Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

14 September 2011

Fighting AIDS: At the Tipping Point

Starting in 2005, a series of randomized clinical trials demonstrated that medical male circumcision significantly reduces a man's risk of acquiring HIV. A recent follow-on study suggests the reduction in risk may be as much as 68% and the protective effect is increasing over time. The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is sponsoring large programs in countries where rates of HIV prevalence are high and levels of circumcision are low to bring this inexpensive and life-saving intervention to millions of men.

In May, a National Institutes of Health (NIH) randomized control trial documented for the first time that treatment also works as an extraordinarily successful tool for prevention. Initiation of antiretroviral treatment (ART) by HIV-positive individuals substantially protected their HIV-negative sexual partners from acquiring HIV. Treatment lowers the viral load of HIV in a person with the virus, greatly reducing the risk of sexual transmission to a partner. ART produced an astonishing 96 percent reduction in risk of HIV transmission, on par with a vaccine.

Earlier this summer, two other studies confirmed an initial proof-of-concept trial demonstrating the effectiveness of antiretroviral medication for pre-exposure prophylaxis (PrEP) among couples. Individuals taking a daily tenofovir or tenofovir/emtricitabine combination experienced infection rates as much as 73% lower than those on a placebo, advancing potential options for prevention among couples where one partner is infected with HIV and the other is not.

Finally, last summer, the CAPRISA study of tenofovir gel microbicide -- funded by PEPFAR through USAID -- found that those using the gel with the active ingredient had an average of 39% fewer HIV infections and 51% fewer genital herpes infections compared to women who used a placebo gel. These results provided the first evidence that an antiretroviral drug in a microbicide preparation can reduce the risk of HIV in women.

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[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

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