The scientific understanding of HIV transmission and antiretroviral treatment has evolved considerably over the past decade. There is a new optimistic message from clinicians, politicians and PLHIV: “HIV is different now” and research demonstrates that there is hope to further improve health outcomes for PLHIV with early initiation of treatment.
A lot of excitement has also been generated by the discovery that an undetectable viral load as a result of early treatment (with a CD4 count between 350 and 550) has the potential to reduce the risk of passing on HIV to a regular sexual partner by 96%.
Much like the virtual elimination of mother-to-child transmission as a result of treatment in resource-rich settings, the community is now excited by another biomedical prevention opportunity: providing early and accessible treatment can make a significant contribution to the virtual elimination of sexual HIV transmission. This is one part of what has become known as “treatment as prevention”.
Australia has committed to the 2015 UN target of ending the prevalence of AIDS by 2030, as part of the Sustainable Development Goals. The target includes 95% of all people living with HIV knowing their HIV status, 95% of people who know their HIV-positive status having access to treatment, and 95% of people on treatment having suppressed viral loads. This commitment reflects the mounting evidence that starting treatment early is beneficial for the individual, and will also help to prevent HIV transmission if the provision of accessible treatment is partnered with efforts to increase HIV testing.
If you are interested in how HIV treatment blocks viral replication at distinct stages, please watch the 5 minute animation at the top of the page, which explains the life cycle of HIV and distinct stages of viral replication.