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World AIDS Day Marks Progress Toward Prevention


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world aids day 2010 december 1 globe with aids awareness ribbonWednesday marks the 22nd annual World AIDS Day. In the past year several scientific advances have helped rekindle convictions that progress is being made against the spread of HIV and AIDS.

Last week researchers presented findings in The New England Journal of Medicine that prophylactic antiretrovirals—along with counseling and other prevention services—reduced HIV infection rates in men who have sex with men by about 44 percent.

For women, a vaginal gel containing tenofovir cut one South African study group’s risk of becoming infected by 54 percent, according to a July report in Science.

Another study, published this September in JAMA, The Journal of the American Medical Association, found that a cheaper drug regime (using neviraprine rather than protease inhibitors) kept children born to HIV-positive mothers disease free. And prophylactic antiretrovirals helped those HIV-infected mothers who breastfed their infants reduce transmission to their children to just 1.1 percent, according to a June study in The New England Journal of Medicine.

But, like the 2009 Thai trail findings that a vaccine reduced infection rates, none of these new promising prevention advances has reduced the transmission rates to the true target: zero.

Some 33.4 million people across the globe have HIV, about two thirds of whom live in Sub-Saharan Africa. A November 29 report by the Institute of Medicine (IOM) concluded that by 2020 the number of Africans with the disease will increase to 30 million—but access to sustaining antiretrovirals will not likely be able to keep pace. "Already in Uganda and a few other nations, we don’t have enough health care workers or [antiretroviral therapy] to meet demands, and health centers are increasingly turning away patients who need these drugs to survive," David Serwadda, a professor at the School of Public Health at Makerere University in Kampala, Uganda, and co-chair of the IOM committee, said in a prepared statement.

In the meantime, innovative approaches are helping infected individuals that have access to antiretrovirals manage their disease. A trial published last month in The Lancet found that a simple weekly text message helped HIV-positive people keep viral levels low.

And more basic research on the disease is helping scientists understand what it does inside the body. One recent study found three ways that the infection develops in the male genital tract, and another showed how evolutionary biology could be used to trace an infection back to a source—results which have held up in U.S. federal courts.

And elevating HIV from health scourge to artistic inspiration, a clever composer has used the HIV genome—sequenced in 2009—to create a lyrical album of the retrovirus’ code as transcribed into hosts’ cells.

Read more about advances in AIDS research—and the challenges that remain—in our in-depth report: What’s Next for AIDS.

Image courtesy of iStockphoto/JuSun

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