Track B report by Dr. Federico Pulido
Plenary Session. MOPL01
MOPL0101. Ending the HIV Epidemic: From Scientific Advances to Public Health Implementation.
During this Plenary Session, Anthony Fauci gave a brilliant talk about the best way to achieve the end of the HIV epidemic. He reviewed the milestones of basic science that have advanced our knowledge of the treatment of HIV infection. This information has enabled the development of two main kinds of interventions: treatment and prevention.
Currently we have 30 antiretroviral drugs, which combined in different regimens have started to change the prognosis of the infection, with expected survivals close to the general population, even in those countries with lower resources. Prevention involves many different, but complementary, biological and behavioral interventions: testing, education, drug/alcohol treatment, condoms, harms reduction, blood screening, PMTCT, STI treatment, male circumcision, microbicides, treatment as prevention and/or PrEP.
While some interventions remain a scientific challenge (vaccine and cure), global implementation (including low and middle income countries) of the other, already available interventions would take as to the final objective of ending the HIV epidemic and have an AIDS-free generation.
Track C report by Christopher Hurt
Anthony Fauci, from the National Institutes of Health (U.S.), summarized key advances in basic and clinical science over the entire epidemic, and then discussed successes in treatment and prevention. Vaccines remain the missing element, but research is ongoing in this area. Momentum is building for an HIV cure – either eradication or a “functional” cure. Successful implementation of these various approaches is possible, but it will require a commitment from all stakeholders, at all levels, worldwide.
Phill Wilson, founder of the Black AIDS Institute, described the situation of U.S. Black men who have sex with men (MSM), who are disproportionately impacted by HIV incidence, noting that the odds that a Black MSM will become infected rises from 1:4 at age 25 to nearly 55% by the time he reaches age 40. But he also acknowledged that the epidemic is much, much broader – and many voices must be a part of the conversation on the HIV epidemic in the United States. He encouraged community and advocacy groups to address misperceptions about HIV treatment and prevention head-on.
Hillary Clinton, U.S. Secretary of State, described new funding initiatives sponsored by the U.S. government, and detailed a shift in strategy for PEPFAR from an “emergency” mode toward building health infrastructure and settling in for the long-term fight. The U.S. is encouraging prevention efforts to be combined, including condoms, counseling and testing, treatment as prevention, voluntary male circumcision, and prevention of mother-to-child transmission. She also emphasized the importance of addressing gender inequality and structural issues that place women at increased risk for HIV acquisition.
Sheila Tlou, with UNAIDS in Botswana, discussed progress on HIV treatment and prevention in Africa, spurred on by grassroots advocacy and governmental commitments in specific countries, continent-wide. She went on to outline a variety of social and structural challenges that remain, as well as potential options for overcoming them.