Dr Thomas C. Quinn Identifies Barriers to Preventing Spread of HIV

The biggest barriers to stopping the transmission of HIV are both the large population of infected people not receiving treatment and the lack of pre-exposure prophylaxis for high-risk individuals, said Thomas C. Quinn, MD, director of the Johns Hopkins Center for Global Health.

Transcript

What are the barriers to preventing the transmission of HIV/AIDS?

I think as we learn more and do more studies on the use of pre-exposure prophylaxis, that the data’s going to be overwhelming. I mean, we’re really only two, three years into these studies and I think it does take some time. Also, the cost needs to decrease. But I think as we do more studies, show more efficacy, and get better acceptance in the countries that have been reticent to accept it, I think we’ll make some headway. So that’s number one.

The second means of prevention is treating the HIV-infected person. So, how are we doing with that? Right now, probably less than 45 percent of the world’s HIV population is under treatment and virally suppressed. So that’s good news, that those individuals are non-infectious or less infectious to their sexual partners, but that means 55 percent of the world’s population is untreated. And that is probably one of the biggest barriers.

It’s getting people to, one, be screened and be tested and to know they’re infected, two, to get them into care, and three, to get them put onto anti-retroviral drugs once in care, and then fourth and lastly, make sure they’re suppressed. If they’re virally suppressed, they’re non-infectious. There’s really been almost no transmissions of individuals who have a completely suppressed viral load of HIV. So I would say the two biggest barriers right now in prevention is not enough people on treatment that need to be on treatment and virally suppressed, and two, the high-risk individuals not getting pre-exposure prophylaxis, which can block HIV acquisition.