Setbacks in the quest for a vaccine against AIDS are leading researchers to think about other ways to cut HIV infections.

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Julio Montaner

Some drug experts at the 17th International AIDS Conference in Mexico City say countries should vastly expand drug treatment to all in need. Not only because relief from suffering is a human right, but because using drugs to lower the amount of HIV in infected people’s blood on a massive, population-wide scale may lower transmission, Vancouver researcher Julio Montaner tells the Health Blog.

Drugs as a shield against AIDS is already a hot topic around the PrEP trials, which seek to keep some 20,000 uninfected volunteers around the world from becoming infected with HIV, an intervention called primary prevention.

But what Montaner has in mind is secondary prevention: keeping HIV-positive folks from passing on the virus by making sure everyone who needs them gets powerful antiviral drug cocktails to push their HIV burdens to undetectable levels.

Preliminary studies in Taiwan and Vancouver offer hope for this, says Montaner, incoming president of the International AIDS Society. But few here go as far as a Swiss report in January suggesting AIDS drugs could obviate the need for condoms if couples agree. That’s a gamble far too risky in the view of most experts here who promote a prevention toolkit that includes testing, treatment, behavior change, condoms and more.

The World Health Organization’s top AIDS official Kevin De Cock tells us he’s waiting for data to validate drugs as preventatives. “There’s biological plausibility,” he told us, “but not proven efficacy.”

Photo from HIV Resistance Response Database Initiative