HIV Treatment Prevents Heterosexual Transmission

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Science  20 May 2011:
Vol. 332, Issue 6032, pp. 902
DOI: 10.1126/science.332.6032.902-b

HIV-infected people who start antiretroviral (ARV) treatment at earlier stages of the disease lowered their risk of transmitting the virus to their sexual partners by 96%, according to a multicountry study that ended abruptly last week.

The $73 million study by the U.S. National Institute of Allergy and Infectious Diseases recruited 1763 couples (97% heterosexual) in which only one partner was infected with the AIDS virus at the start. Half the participants received ARVs immediately, while the other half waited until their infections caused serious immune damage.

An analysis 6 years into the study, which was planned to last 10 years, found that 39 people had become infected, 28 from their regular partners. Of those 28, all but one had a partner in the group that waited to start treatment.

The dramatic result mirrors findings from less-rigorous earlier studies. Still, says Michel Sidibé, who heads the Joint United Nations Programme on HIV/AIDS, “it's a game-changer in the AIDS response.” Some HIV/AIDS advocates caution that the good news will have an impact only if the world massively scales up distribution of ARVs to people who can't afford them, which there are no plans to do.

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