Recently, the World Health Organization (WHO) issued new HIV treatment and prevention guidelines that encourage anyone with HIV to begin antiretroviral therapy immediately after diagnosis. Previous guidelines recommended waiting to treat HIV-infected people until their immune systems show signs of illness. The guidelines also recommend that people at substantial risk of infection take a daily dose of oral pre-exposure prophylaxis (PrEP), which can help reduce the risk of acquiring HIV infection when taken regularly.
These revisions bring us a step closer to controlling HIV/AIDS.
But before someone can seek treatment, they need to know whether they have HIV or not. HIV testing can be lifesaving, and it is a vital first step in prevention and proper treatment.
It has been more than 30 years since we began working together at the Centers for Disease Control and Prevention (CDC) in Atlanta to wage a war against HIV and AIDS. Since then, we have witnessed tremendous advances in prevention, testing and treatment. Yet, despite all of the progress, we continue to face new challenges, frustrations and a continual need for more action. While we agree the WHO’s new guidelines are a powerful step to eliminating this disease, more can be done.
To support the WHO’s early treatment mission, we must first prioritize HIV testing. More than 1.2 million people in the United States are living with HIV, but almost 1 in 8 don’t know that they have it. Atlanta is ranked No. 5 among cities in the United States when it comes to the rate of new HIV diagnoses. What is disconcerting is that by the time people are diagnosed in Atlanta, almost one-third (29.4 percent) have advanced to clinical AIDS.
In order to know whether someone has recently contracted HIV, people must make sure they are being tested with methods that are able to detect the HIV virus soon after infection. Last year, the CDC recommended that laboratories use the latest HIV testing technology to better identify early cases. Called fourth-generation tests, or HIV Combo, these tests can screen for both antibodies to the virus and antigens (a protein of HIV), and can detect HIV infection earlier than older antibody-only tests.
HIV Combo tests are available in the United States, but despite the CDC’s recommendation, many U.S. testing facilities are not using the latest testing technology, including some in Atlanta. The new WHO guidelines could have enormous impact on those infected and those at high risk in the U.S. and globally, but in order to be effective, it is important to place a strong emphasis on testing.
After more than 30 years on the front lines of the war against HIV, we now know so much more than when we started. Scientific breakthroughs have saved and prolonged the lives of millions in the U.S. and throughout the world. While our mission is not yet complete, we know that by getting the right information about HIV status at the right time, we can turn the tide against the disease.
So, do your part. Talk to your doctor, get tested, and learn about treatment options at the earliest stage possible.
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Dr. James W. Curran is dean of public health for the Rollins School of Public Health at Emory University and co-director at the Emory Center for AIDS Research.Dr. Gerald Schochetman is senior director of diagnostic research for Abbott, a global healthcare firm.