A generalized graph of the relationship between HIV Viral Load and CD4 counts over the average course of untreated HIV infection; any particular individual’s disease course may vary considerably. CD4+ T cell count, cells per µL – HIV RNA copies per mL of plasma
HIV Treatment is HIV Prevention. They are inter-twined, dependent on each other. You can not effectively have one without the other. Treatment of people with HIV/AIDS means reducing their Viral Loads. The lower someone’s Viral Load is, the less infectious they are. The less infectious people are, the fewer new infections. That’s Basic Prevention 101. Treating infected people and making them less infectious is how you stop an epidemic from spreading.
One of the key problems is that 20% of HIV infected people don’t know their HIV status. We can assume that these people not only have high viral loads, but also are not practicing safer sex and therefore are out there infecting other people. Some doctors believe these people are THE link to new HIV infections.
The Florida Department of Health estimates that there are 125,000 Floridians infected with HIV/AIDS and more than 25,000 of these do not know their status. Nationwide there are more than 1,000,000 Americans infected with HIV/AIDS with more than 200,000 not knowing their HIV status.
The CDC is currently estimating that 56,000 Americans become infected with HIV every year. Each HIV infection will cost more than $600,000 in prescription drugs and medical coverage. The numbers are staggering both as a national health issue and as a national economic issue. HIV/AIDS is not only a personal health problem, it’s a national epidemic of enormous proportions. You can not have a healthy America without healthy Americans.
The answer may not be as complicated as you might think, Test, Treat and Educate. Seek and Treat is what they call it in British Columbia, Canada. Treatment not only saves lives, it can be one of the most compelling prevention tools we have.
We need to reduce the barriers that prevent people from getting tested. The fear of testing positive will always be there, but we can reduce the stigma of being positive. Knowing that if they test positive, treatment will be available, will also encourage people to get tested and know their status.
This site advocates not only a Seek and Treat program to reduce new infections but also education. When you test someone, you also counsel them on their risk factors so they can make more informed decisions. Negative people need to be counseled to take personal responsibility for staying negative. Risky behavior is like playing Russian roulette. If you keep pulling the trigger, sooner or later the cartridge is going to have the bullet. Law or no law, when 20% of HIV positive people don’t know their status, disclosure laws are not going to keep someone negative.
We also believe that the CDC guidelines for when someone positive starts drug therapy should reflect not only the patient’s own personal health, but also their level of infectiousness. Currently the CDC reccomends starting drug therapy based on CD4 T-Cell counts. We believe it should be based also on the Viral Load. A healthy CD4 T-Cell count with a High Viral Load might indicate that the patient personally doesn’t need HIV drug therapy, but reducing his viral load will help him from infecting other people.
But as budgets are cut nationwide, ADAP (AIDS Drug Assistance Program) are also being cut. Today there are over 2,700 Americans, over 1,000 Floridians and over 300 Broward County residents on ADAP waiting lists. Even during budget cutting, there are some programs that make no sense to cut. A program that dramatically impacts a national health epidemic is one of them. As a nation, we can not afford to cut ADAP. The cost of 56,000 new infections each year will cost the nation more than the current costs of providing AIDS Drugs. We must find ways to reduce those tragic numbers.
Seek and Treat or Test, Treat and Educate, I don’t care what you call it,just do it. If not for the physical health of the individuals then do it for the long term economic health of the country. This is the right thing to do.