May 18, 2011
The Canadian researcher behind British Columbia's "test-and-treat" HIV policy has seen this approach further vindicated by a new US study. In that randomized controlled trial, initiating antiretroviral therapy before HIV patients' health deteriorated reduced their risk of HIV transmission to heterosexual partners by 96 percent.
The US trial confirmed earlier observational studies dating back to 2006 by Dr. Julio Montaner, chair of AIDS research at the University of British Columbia's faculty of medicine, whose research has influenced British Columbia's HIV treatment policies. Other Canadian provinces should now focus on getting people with HIV diagnosed and treated at earlier stages, Montaner said.
"They should rally behind this strategy, which British Columbia has demonstrated is life-saving, highly effective at preventing transmission and highly cost-effective," Montaner said. "The evidence today is absolutely definitive and overwhelming. Not implementing these kinds of programs would be negligent."
In British Columbia, an intensive campaign to increase HIV treatment rates led to a 52 percent reduction in new HIV cases between 1996 and 2009. However, some observers still wanted data from a randomized controlled trial.
"Programs that do not recommend liberal testing and liberal use of antiretroviral therapy will see their number of HIV-infected people getting sick increase and the number of people infected with HIV grow," Montaner said. "At the end of the day that's bad for the people, bad for the community and is bad for the public purse."
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