Monday, August 20, 2012

Road to an AIDS-free world

MELBOURNE: The World AIDS Conference is held every two years and aims to not only increase awareness about HIV, but to also find that elusive cure. Held in Washington this past July, the conference once again brought scientists and patients together, inspiring the hope of an AIDS free world. Rachel Barnes spoke to conference attendees, Professor Sharon Lewin from the Burnet Institute and Matt Dixon from the Victorian AIDS Council.

Co-head of the Centre of Virology at the Burnet Institute and Director of Infectious Disease at Alfred and Monash, Professor Sharon Lewin is a key player when it comes to challenging HIV. Professor Lewin not only works as a scientist in a laboratory researching the disease but she also actively works as an infectious disease physician with HIV patients. Professor Lewin has been attending the conference for 20 years: “The World AIDS Conference is a real landmark event for all people working in HIV,” Professor Lewin says. “It’s often not the peak scientific conference but there’s a lot of detailed scientific information presented and it’s a really important conference to track how we’re going and see the really important changes in the field and how to implement them.”

Despite a previous lack of scientific content at the conference it is now a place where scientists can meet up and network their ideas. However, the event still continues to push its original key goal of equality.

“The conference has fought for reducing stigma and discrimination for years,” Professor Lewin says. “It’s been a hallmark agenda of the International AIDS Society and of that conference.”

Every conference celebrates people with HIV and strives to show the world that they are not second class citizens. As well as this, there are two other main themes at the event; one of these is the importance of finding a cure for HIV and how this would make a big difference to the strategies of getting people on treatment.

“If you can find a cure it means that people don’t need to be on treatment for forty to fifty years, they might only need to be on treatment for five or ten years and that would free up a lot of capacity and money to treat more people,” she says.

However, until this is found there are actually current ways to control HIV, which can essentially rid the world of AIDS. While current treatments do not mean the end of the HIV virus, it does mean those who can access treatment can hope to live relatively disease free.

One of the main goals at the conference is to reduce new infections to 50% by 2015. We know that we already have the tools to do this, what we need now is to figure out how to actively get people tested, finding people that are positive, getting them in care, and keeping them on treatment.

“One area we really need to work on is increasing testing... If we could do that really effectively everywhere we could basically eliminate AIDS,” Professor Lewin says.

It’s no question as to whether or not Australia is doing this effectively, we have an extremely low infection rate with basically a steady one thousand new diagnoses a year for the past ten years. The question is, how we can do this even better?

“Although our infection rates are low we need to look at ways as to how we can get that even lower,” Professor Lewin says. “How we can test people earlier and that could involve home based testing or rapid testing. Starting treatment at the right time and keeping people in them.”

Although HIV is considered to be low prevalence in Australia, it is high prevalence in certain risk groups and Professor Lewin says we need to change the approach we have been using for the past ten years if we want to get our rates even lower. With HIV in Australia predominately found in gay men, Professor Lewin says the message has to get out to them.

“Gay men are in a very significant high risk group and they should be investing in more aggressive testing,” she says.

“Because once you get tested then you know what your risk is, you can access treatment which reduces your risk of transmission and you can access treatment which reduces your risk of getting sick.”

The Executive Director of the Victorian AIDS council, Matt Dixon went to both the World AIDS Conference and the Global forum on MSM [Men who have Sex with Men]. The Forum is a pre-conference meeting that concentrates on gay men, MSM and trans people.

Dixon agrees with Professor Lewin and believes that we need to focus on assisting those in high risk groups. Rapid testing could be one answer to this issue as it enables people to get a test result in twenty minutes rather than the current two weeks. Though Australia does not have access to it yet, Dixon is hoping this will change soon. “We are hoping to work with the Victorian Government and other partners to do a trial of rapid testing in a community setting,” he says.

One of the things that excited him most about the conference was learning about new prevention developments.

“It was very useful to hear more about PrEP (Pre-Exposure Prophylaxis) where a person who is HIV negative may take antiretrovirals in order to protect themselves from becoming HIV positive. We are keen that trials of PrEP happen in Australia, so we can work out how it should be used and who it would be most useful for.”

Despite the new research and treatment options, Dixon says that high HIV rates are found in gay men because of the negative impact of restrictive laws and cultures. He believes this can all be changed by non-clinical treatments.

“The answer to HIV lies as much in human rights and equality as it does in vaccines or treatments,” he says.

With the situation in the worst HIV affected nations getting better each day, it may only be a matter of time before we see an AIDS free world.

“We know what to do and now we have to work out how to do it and how to make it sustainable,” Professor Lewin says.

Even in the worst effected nation we are starting to hear some great success stories. Though 80 percent of people living with AIDS are located in Africa, the number of new infections has been reduced by 20 percent and the number of people on treatment has increased. With this kind of news coming from the worst affected country, it would seem we are at the very least, heading in the right direction.

World AIDS Conference 2014 will be held in Melbourne. For more information: