[Viva] Fwd: GNP+ : Results of iPrEx study remind us why universal access to HIV treatment and prevention is crucial

Wed Nov 24 23:24:35 PST 2010

This has been in the news lately.
fyi

---------- Forwarded message ----------
From: Martin Stolk (GNP+) <mstolk at gnpplus.net>
Date: Wed, Nov 24, 2010 at 9:05 AM
Subject: GNP+ : Results of iPrEx study remind us why universal access to HIV
treatment and prevention is crucial
To: margaritesanchez at gmail.com

*Amsterdam, 23 November 2010 - The Global Network of People living with HIV
recognises the contribution of researchers and trial participants;
emphasises the role of people living with HIV in ARV-based prevention; and
calls on new prevention tools to be placed within the broader universal
access movement.*

Results of the Pre-exposure Prophylaxis Initiative (iPrEx) study indicate
that a daily oral dose of two antiretrovirals (ARVs) in one pill reduced the
number of new HIV infections among sexually active men and transgender women
who have sex with men by 44%. The study, which was conducted among 2,499
HIV-negative individuals between the ages of 18 and 67 in six countries –
Brazil, Ecuador, Peru, South Africa, Thailand and the United States – found
that for individuals with 90% or greater daily adherence, there was 73%
reduced risk.

This significant HIV prevention development highlights the importance of
further research to respond to the HIV prevention needs of key populations
that are disproportionately affected by HIV.

GNP+ recognises the contribution of the men and transgender women who took
part in the study. Of the almost 5000 individuals who were screened for the
study, 410 were found to be living with HIV and, thus, ineligible for
enrolment.  A further 110 individuals seroconverted during the course of the
trial. These individuals with HIV-positive test results remind us of the
impact of HIV prevention studies on the lives of people living with HIV.
GNP+ calls on governments and those involved in funding and implementing
these studies to ensure that all those who are found to be HIV-positive
during screening or during HIV prevention trials are provided with the
necessary treatment, care and support.

The results of the iPrEx study illustrate why it is crucial to ensure
universal access to both treatment and prevention. We must carefully
consider the implications of providing ARVs to HIV-negative people as we
continue to secure and provide treatment for people living with HIV. Despite
unprecedented progress over the past decade towards universal access to
antiretroviral therapy (ART), it is estimated that by the end of 2009 only
36% of the 14.6 million people in low- and middle-income countries who need
treatment[1] were receiving ART. Recent reports from Africa and Eastern
Europe [2] highlight that governments are beginning to cap the number of
people living with HIV enrolled in treatment programmes and that drug
stockouts are becoming increasingly more frequent.

Kevin Moody, International Coordinator and CEO of the Global Network of
People living with HIV states:

“As treatment and prevention come together, it is important to involve
HIV-positive people in discussions about how PrEP can and should be made
available in the future. People living with HIV have a critically important
role to play in HIV prevention, both for the development of new HIV
prevention tools and in advocating for improved access to existing
prevention options”.

Jorge Beloqui of Grupo de Incentivo à Vida and ABIA – networks of people
living with HIV in Brazil - adds:

“As community members with a great deal of insight into the realities of
living with HIV, and with professional as well as personal expertise, people
living with HIV can provide guidance on a range of ethical and practical
issues. People living with HIV can also provide guidance on how to mitigate
the harm of HIV-related stigma, which may be a barrier to HIV testing,
disclosure of HIV-positive status and the ability and willingness to
follow-up linkages to prevention, treatment, care and support – all key
issues for the delivery of PrEP”.

Advocacy for PrEP and other new HIV prevention tools should be placed within
the broader context of universal access for treatment, prevention, care and
support. Globally, less than one person in five at risk of acquiring HIV has
access to basic HIV prevention services. In many settings around the world
there remains inadequate access to male and female condoms, needle/syringe
exchange, medical male circumcision, post-exposure prophylaxis (PEP),
prevention of vertical transmission and voluntary counseling and testing.

Advocating for improved access to these proven prevention methods sets the
stage for the effective introduction of new prevention tools. This requires
further collaboration between prevention advocates and treatment activists
as well as broader community engagement. This broad based collaboration is
key to promoting a holistic, human rights-framed approach to HIV prevention,
which enables people living with and affected by HIV to achieve Positive
Health, Dignity and Prevention.
------------------------------

*The Global Network of People living with HIV (GNP+) *is a global network
for and by people living with HIV. GNP+ advocates to improve the quality of
life of people living with HIV. The central theme for the work of GNP+ is
Reclaiming Our Lives! GNP+ programmes are organised under four platforms of
action: Empowerment; Positive Health, Dignity and Prevention; Human Rights;
and Sexual and Reproductive Health and Rights.

*For more information about this news release:* Please contact GNP+ (Martin
Stolk, Communications officer, by email mstolk at gnpplus.net, or phone
+31-20-423 4114 or +31-6-1991 2406)
------------------------------

[1] Numbers based on the November 2009 WHO ART Guidelines, which recommend
commencing ART before CD4 counts fall below 350 cells/mm3. Prior guidance
recommended treatment for people with advanced symptoms of HIV disease, or a
CD4 count below 200 without symptoms. See
www.who.int/hiv/pub/arv/advice/en/index.html

[2] The website www.pereboi.ru from the International Treatment Preparedness
Coalition in Eastern Europe and Central Asia (ITPCru) reports stockouts in
Ulyanovsk, Samara, Arkhangelsk, the Moscow Oblast, Vladimir, Kaliningrad,
Saratov and other regions.

WHO/UNAIDS/UNICEF. Towards universal access: scaling up priority HIV/AIDS
interventions in the health sector. Geneva, 2010.

ITPC. Missing the Target 8 - Rationing Funds, Risking Lives: World
Backtracks on HIV Treatment, April 2010.

Boseley S. Romania runs out of Aids drugs. The Guardian, April 23, 2010.

WHO. Universal access by 2010. WHO website, Accessed April 14, 2010.

GNP+,UNAIDS. 2010. Policy Framework: Positive Health, Dignity and
Prevention. Amsterdam, GNP+ (forthcoming).

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