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One of the most urgent problems in HIV/AIDS policy is in deciding how best to allocate resources toward preventing new infections or treating infected individuals.
An analysis by Joshua Salomon and colleagues in the premier open-access journal PLoS Medicine, published online January 11, 2005, suggests that an exclusive focus on one or the other of these alternatives will yield minimal benefits--failing to integrate the two approaches could have a catastrophic effect on the global toll of HIV/AIDS by 2020. In this modeling study the authors analyze the epidemic in sub-Saharan Africa (where three-fourths of deaths from AIDS occur). With no change in current levels of prevention and care, it is predicted that there will be 3.7 million new HIV infections and 2.6 million adults dying of AIDS in this region each year within the next two decades. The authors predict that combining effective prevention and treatment efforts, however, could yield substantially greater benefits than the sum of the two alone--lowering projected new infections by 74% and projected annual mortality by half. These percentages translate into 29 million new infections and 10 million deaths averted between 2004 and 2020. While treatment itself can be life-saving, long-term reductions in AIDS deaths will be achieved only if new infections are curbed. What is more, campaigns to expand treatment access in poor countries will only be sustainable if prevention efforts are strengthened at the same time. As the authors say: "Treatment can enable more effective prevention, and prevention makes treatment affordable. Sustained progress in the global fight against HIV/AIDS will be attained only through a comprehensive response."
Citation: Salomon JA, Hogan DR, Stover J, Stanecki KA, Walker N, et al. (2005) Integrating HIV prevention and treatment: From slogans to impact. PLoS Med 2 (1): e16.
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