MELBOURNE, Australia — In preparation for the International AIDS Conference in Melbourne on July 20, the World Health Organization issued a series of consolidated guidelines for combating the illness among most at-risk populations.
The WHO specifically recommends that men who have sex with men, or MSM, take antiretroviral medicines as an additional preventative to contacting HIV.
Condom use is still the number one way to prevent HIV, but for certain key populations including MSM, further measures must be considered, according to the WHO.
According to a study by Dr. Chris Breyer of Johns Hopkins University Bloomberg School of Public Health, on a global level, MSM have disproportionally higher HIV prevalence rates than the general population of sexually active adults.
This statistic holds true in every region of the world, with its highest rates in sub-Saharan Africa and the Caribbean.
Contributing to MSM community’s high prevalence rates of HIV across the world are certain socioeconomic factors that inhibit treatment and care. These include discrimination and criminalization due to sexual orientation and lack of access to healthcare options.
The data also suggests that the incidence of HIV infections amongst MSM is either stable or rising around the world.
A published report by the International AIDS Society that tracked a group of MSM in Thailand revealed that over a period of 60 months, 23 percent of sexually active Thai MSM in the study of all ages became infected with HIV.
This rise in virus contraction occurred despite the facts that the country has good antiretroviral therapy access, homosexuality is not a crime in Thailand and infections among the heterosexual population are decreasing.
It is clear that a change in certain social perceptions and government laws, such as the elimination of homophobia and the normalization of same sex practices, would help contribute to the decline of HIV infection rates amongst MSM groups. However, at the moment, the promotion of pre-exposure prophylaxis, or PrEP, can contribute to lowering the number of new infections more quickly.
Research estimates that PrEP can globally reduce HIV incidence among MSM by 20-25 percent and would prevent nearly 1 million new illnesses among the population over the next 10 years.
PrEP is a pill, a combination of two ARVs, commonly known as Truvada that is taken by people who do not have HIV but who are at a high risk of contracting the disease. Proper consumption of this drug on a daily basis has demonstrated a reduction in the risk of the HIV infection by up to 92 percent.
The pill already gained approval in many countries, but has sparked some controversy surrounding its potentially serious side effects in healthy people and its encouragement of risky sexual behavior.
However, the WHO’s HIV department claims that the concerns surrounding the use of the HIV drug for preventative measures are not justified.
According to recent studies involving PrEP practice, the rate of adverse reactions are low. In regards to influencing sexual behavior, it appears that individuals who choose the PrEP method already have difficulties with condoms, and thus the promotion of the drug does not correlate with a decline in condom usage.
In order to combat the drug’s high costs, the company that makes the pill, Gilead Sciences, authorized its manufacturing in lower income countries such as South Africa and India. As a result, the cost of PrEP in these regions has declined to about 25 cents a day.
The WHO guidelines are non-binding for governments and act as a more suggestive measure for future legislative action. Yet, the organization is hopeful that the release will impel countries to pay more attention to the HIV treatment and prevention of its most vulnerable populations.
“None of these people live in isolation,” said Dr. Gottfried Hirnschall, Director of the HIV Department at the WHO. “Failure to provide services to the people who are at greatest risk of HIV jeopardizes further progress against the global epidemic and threatens the health and wellbeing of individuals, their families and the broader community.”
– Talia Langman
Sources: Blog.Aids, WHO, NPR, All Africa
Photo: KQED