Abstract
In 2010, the fourth decade of the HIV pandemic arrived during a time of unprecedented success in HIV prevention. Globally, UNAIDS estimated that new HIV infections fell by 33% between 2001 and 2011; new infections among adults and adolescents fell by 50% or more in 26 countries (more than half of these countries were in sub-Saharan Africa), and new infections among children worldwide dropped by 52%. The declines in new HIV infections are particularly evident in countries with sustained and more strategic investments, which take into account the specifics of local epidemics, increased political leadership and community engagement in response to the HIV epidemic, and scale up of HIV prevention and treatment programmes.The rapidly growing delivery of antiretrovirals to women and infant feedingbased prevention programmes has resulted in a sharp decline in new HIV diagnoses among children. The encouraging declines in HIV infections can also be attributed to the improved effectiveness of combination antiretroviral treatment (cART), an expanded range of improved medications, the declining prices that make cART more accessible to people in low-income countries, growing coverage with HIV testing, and improved access to prevention and treatment services (particularly for women and young people in low-income countries). Global investment in the AIDS response jumped from US$3.8 billion in 2002 to US$18.9 billion in 2012. (Published: 1 December 2013) Citation: Zablotska I. Journal of the International AIDS Society 2013, 16 :18933 http://www.jiasociety.org/index.php/jias/article/view/18933 | http://dx.doi.org/10.7448/IAS.16.1.18933
Highlights
The new decade saw a revolution in HIV prevention with ground-breaking scientific advances in HIV biomedical prevention, and proof that microbicides containing an antiretroviral agent can reduce sexual transmission of HIV to women by 39% [3], that earlier start of treatment by HIVpositive people can reduce the risk of onward transmission by as much as 96% [4], and that consistent, correct use of a daily antiretroviral tablet by men who have sex with men (MSM) can achieve substantial reductions in HIV infections [5]
In response to the excitement and optimism surrounding the preventative effects of antiretroviral medications, the UN member states considered and unanimously approved the new Political Declaration on HIV/AIDS at a special session of the General Assembly in New York in 2011 [6]
In the past two years, research on HIV biomedical prevention has focused on adapting the new prevention strategies to the context of local HIV epidemics [8]
Summary
The new decade saw a revolution in HIV prevention with ground-breaking scientific advances in HIV biomedical prevention, and proof that microbicides containing an antiretroviral agent can reduce sexual transmission of HIV to women by 39% [3], that earlier start of treatment by HIVpositive people (treatment as prevention or TasP) can reduce the risk of onward transmission by as much as 96% [4], and that consistent, correct use of a daily antiretroviral tablet by men who have sex with men (MSM) can achieve substantial reductions in HIV infections (pre-exposure prophylaxis or PrEP) [5]. In response to the excitement and optimism surrounding the preventative effects of antiretroviral medications, the UN member states considered and unanimously approved the new Political Declaration on HIV/AIDS at a special session of the General Assembly in New York in 2011 [6].
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