Though much progress appears to have been made, it may be premature to celebrate the end of the AIDS epidemic.
The pope's qualified comments on condom use -- that it was better to use a condom than not and spread infection -- have yet to gain acceptance down the church ranks. In many areas of the world, local mores as much as religious beliefs stand in the way of practicing safe sex, such as the practice of men having multiple, simultaneous long-term relationships. (When the pope visited Africa just last year, he said that using condoms was wrong.)
"In Africa most HIV transmission takes place in long-term relationships," Dr. Helen Epstein, a molecular biologist and prominent writer on the AIDS epidemic, told the Times of London. "People use condoms in casual relationships, and with prostitutes, but that accounts for a relatively small part of the epidemic in the 'AIDS epicenter' of East and southern Africa."
Then there's Truvada, which appears to be a miracle drug. (Actually, it's two anti-retroviral drugs combined, Viread and Emtriva.) When taken daily, Truvada has been shown in tests to be 90 percent effective in stopping gay men from getting the disease through sexual intercourse.
"More studies, now under way, are needed to see whether the results can be duplicated, whether other anti-retroviral drugs will work and whether they will protect heterosexual men and women, prostitutes and drug users who share needles," reports The New York Times. "There is no medical reason to think the pill would not work in other groups, since it attacks the virus in the blood, not in the vaginal wall as a microbicide does."
But a daily dose of Truvada for a year costs between $5,000 and $14,000 in the United States. And while insurance companies typically pay for such expensive treatments for those already infected with HIV, they don't cover the use of the drug as a preventive measure. Generic versions of the pill sell for 40 cents each ($146 a year) in poorer countries, but that's still expensive in such places.
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"Globally, only about 5 million of the 33 million people infected with the AIDS virus are on anti-retroviral drugs, and in an era of tight foreign-aid budgets, that number is not expected to rise quickly," reports the Times. (Oddly, Gilead Sciences, the company that manufactures Truvada, has seen its stock price slide following news of the tests.)It's difficult to imagine people spending such sums out of pocket -- whether $10,000 in the United States or $146 in Uganda -- anytime soon. But in the absence of a vaccine, prevention is the best strategy. And though the fight against AIDS is far from over, those fighting the disease's spread have just been handed two powerful tools.
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