MORE HIV-positive men need to think about starting treatment straight after diagnosis if ambitious targets to end HIV transmission by 2020 are to be met, the head of NSW-based LGBTI health body ACON has said.
The comments come as the organisation launches a major new sexual health campaign that also aims to clear up confusion surrounding one of the newest buzzwords in the HIV lexicon.
Talking to the Star Observer, ACON chief executive Nicolas Parkhill said there was increasing evidence that starting medication sooner had personal health benefits as well as protecting others.
“Treating early is one of the ways that we can reduce transmission and improve the health and wellbeing of our community,” he said.
“But only looking at one approach isn’t sufficient… We need to continue to test for HIV at high rates and we need to continue to utilise the prevention tools we already have, particularly condoms.
“It is only with a comprehensive approach and engaged community that takes ownership over these strategies that we can end the epidemic.”
Initial findings from Europe’s Partner study, released last year, found there was generally a one per cent chance, and at most a four per cent chance, of a person with HIV passing the virus onto their partner if their viral load was practically nil.
Taking antiretroviral therapy (ART) is effective in lowering viral loads but, previously, starting treatment hadn’t been recommended until after a person’s CD4 count had fallen below 350 – often some time after the initial diagnosis when viral loads are high.
Australian guidelines now recommend starting ART at any time after infection.
Last year, all the country’s health ministers reaffirmed the goal of the “virtual elimination” of all new HIV transmissions by 2020.
A phrase used throughout the ACON campaign is “undetectable” which, according to Parkhill, was increasingly being used online but understanding of the term was mixed.
“Depending on the context it could be used as a statement about overall health or it could also be used in sexual situations to indicate decreased risk of HIV transmission,” he said.
“It reflects the increasingly nuanced way that gay men relate to HIV [and] one of the goals of this campaign is to ensure that there is a consistent understanding of what the term means and what the impact is for people who are using it is a risk reduction strategy.”
Parkhill said preventing HIV transmission was the responsibility of both positive and negative people but the increasing use of terms such as “undetectable” could enable more open discussions between partners.
However, he was at pains to say the campaign wasn’t about demanding people treat early: “We recognise that there are differing opinions in our community about when to start treatment and we hope that conversations about this occur and that people make decisions about when to start treatment from a fully informed place.”