December 1st is World AIDS Day, a day to honor the 34 million people living with HIV, remember the nearly 30 million people who have died of AIDS-related causes, and assess the progress we’ve made and the challenges that remain. On this World AIDS Day, I am optimistic that we will continue to make progress, but mindful of the significant challenges that we still face.
I live and work in KwaZulu-Natal, a province in South Africa with the highest prevalence of HIV in the country. My wife, Quarraisha, and I first embarked on a career of HIV research in 1989 when we conducted a community-based study on HIV in the general population in rural South Africa. The study results demonstrated the huge burden of HIV in young women. Young women were three times more likely to be infected with HIV than young men. For the past 22 years, we have dedicated our careers to finding technologies to prevent HIV, with an emphasis on technologies that can empower women to protect themselves from HIV, since they still bear the brunt of the epidemic.
Until recently, men have largely controlled most forms of HIV prevention: male circumcision, condom use, abstinence and remaining faithful. In the past 15 months, however, we have witnessed a sea-change.
During this period, studies have suggested that a variety of HIV prevention methods may be effective. A topical microbicide demonstrated 39 percent effective in preventing HIV in women; taking an antiviral pill daily reduced HIV in men who have sex with men by 44 percent. Treatment as prevention also came to the fore; when an HIV-positive partner started treatment early there was a 96 percent reduction in risk of transmission to the uninfected partner.
These findings show the potential for women to take control of HIV prevention and have given us new hope that we can dramatically change the course of the epidemic.
To be sure, there will continue to be setbacks and challenges. Just last week, another study evaluating the use of a topical microbicide in women was halted because no measurable protection was seen. More research on the potential of ARV-based topical microbicides and other HIV prevention tools for women is needed to enhance the discussion of the future of these discoveries.
In the meantime, thanks to lifesaving antiretroviral therapy, it is possible to live a healthy life with HIV. The recent cascade of positive scientific discoveries in HIV prevention underscores the importance of HIV testing as a key entry point, not only for treatment, but also for prevention. Knowing one’s HIV status provides an opportunity to explore different prevention options and decide which one is the best choice. In short, knowing one’s HIV status is now more important than ever.
We have an opportunity to change the course of the HIV epidemic. And this is only the start. We will continue to build on our results and, in the next five to seven years, I believe we will have an even wider range of effective prevention tools. The challenge now is to continue investing in research and to translate existing findings into policy and implementation. While this is difficult, I am confident the HIV community will come together to put these new tools into the hands of those who need them most.
On this World AIDS Day, there is reason for hope.