November 16, 2009
A controversial strategy to eradicate HIV with aggressive treatment of those already infected is being tested in Washington.
"The purpose is to get the level [of HIV in the blood] down so that people will not infect anyone because their viral load is so low," said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. "The philosophy is if you could test everybody, and treat everybody who has HIV, you could use treatment as prevention."
The experiment follows a World Health Organization report last year that suggested the strategy could reduce HIV prevalence to 1 percent in 50 years. It is to be launched by the White House around the time of World AIDS Day, Dec. 1.
The approach relies on global universal treatment with antiretroviral medications. The study protocol calls for health department personnel to be schooled in modernizing patient record-keeping and encouraging patients to take medication even when they feel well.
One study area is Anacostia, a predominately African-American community on Washington's south side. A similar experiment is underway in the Bronx, New York City.
Detractors suggest there is no scientific evidence to suggest the approach will work and that it would be financially prohibitive to implement even if it were effective.
"It's so far in the hypothetical stage that I wouldn't even rank it" among the proven methods of controlling HIV such as condoms and needle exchange, Fauci acknowledged.
Bradley G. Wagner and Sally Blowers, University of California-Los Angeles researchers who say they advanced the "treatment as prevention" approach 10 years ago, approved of the WHO strategy albeit with lower expectations.