What Are the Main Components of a "Treatment as Prevention" Program?
- Increasing the Number of People Who Know They Are HIV-Positive. In Canada, it is estimated that 26% of people living...
- Increasing the Number of People With HIV Receiving Treatment. In order for treatment as prevention to work we need to...
- Clinical Eligibility. In the mid 1990s anti-HIV treatments,...
Full Answer
What does prevention is better than cure mean?
Apr 27, 2022 · Treatment as Prevention (TasP) refers to taking HIV medicine to prevent the sexual transmission of HIV. It is one of the most highly effective options for preventing HIV transmission. People with HIV who take HIV medicine (called antiretroviral therapy or ART) as prescribed and get and keep an undetectable viral load—a very low level of HIV in the …
What are the principles of treatment and Prevention?
Treatment as prevention is a term that refers to the impact that treatment has on viral load, and therefore HIV transmission risk.
Is treatment the same thing as prevention?
Mar 26, 2013 · Treatment with ARVs is one form of prevention, but it's not a foolproof method for preventing the spread of HIV. Antiretroviral treatment lowers your risk of …
Is prevention the best treatment?
A person living with HIV but undetectable can not transmit HIV. The medication TREATMENT is PREVENTION of spreading hiv. I have also heard people interpret it as being on prep and regularly being tested for std. 9. level 1. Postcrapitalism. · 3y · edited 3y 35-39.
What is meant by treatment as prevention?
When did treatment as prevention start?
What is the meaning of u u?
Do I need to take PrEP if my partner is undetectable?
Can I infect someone while on ARVs?
What does u'u mean in texting?
Is Untransmittable a word?
What the meaning of undetectable?
: unable to be detected : impossible to discover or notice : not detectable an almost undetectable change undetectable traces of poison Signs of life may be so minimal as to be undetectable by modern instruments …—
How does treatment as prevention work?
Treatment as prevention has been used as a form of controlling the spread of HIV since the mid-1990s, initially in the context of preventing the transmission of the virus from mothers to their children. Research in 1994 revealed how the drug zidovudine can reduce vertical transmission. The testing and treatment of HIV-positive mothers during pregnancy, childbirth, and breastfeeding has since led to the reduction of the risk of transmission by up to 95%. A program for offering ARVs for life to any HIV-positive pregnant person called "Option B+" served as a precursor to the "test and treat" strategy that is now being rolled out in various countries. Assessments of the Option B+ program are able to aid in the improvement and further establishment of "test and treat".
What is HIV management?
Management of HIV/AIDS includes services such as HIV testing and diagnosing, consistent HIV care and treatment, education lessons regarding how to use ART effectively and distribution methods to ensure individuals receive their medications.
What is a tasp?
Treatment as prevention (TasP) is a concept in public health that promotes treatment as a way to prevent and reduce the likelihood of HIV illness, death and transmission from an infected individual to others. Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, ...
Does TasP prevent HIV?
Although some experts narrow this to only include preventing infections, treatment prevents illnesses such as tuberculosis and has been shown to prevent death. The dual impact on well being and its 100% effectiveness in reducing transmission makes TasP the most important element in the HIV prevention toolkit.
What is ART therapy?
In relation to HIV, antiretroviral therapy (ART) is a three or more drug combination therapy that is used to decrease the viral load, or the measured amount of virus, in an infected individual. Such medications are used as a preventative for infected individuals to not only spread the HIV virus to their negative partners ...
What is undetectability in HIV?
Undetectability ensures that infection does not necessarily have an effect on a person's general health, and that there is no longer a risk of passing along HIV to others. Consistent adherence to an ARV regimen, monitoring, and testing are essential for continued confirmed viral suppression. Treatment as prevention rose to great prominence in 2011, ...
When will HIV/AIDS be eliminated?
The diminished rate of new HIV infections brought about by these strategies are marked progress towards UNAIDS' 90-90-90 and 95-95-95 target to eliminate HIV/AIDS as a public health crisis by 2030.
What is treatment as prevention?
Treatment as prevention is a new potential approach to help curb the growth of the HIV epidemic. If we take a step back, away from the science and all the questions about whether and how much it will work -- bringing more people into care is essential regardless of any prevention benefit.
Why is community based HIV prevention important?
Therefore, the community has an important role to play in ensuring that the human rights of people at risk for or living with HIV are safeguarded independent of the potential public health benefits of this approach .
What is observational research?
Observational research investigates the outcome of something that is naturally occurring. The researcher does not assign a person to either treatment or no treatment -- it is something that has happened naturally.
What is a model study?
A modelling study is a hypothetical description of what could happen if a change is made in a population or community. Modelling studies have attempted to explain the relationship between the effect of HAART and viral load on HIV transmission. A model developed by researchers in B.C. suggests that, at a population level, HAART may reduce the risk of HIV transmission. The model predicted that, with increasing numbers of people receiving HAART, there will be fewer transmissions within the population. However, the model suggests that at least 75% of people who are clinically eligible for treatment would have to receive treatment for there to be a substantial reduction in HIV transmission. 6
Does HAART reduce HIV?
A model developed by researchers in B.C. suggests that, at a population level, HAART may reduce the risk of HIV transmission. The model predicted that, with increasing numbers of people receiving HAART, there will be fewer transmissions within the population.
What is the best way to determine if a cause-effect relationship exists between treatment and outcome?
Randomized controlled trials (RCTs) are the most rigorous form of scientific study. They are the best way to determine whether a cause-effect relationship exists between treatment and outcome. This is because everyone has the same chance of being assigned to a treatment group or a control group and no one knows which group they are in. This means we can be pretty sure that any difference found is due to the intervention or treatment and not because of differences between the groups.
What is the name of the treatment for HIV?
In the mid 1990s anti-HIV treatments, called highly active antiretroviral therapy (HAART) became available for people living with HIV. HAART has been shown to significantly reduce the risk of illness and death as result of HIV. 26-31
What is a tasp?
HIV Treatment as Prevention (TasP) is an evidence-based strategy by which persons with an undetectable viral load are far less likely to transmit the virus to an uninfected sexual partner. While TasP was initially seen as a means of reducing individual risk when the concept was first introduced in 2006, it was only in 2010 ...
What is HTPN 052?
The HTPN 052 trial —which studied the impact of antiretroviral therapy (ART) on transmission rates in serodiscordant heterosexual couples —was stopped nearly four years early when it was shown that individuals on treatment were 96 percent less likely to infect their partners than participants who weren't.
How many people are unaware of HIV?
In the U.S., as many as one in five people with HIV are fully unaware of their status. In response, the U.S. Prevention Services Task Force is now recommending the once-off testing of all Americans ages 15 to 65 as part of a routine doctor's visit. It would require intensifying the follow-up of existing patients.
How many people with HIV are suppressed?
In fact, according to the CDC, only 59.8 percent of people with HIV are virally suppressed. These not only include people who refuse testing and treatment but those who fail to take their drugs every day as prescribed. With that being said, the aims of the strategy remain strong.
Why is TasP considered inconceivable?
Prior to the introduction of newer-generation antiretroviral drugs, TasP was considered inconceivable due to high levels of drug toxicities and viral suppression rates that only hovered around 80 percent, even for those with perfect adherence.
Who is James Myhre?
James Myhre is an American journalist and HIV educator. Latesha Elopre, MD, is a board-certified internist specializing in HIV and an assistant professor of infectious diseases at the University of Alabama at Birmingham. HIV Treatment as Prevention (TasP) is an evidence-based strategy by which persons with an undetectable viral load are far less ...
What is preventive medicine?
Preventive medicine is an important field of medicine.
Why is preventive medicine important?
Preventive medicine is an important field of medicine. It not only keeps patients and communities healthy, but it also helps keeps health costs down. All doctors incorporate some degree of preventive medicine into their practice. But primary care physicians are especially good at helping their patients stay healthy.
What does a syringe do?
They may provide you counseling for unhealthy habits, run preventive health screenings and give you immunizations, like a shot for pneumonia or shingles. They may work with patients who could benefit from lifestyle changes, such as those with diabetes, smokers or those who are overweight.
How often do you get colon cancer?
Colon cancer (colonoscopy) — Every 5-10 years after age 50. Healthy habits are important, too. Things like eating well, exercising and avoiding tobacco help us stay healthy, avoid disease and minimize the effects of disease. Practicing preventive medicine can also save you money.
What is the treatment for HIV?
People with HIV should take medicine to treat HIV as soon as possible. HIV medicine is called antiretroviral therapy, or ART. If taken as prescribed, HIV medicine reduces the amount of HIV in the body ( viral load) to a very low level, which keeps the immune system working and prevents illness. This is called viral suppression —defined as having ...
What is HIV medicine?
HIV medicine is called antiretroviral therapy, or ART. If taken as prescribed, HIV medicine reduces the amount of HIV in the body ( viral load) to a very low level, which keeps the immune system working and prevents illness.
How does HIV medicine work?
HIV medicine is called antiretroviral therapy, or ART. If taken as prescribed, HIV medicine reduces the amount of HIV in the body ( viral load) to a very low level , which keeps the immune system working and prevents illness . This is called viral suppression —defined as having less than 200 copies of HIV per milliliter of blood. HIV medicine can even make the viral load so low that a test can’t detect it. This is called an undetectable viral load.
How does HIV medicine affect the immune system?
If taken as prescribed, HIV medicine reduces the amount of HIV in the body ( viral load) to a very low level, which keeps the immune system working and prevents illness. This is called viral suppression —defined as having less than 200 copies of HIV per milliliter of blood.
Can HIV be transmitted to HIV-negative partners?
A person with HIV who takes HIV medicine as prescribed and gets and stays virally suppressed or undetectable can stay healthy and has effectively no risk of sexually transmitting HIV to HIV-negative partners.
Can a mother breastfeed a baby with HIV?
Current recommendation in the United States is that mothers with HIV should not breastfeed their infants. † The risk of transmitting HIV to the baby can be 1% or less if the mother takes HIV medicine daily as prescribed throughout pregnancy, labor, and delivery and gives HIV medicine to her baby for 4-6 weeks after giving birth.
What is the number for HIV testing during pregnancy?
Provides clinicians with around-the-clock advice on indications and interpretations of HIV testing in pregnancy, and consultation on antiretroviral use during pregnancy, labor and delivery, and the postpartum period.#N#1-888-448-8765 | 24 hours, seven days a week
Overview
Treatment as prevention (TasP) is a concept in public health that promotes treatment as a way to prevent and reduce the likelihood of HIV illness, death and transmission from an infected individual to others. Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, death and transmission was first proposed in 2000 by Garnett et al. The term is often used to talk about treating people that are currently living with hu…
HIV Prevention Trials Network clinical trial 052
Early work by Quinn in Uganda demonstrated that transmission was reduced by over 90% when people living with HIV were on treatment and virally suppressed. Observational evidence accumulated and the Attia metaanalysis supported the 2008 Swiss Statementthat said that those suppressed on treatment had little or no chance of transmission. Many experts, citing the Bradford Hill criteria, accepted this observational data. However, others called for randomized c…
Implementation
Treatment as prevention has been used as a form of controlling the spread of HIV since the mid-1990s, initially in the context of preventing the transmission of the virus from mothers to their children. Research in 1994 revealed how the drug zidovudine can reduce vertical transmission. The testing and treatment of HIV-positive mothers during pregnancy, childbirth, and breastfeeding has since led to the reduction of the risk of transmission by up to 95%. A program for offering A…
Challenges and risks associated with Treatment as Prevention
While TasP has a huge potential to prevent the further spread of HIV worldwide, the major barrier to implementing TasP is lack of political will. Specifically, estimates suggest that only around 60% of all resources for HIV go towards ensuring diagnosis and treatment while the rest is spent on other priorities. In some African countries multiple billions of dollars have been allocated with some only achieving 60-70% ART coverage. Global HIV control priorities often include 90-90-90 …
Short-term and long-term solutions
In 2002, The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund)was a financial initiative developed to raise and provide funding to the developing world in an attempt to enhance their care and treatment programs for individuals who are living with HIV/AIDS, TB and malaria. For the international organization to be successful, developed countries must work in conjunction with third-world countries, private organizations, civil society and afflicted communities to ease t…
Moving forward
Treatment as prevention has the ability to shift the paradigm of how HIV is received and treated. The effects of universal testing and treatment, and connecting people with resources for care will allow for global effects in terms of reduced rates of new HIV infections. The success of TasP is contingent upon innovation in strategies to increase the rate of HIV testing, along with exploring other dimensions of improving adherence, such as including cognitive and emotional support in …
What Is Treatment as Prevention?
- We know that treatment for HIV can effectively reduce the amount of virus in the blood of someone living with HIV (often to levels that cannot be detected by current viral load tests). For many people this reduction in the amount of virus may reduce infectivity (their ability to transmit the virus). However, we also know that treatment does not eli...
How Do We Know If Treatment as Prevention Will Work?
- We don't really know for certain if treatment of a large group of people and the resulting reduction in average viral load will result in a meaningful and reliable reduction in HIV transmission. However, four types of evidence suggest that it might work at a population level: 1. studies on mother-to-child (vertical) transmission; 2. studies of serodiscordant couples; 3. ecological studi…
Why Doesn't Treatment as Prevention Work on An Individual level?
- "Viral load" is a measure of the amount of the virus in the body of someone living with HIV. When someone is successfully treated for HIV with HAART, the blood viral load test reads as "undetectable." However, this does not mean that the virus is not present; rather, the level of virus in the blood is very low -- too low for the test to find it. However, since there is still virus in the bo…
What Are The Main Components of A "Treatment as Prevention" Program?
- Increasing the Number of People Who Know They Are HIV-Positive
In Canada, it is estimated that 26% of people living with HIV don't know they have HIV.22This means that approximately 16,900 people in Canada are unaware they have HIV because they haven't been tested (or tested recently enough to know they are now HIV-positive). Increasing th… - Increasing the Number of People With HIV Receiving Treatment
In order for treatment as prevention to work we need to increase the number of people on treatment. This can be done by increasing the number of people who access care and treatment and increasing the number of people who are clinically eligible for HAART.
What Does This Approach Mean For Community-Based Agencies?
- Community-based AIDS service organizations (ASOs) in Canada have been at the forefront of HIV prevention since HIV emerged in our communities. The work that has been done has been integral to prevention efforts in Canada. With the advent of potential new approaches to HIV prevention, such as treatment as prevention, there may be exciting changes to community-based programm…
Impact on Services
- In addition to programming aimed at increasing testing and treatment, community agencies may have additional demands on them for other services. As discussed, research has found that some marginalized people are not currently accessing treatment. However, many of these people are not well positioned to start treatment due to competing priorities in their life, such as poverty, dr…
Funding
- The cost of increasing the number of people on therapy could have a large financial impact. There is some concern that this increasing cost could lead to prevention dollars being diverted to finance treatment costs (since treatment is now seen as a form of prevention). The community must fight to ensure that funding agencies do not divert dollars in this manner. It should be note…
What Is Happening on The Ground?
- In April 2009 at the Canadian Association of HIV Researchers (CAHR) conference in Vancouver, Gordon Campbell, the premier of B.C., announced that his government was committed to implementing several pilot projects in the province to test programming that will bring more people into treatment. This announcement followed more than a year of meetings between the …
to Wrap Up ...
- Treatment as prevention is a new potential approach to help curb the growth of the HIV epidemic. If we take a step back, away from the science and all the questions about whether and how much it will work -- bringing more people into care is essential regardless of any prevention benefit. Despite access to care and treatment in Canada, people are being diagnosed with HIV infection l…
References
- Volmink J, Siegfried N, van der Merwe L, Brocklehurst P. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database of Systematic Reviews2006, Issue 4...
- Attia S, Egger M, Muller M, Zwahlen M, Low N. Sexual transmission of HIV according to viral load and antiretroviral therapy: Systematic review and meta-analysis. AIDS. 2009. 23:1397-14…
- Volmink J, Siegfried N, van der Merwe L, Brocklehurst P. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database of Systematic Reviews2006, Issue 4...
- Attia S, Egger M, Muller M, Zwahlen M, Low N. Sexual transmission of HIV according to viral load and antiretroviral therapy: Systematic review and meta-analysis. AIDS. 2009. 23:1397-1404.
- Fang CT, Jsu HM, Twu SJ, et al. Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan. Journal of Infectious Diseases. 2004.190:879-885
Research Breakthrough
Undetectable = Untransmittable
- The HTPN 052 was only the starting point in the journey to implement TasP. Between 2010 and 2018, two studies—called PARTNER1 and PARTNER2—aimed to evaluate the risk of transmission in gay and heterosexual mixed-status couples in whom the HIV-infected partner was virally suppressed This was considered significant since only 2 percent of couples in the HTPN 052 wa…
Challenges in Implementation
- Prior to the introduction of newer-generation antiretroviral drugs, TasP was considered inconceivable due to high levels of drug toxicities and viral suppression rates that only hovered around 80 percent, even for those with perfect adherence. The picture has largely changed in recent years, with the introduction of more effective, cheaper medications. Even in heavily hit co…
Evidence in Support to Tasp
- The city of San Francisco may be the closest thing to a proof of concept for TasP. With gay and bisexual mencomprising nearly 90 percent of the city's infected population, consistent, targeted intervention has resulted in a low rate of undiagnosed cases. But most agree that San Francisco has a unique dynamic to other HIV populations. There is still insufficient evidence to support wh…