NIAID Now | July 23, 2019
How to end the HIV epidemic is a theme of many conversations and presentations at the 10th International AIDS Society Conference on HIV Science (IAS 2019) in Mexico City. After delivering presentations on that topic, Dr. Anthony Fauci, Director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID), shared his thoughts with HIV.gov. He observed that we now have the HIV prevention and treatment tools that, if implemented properly and aggressively, could theoretically end the HIV epidemic. He also acknowledged that implementation is a key issue and that there is a need for continued innovation and research to address implementation obstacles such as difficulties with adherence to daily pill regimens and access to and engagement in prevention and care services.
In conversation with his colleague Anne Rancourt, Dr. Fauci discussed:
- Ending the HIV Epidemic in the U.S.: Dr. Fauci described the recently launched Ending the HIV Epidemic: A Plan for America, which has set goals of decreasing HIV transmissions by 75 percent in 5 years and by 90 percent in 10 years. He and his HHS colleagues who designed the initiative believe that these goals can be achieved by aggressively implementing geographically and demographically focused HIV testing, prevention, and treatment (including PrEP and treatment as prevention).
- HIV vaccine: Dr. Fauci explained that research continues for a safe and effective HIV vaccine because that will be a “nail in the coffin” for the epidemic. Since it can be challenging to get the existing HIV prevention and treatment tools to all those who need them, he noted, “if you want a truly global, effective, durable end to the epidemic, the only way you’re going to do that is with a safe and effective vaccine together with all the other preventative modalities.”
- U=U: U=U (Undetectable equals Untransmittable), also sometimes called treatment as prevention, is also an important tool in the HIV prevention toolbox. He emphasized that a person who maintains an undetectable viral load by taking daily HIV medication cannot pass the virus to an HIV-negative sexual partner, calling this “the foundation of being able to end the epidemic.”
- PrEP: He noted the need for HIV pre-exposure prophylaxis (PrEP) in combination with treatment as prevention as essential to ending the epidemic. He pointed to results from four population-level studies from Africa that have suggested that PrEP in addition to universal treatment as prevention is required to reduce HIV incidence.
- Ongoing prevention and treatment research: He highlighted several areas of research being discussed at the conference, including studies on long-acting antiretroviral therapy, passive transfer of monoclonal antibodies, and new modes of delivering PrEP.
Asked if he is optimistic about whether we can truly end the epidemic with the available tools and new science, Dr. Fauci affirmed that he is. “I don’t think it will be easy and I don’t think it will happen spontaneously. A lot of effort has to be put into it. But the one thing I’m absolutely certain of is that it’s possible...Right now it’s definitely possible. We just need to do it.”
View Dr. Fauci’s presentations from the 2019 IAS Conference on HIV Science:
More Interviews to Follow
Dr. Fauci’s NIAID colleagues Dr. Carl Dieffenbach and Anne Rancourt will share additional HIV research highlights from the conference in Facebook Live interviews on HIV.gov on Tuesday and Wednesday. Follow HIV.gov on Facebook or Twitter for schedule updates and reminders about these interviews.
About the Conference
The biennial IAS Conference on HIV Science is the largest open scientific conference on HIV and has assembled more than 6,000 participants from more than 160 countries. This conference presents the latest critical advances in basic, clinical, and operational research that move science into policy and practice. Findings from research supported by the NIH as well as the Centers for Disease Control and Prevention and USAID are among the more than 1,000 abstracts that will be presented.
Read more about potential future long-acting prevention tools being studied on HIV.gov’s recently updated page “Long-acting HIV Prevention Tools.”