration has received more than 15,000 endorsements from a broad range of leaders in science, medicine, and public health, including five Nobel laureates.

Further BC-CfE research presented at the conference highlighted the benefits of primary care interventions for HIV-positive individuals. Analyzing data from St. Paul’s, the researchers found low adherence to HIV medication, unsafe drug use practices, and unstable housing contributed to emergency department visits by persons living with HIV and AIDS. The study suggests social interventions at the primary care level, such as medication support, harm reduction services, and supportive housing, can improve the health of this population while averting health care costs through decreased resource usage.

Other key developments of AIDS 2010 included:
• The announcement of a vaginal gel that has been shown to reduce the risk of HIV infection by 40 per cent;
• A call by Bill Clinton and Bill Gates for more efficient use of AIDS funding; and
• A demand for greater respect of the human rights of individuals living with HIV and AIDS.