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IAS 2011: Biomedical Prevention a Watershed, Global Access Remains Elusive

The 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011) opened Sunday with applause for recent breakthroughs in biomedical prevention of HIV transmission, coupled with acknowledgement that much remains to be done to bring the benefits of science to people with and at risk for HIV/AIDS worldwide.

The conference, which runs July 17-20 in Rome, is a key HIV research meeting alternating with the larger International AIDS Conference. Typically focusing on antiretroviral therapy and management of complications, this year's meeting has a heavy emphasis on biomedical prevention, or use of antiretroviral agents and other medical interventions to reduce transmission risk.

"It's no longer 'treatment as prevention', it's 'treatment is prevention'," said local conference co-chair Stefano Vella.

At the opening plenary and press conference Sunday evening, IAS president and international co-chair Elly Katabira summarized recent advances in the field, many of which will be presented in detail at the meeting.

The iPrEx study showed that pre-exposure prophylaxis, or PrEP, using tenofovir/emtricitabine (the drugs in Truvada) reduced transmission by 73% among men who have sex with men who reported the best adherence. Data released last week from the Partners PrEP and TDF2 studies showed an even greater reduction in transmission within heterosexual couples. HTPN 052 showed that early treatment reduces the risk of transmission by 96%, again among heterosexuals. Only the Fem-PREP study has failed to demonstrate significant benefit

"We are at a scientific watershed in the global AIDS response," Katabira said. "The results presented this week could prove to be as important for the future as the antiretroviral breakthroughs of the 1990s."

Enthusiasm about successful prevention approaches after several years of failures is reflected in the more than 3000 submitted abstracts and 5000 conference attendees -- the largest numbers ever.

But many challenges remain when it comes to translating scientific breakthroughs into universal access to treatment for people living with HIV and effective prevention for those at risk.

"It is especially important that we talk about remodeling the AIDS response as a long-term policy rather than a global emergency," Katabira said. In particular, he expressed concern about international trade and patent laws currently under negotiation that could hamper access to essential medicines.

"This is a significant threat to access to generic drugs in countries like Uganda," he stressed. "Loss of access in low- and middle income countries would be a tragedy. Access to all drugs, including generics may not be diminished by new laws anywhere in the world."

"The time has come for universal access to science," said plenary keynote speaker Michel Sidibé, executive director of UNAIDS. But also stressed the need to tear down other types of barriers to prevention and treatment, including stigma, discrimination, and laws against heavily impacted groups such as gay men, sex workers, and drug users.

"Science without activism is like evidence without action," Sidibé concluded.

Elly Katabira at opening press conference [VIDEO]

Michel Sidibé at opening press conference [VIDEO]

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7/17/11