By now, virtually every major medical group on the planet agrees on one simple piece of fact: The sooner you know about H.I.V., the more likely you are to prevent, cure or delay the onset of the disease.
How? With effective treatment, one way or another.
HIV/AIDS has a 50/50 death rate among those who are infected. This is far too high — and the majority of people with this disease have no symptoms. This discrepancy often leads to the dangerous practice of injection drug use (ISD), as those who have no symptoms could infect others in this very dangerous way. The population most at risk, according to most research, is men who have sex with men (MSM), young men and transgender people, people living in Africa, Eastern Europe and India.
One can imagine how heartbreaking it would be to meet people infected with HIV, only to find out later that an unwitting partner had unwittingly become infected. No amount of life-saving treatment could have averted this infection. However, treatment would have prevented a great deal of unnecessary suffering, to the point where infections could be effectively eliminated among those who were infected by a needle stick or having unprotected sex.
A LIFE ON LIFESAVING TREATMENT
For those who are infected but unaware that they have it, the situation is even more grim. Drugs like PrEP work, but only once they have been taken for six months to a year. Many people live without knowing they are infected for a very long time, oftentimes much longer than the window that is considered effective. Not only is it heartbreaking for a person to live a life without knowing they were infected, but many others, as well. This is why it is so important to treat more aggressively. But this is also because many medical treatments have multiple side effects. Adding PrEP to a person’s otherwise medically strong cocktail can carry serious health risks.
So what can one life tell us about the battle against H.I.V.? As the public awareness of HIV/AIDS has increased in recent years, people have become more familiar with this disease and have become more likely to recognize and get the life-saving care they need when they need it. Consequently, although infection rates have not dropped as dramatically as they once were, infection rates are still drastically down compared to 30 years ago.
This is a problem of our health care system. While treatments for HIV are considered relatively safe for those who use them effectively, most people with HIV/AIDS are not able to receive the full help they need. The uninsured, who account for 45 percent of those living with HIV/AIDS, often receive little attention from their health care systems. Other people are left to die on the streets of America as the rest of us just figure out what it means to live “healthily.” Of those people who have healthcare, 70 percent still are not getting the preventative care they need. This is unacceptable.
With a new drug called Epivir called to market in the next few months, HIV experts say that a light has been thrown on the dark side of this ongoing fight.
A MOVE IN THE RIGHT DIRECTION
Epivir is a new cocktail of medications and was developed with the specific goal of preventing HIV among those who are likely to develop the disease, including people who inject drugs. Doctors say that it works best when taken by more than one person per week. It does not work well in those who inject drugs but could work equally well in those who do not inject drugs. It is designed to work with other well-used HIV-prevention drugs that have been in use since the early 1990s. The design and drug regimen for this drug was designed by the NIH’s National Institute of Allergy and Infectious Diseases.
The question is whether or not it will really work. That remains to be seen, as the treatment is only just coming to market. A randomized, placebo-controlled trial is currently underway with people living in the Boston area, to test the effect of Epivir over an 18-month period. Early results are promising; in early September, a press release announced that preliminary results were very promising. A total of 385 people with HIV/AIDS are enrolled in the study, and after completing the 18-month treatment course, 200 were found to be in remission. Those in remission may then begin a post-treatment drug maintenance regimen to maintain their remission indefinitely. It is very promising and will be interesting to see if other people with HIV/AIDS will develop similarly encouraging results.
Although it is very likely that this drug will ultimately fail, once it is used widely, we could once again stop feeling so sad when someone dies of H.I.V