A simple pill taken every day, known as “pre-exposure prophylaxis” or PrEP, can help prevent an infection with HIV. Doctors should offer PrEP to people at high risk of acquiring HIV, according to a new US Preventive Services Task Force statement published Tuesday.
The task force, an independent panel of experts tasked with making recommendations for doctors, also updated a past guideline calling for everyone between the ages of 15 and 65, pregnant women and others who are at increased risk for HIV be screened for the virus.
Screening is necessary because after early flu-like symptoms, the virus does not cause any signs or symptoms for several years, the task force noted in a second new statement published Tuesday. Both statements were published in the Journal of the American Medical Association.
There is no cure for HIV (human immunodeficiency virus), the life-long viral infection that attacks the body’s immune system and can have significant health consequences. However, the virus is treatable with a combination of drugs known as antiretroviral therapy that reduces the amount of virus in a person’s blood and it is preventable by using PrEP, which was approved by the US Food and Drug Administration in 2012.
New initiative to reduce HIV infections
Currently, about 1.1 million Americans are living with HIV, yet up to 15% of them do not know they have it, according to the task force.
“The Recommendation Statement is extremely timely, given a national initiative to end the HIV epidemic, and the accompanying evidence report shows PrEP to be both safe and highly effective in preventing HIV acquisition,” wrote Dr. Hyman Scott and Dr. Paul Volberding in an editorial published Tuesday in JAMA.
Scott is a research director at the San Francisco Department of Public Health and Volberding is the director of the AIDS Research Institute at the University of California, San Francisco.
Earlier this year, the US Department of Health and Human Services detailed a new initiative to reduce new HIV infections in the US by at least 90% over 10 years. The program will focus on the 48 counties with the highest HIV rates, the seven states with high HIV rates in rural areas and Washington, DC, and San Juan, Puerto Rico.
The states are Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina.
There are 44,000 new HIV infections each year, according to a Vital Signs report from the US Centers for Disease Control and Prevention.
How the virus spreads
Most new infections are transmitted by 40% of people infected with HIV – those who have not been diagnosed or have been diagnosed but are not yet receiving care.
A majority of people taking antiretroviral therapy can suppress the virus in their bodies within six months of starting therapy. When HIV-positive people maintain suppression by continuing therapy, they effectively pose no risk of infecting sexual partners and they also can live long, healthy lives, according to the CDC.
People who are newly infected and are unaware of their status led to 4% of new infections, according to CDC scientists who estimated past transmission and treatment rates.
Longer-term infected people who are unaware of their status accounted for 33.6% of new infections. People aware of their status but not receiving care accounted for 42.6%. Those receiving care but not fully suppressed accounted for 19.8% of new infections.
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People living with HIV who maintain viral suppression with treatment contributed no new infections, according to CDC scientists.
President Donald Trump called for the elimination of HIV transmissions in the United States by 2030 during his State of the Union address in February.