Two AIDS concepts unite in bid to end pandemic
“Treatment As Prevention” (TasP) and “Undetectable equals Untransmittable” (U=U), two concepts or treatment perspectives about AIDS with the same goals, surround the observance of World AIDS Day 2019. When joined together, they reveal a new framework around the evolving face of AIDS.
These seemingly opposing ideas came from decades of research and experience from different areas: (1) science/ scientists, and (2) community/ PLWA (people living with AIDS).
This difference matters greatly as we build multiple pathways to end the AIDS worldwide pandemic — the first light of an end is in sight. Each of these concepts directly affects the lives of 37.9 million PLWA, including 1.7 million children worldwide, and together they bring hope.
Do we listen to the voice from the PLWA community or listen only to the proven science from doctors? Or both?
Doctors built the concepts of TasP. In 1996, the first protease inhibitor drugs were released by the Centers for Disease Control after drug trials showed initial successes. Several drug companies produced numerous generations of refined, protease inhibitor-type drugs that have successfully reduced the titer, or concentration, of the AIDS virus in the bloodstream to an “undetectable” level. This treatment protocol became known as antiretroviral therapy (ART).
In a letter dated August 30 from Dr. Eugene McCray, director of AIDS Prevention at the CDC in Atlanta, wrote: “For ART, the science is strong and clear; the data show that the effectiveness for ART with viral suppression is estimated to be 100% for preventing sexual transmission of HIV. In other words, for persons taking ART as prescribed, and achieving and maintaining viral suppression, there is effectively no risk of transmitting HIV through sex.”
Repeated and subsequent lab bloodwork with undetectable results is also described as “viral suppression.” The scientists’ work provided one proven pathway to end the AIDS pandemic, but it required that every patient must follow and sustain ART protocol for their entire lifetime.
PLWA community member Bruce Richman began leading the charge to educate communities about another evolving concept: U=U.
As early as 2008, the Swiss government released the “Swiss Statement” by Dr. Pietro Vernazza. Also known as the “Big Secret,” it revealed that effective treatment (undetectable status) rendered a person no longer sexually infectious. Afterwards, one major AIDS group and government department after another, for many years, added their endorsements to the U=U program as Community Partners.
In early 2016, a collaboration of the U.S., Denmark, Switzerland and Australia issued the first U=U Global Consensus Statement as an advocacy tool. The U=U Movement has leveraged the first consensus statement and additional statements from its partners to build a growing group of over 900 Community Partners from nearly 100 countries. The U=U statements have been translated into 15 languages, and they also appear on Facebook and Twitter using the hashtag: #UequalsU. View the program at: www.preventionaccess. -org. But without continuous and sustained access to health care and meds, these two converging solutions will not work to effectively end the AIDS pandemic.
Ending the pandemic means retaining 100% of PLWA in complete adherence to meds for the rest of their lives; 2.3 million PLWA in the U.S. is a daunting task. In order to end the pandemic, the community is now faced with the task of reaching those hard-hit by AIDS: gay men of color, transgendered, black women, Latinas, and drug users, the most stigmatized and discriminated against, and living on the margins of our society.
AIDS has always been a fight. Light your candle and join the fight.