HIV rate in SF could be cut sharply with expanded treatment, study predicts

Published: April 13, 2011

April. 13, 2011 – If HIV-infected adults in San Francisco began taking antiretroviral treatments as soon as they were diagnosed, the rate of new HIV infections among men who have sex with men would be cut by almost 6o percent over five years, according to a new study by scientists at the University of California, San Francisco.

In San Francisco, men who have sex with men comprise more than three quarters of the population of people living with HIV and more than three quarters of new HIV infections occur in this group. The study looked specifically at the impact of treatment upon rates of new HIV infections in this population.

The finding is published in the April 15, 2011 issue of Clinical Infections Diseases

The decision of when to begin treatment with antiretroviral drugs is a subject of some debate, with the experts evenly split on whether to begin antiretroviral therapy immediately upon HIV diagnosis or waiting until a patient’s CD4 cell count drops below 500 cells per microliter.

Early last year, the UCSF Division of HIV/AIDS at San Francisco General became the first clinical practice in the country to recommend treatment upon diagnosis to all of its HIV-infected patients. The San Francisco Department of Public Health followed suit shortly thereafter. The two programs combined treat about a third of the HIV-infected patient population in San Francisco.

"San Francisco has been successful in promoting HIV testing for individuals at risk and in getting infected persons into care and effective treatment" said study lead investigator, Edwin D. Charlebois, MPH, PhD, associate professor of medicine at the UCSF Center for AIDS Prevention Studies. "In this study, we sought to estimate what the outcomes of different strategies including immediate and universal treatment would be on the rate of new infections – the community level HIV prevention effect."

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