New HIV Prevention and Treatment Must Be Implemented and Optimized, NIH Says

Optimization and implementation of effective toolkits for HIV prevention and treatment may have a major impact on the HIV pandemic, according to experts from the National Institute of Health.

Researchers explained that basic and clinical biomedical research over the past decades has led to “toolkits” involving highly effective interventions for preventing and treating HIV.

“Despite many successes in decreasing incidence and mortality of HIV, major challenges remain in the goal of ending the HIV pandemic in the United States and globally,” explained the authors of the report. “Overcoming these challenges will require optimization of the implementation of existing interventions for HIV prevention and treatment together with the continued development of new and innovative approaches that can be readily utilized by individuals with HIV and those at risk of infection.“

Currently, antiretroviral therapy (ART) is used to improve health and prolong the lives of patients with HIV while also actively preventing spreading the virus. For example, people without HIV but at risk may take antiretroviral drugs as pre-exposure prophylaxis (PrEP) to prevent exposure.

Despite the efficacy of such drugs, the authors emphasized the need for maximizing the implementation and improving treatment and prevention tools because adherence challenges remain.

“The need to take a medication for any disease, even just a single pill per day is for some people a considerable burden, and adherence to both HIV treatment and prevention regimens remains suboptimal,” the authors stated. “The underlying reasons for poor adherence are multifaceted and include the inclination to avoid a pill that may be a daily reminder that one is living with HIV. Stigma, sometimes leading to violence that is associated with taking daily ART also is an important stumbling block.”

New approaches that researchers are considering include a cure that would eradicate HIV or maintain it at very low levels, as well as long-acting ART that would not need to be taken every day. Additionally, the report noted that scientists are working towards developing a preventive HIV vaccine.

“In 2019, robust toolkits for treating and preventing HIV infection are available. It is essential that we maximally implement these existing interventions while continuing to pursue the discovery and development of innovative approaches, novel technologies, and experimental interventions,” concluded the authors. “These new tools potentially will have improved efficacy, but also could help achieve greater coverage because of better acceptability/usability by people with HIV or at risk of infection.”