Early treatment for HIV patients should be the government‘s main HIV/AIDS prevention strategy, the Taiwan AIDS Society said yesterday, citing recent studies that have shown that early treatment is associated with a 96 percent relative risk reduction in HIV transmission compared with delayed therapy.
Since 1984, the number of reported HIV cases in the country is 24,239. In the past five years, the number of new HIV infections has been highest among people aged between 20 and 29, followed by those aged 30 to 39, society director-general Lin Hsi-hsun (林錫勳) said.
“The two age groups account for 77 percent of the total infections reported since 1984,” he added.
The ABC — Abstain, Be faithful and use a Condom — approach used to be the leading HIV prevention strategy, which should now be replaced by the new ABCDE approach, with the extra D standing for Drugs and E for Education, Lin said.
While past prevention strategies promoted behavioral changes, Lin said the new approach is a “combination prevention” program, incorporating many HIV prevention methods, including education, legal reform and early antiretroviral treatment.
“Sex and HIV prevention education should be taught at a young age, as is gender equality. Eliminating the stigma and discrimination against people with HIV should also be part of the education program,” Lin said.
“Building a zero-discrimination environment can also be supported by revising any laws that discriminate against people with HIV,” Lin added.
Lin was referring to Article 21 of the HIV Infection Control and Patient Rights Protection Act (人類免疫缺乏病毒傳染防治及感染者權益保障條例), which states that “individuals who are fully aware that they are infected who have, by concealing the fact, unsafe sex with others … shall be sentenced to five years to twelve years in prison,” a law that Lin believes reduces people’s willingness to be screened for the virus.
“The law was drafted in a different temporal context, when the treatment and control of HIV infection was not as developed and effective,” Lin said, adding that studies have shown that if a patient’s viral load is well-managed and reduced to a level lower than 400 copies per milliliter, the transmission rate can be close to zero.
Underscoring that early antiretroviral therapy has been shown to be associated with risk reduction in HIV transmission, Lin proposed to have payment for the treatment, which is currently shouldered by the annual budget of the Centers for Disease Control, covered by the National Health Insurance.
“No group should be excluded from NHI,” Lin said. “Some might oppose the idea by saying that the NHI can hardly sustain itself with its existing funding. However, they are overlooking the fact that an even greater financial burden is lurking with an annual 15 percent increase in HIV infections.”