UN Dispatch will be at the International AIDS Conference in Washington, DC all week.  This is huge gathering of HIV/AIDS activists, researchers, policy makers, and NGOs.

What may be one of the lasting take-aways of the 2012 conference is a paper published in the Journal of the American Medical Association recommending that patients diagnosed with HIV start taking anti-retroviral drugs immediately upon diagnosis.

Traditionally, a patient that tests HIV positive waits until his or her CD4 blood cell count reaches a certain threshold.  The doctors routinely check the patients CD4 count, and wait until it drops to a certain level before prescribing ARVs. The idea was that 1) patients not showing symptoms might not consistently take the drugs, and resistance might develop; 2) there were some risks of side-effects of ARVs.

New recommendations from the International Antiviral Society-USA called that logic into question. A series of studies have shown a multitude of benefits of taking ARVs early, for both the patient and for the global fight against the spread of the disease. A patient with HIV who is on ARVs is much less likely to transmit the virus than an untreated patient. ARTs can be a prevention tool–not just a way to treat people living with HIV.

The caveat here is that getting people on treatment at time of diagnosis is really only possible in rich countries. Even though the price of ARVs has dropped dramatically in recent years (to under $100/year/patient), it would be prohibitively expensive for health budgets of Sub-Saharan African countries where the HIV burden is the highest.  Putting people on treatment early  means they will be on treatment longer, which is too expensive for resource constrained countries.

So, while this announcement is further sign of the technological progress we are making against the virus it is yet another reminder of the urgency of scaling up funding to bring these innovations to the people and places that need it the most.

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