November 16, 2011
Hope For More Options In Couples Where One Partner Is HIV Positive
Press Release from PLoS Medicine
In sub-Saharan Africa, couples in long-term relationships where one partner is HIV-positive and the other is HIV-negative (HIV serodiscordant couples) could benefit from anti-AIDS drugs (antiretroviral therapy) given either as treatment or as a prevention measure (prophylaxis) to reduce the risk of HIV transmission. These findings, from a modeling study led by Timothy Hallett from Imperial College London and published in this week's PLoS Medicine, also show that this strategy could be cost-effective.
To keep couples alive without the HIV-uninfected partner becoming infected, the authors found that it could be at least as cost-effective to provide prophylaxis to the uninfected partner as to initiate antiretroviral therapy earlier than current guidelines in the infected partner. Specifically, the most cost-effective strategy for couples could be to use prophylaxis in the uninfected partner prior to starting antiretroviral therapy in the infected partner.
These findings suggest that prophylaxis may become a valuable addition, in some settings, to existing approaches for HIV prevention such as condom promotion, male circumcision programs and anti-retroviral treatment.
The authors say: "We hope [these findings] might inform the choices that will be available for HIV prevention in couples. We note, however, that it is important that many other considerations besides cost effectiveness should inform decision-making for HIV treatment initiation and provision of [prophylaxis] in couples, including equitable access and the preferences of the couples themselves."
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