International Developments in HIV/AIDS

Yesterday’s exciting announcement, and subsequent reaction from a variety of organizations involved with AIDS is a great example of the excellent work being done overseas in the fight to end HIV.

Thailand, the location of the newly-completed clinical trial, has encountered extreme risk for HIV/AIDS, and undertook initiatives to make sure that those risks were minimized for its population. Despite such risk factors as a large sex and sex tourism industry, Thailand has managed to reduce its previously increasing rate of HIV infection through broad education programs for the public.

HIV and AIDS treatments in Thailand are also aggressively pursued by the government, which has gone as far announcing a decision in 2005 to produce anti-retroviral medications on its own, rather than relying on expensive, often foreign-produced, patented medications. This, combined with a broad yet targeted national education program about the disease, its effects, and treatment options, has allowed the Thai government to take charge of its HIV/AIDS burden. As of 2006, according to UNAIDS, 88% of infected Thai persons were receiving ART

Another interesting component of the recent study completed in Thailand was the decision to use individuals at moderate risk for HIV infection, rather than those at extremely high risk, such as sex workers, IDUs, and MSM. Again, it is far too early to draw conclusions about the effectiveness of the tested vaccine regime, but one aspect to be considered is the use of moderate-risk Thai citizens rather than high-risk Thai citizens, and how the selected population differs from those not studied. Since both the placebo group and the vaccinated group received HIV prevention counseling, and neither group was considered high-risk, there may be a significant difference in the effectiveness of the prevention counseling on non-high-risk individuals, in addition to the benefit provided by the vaccine itself. This is a hypothetical point to consider, but one we assume the researchers will be taking into account.

The Thai study will eventually produce many revelations in the search for a cure to AIDS, although at the moment, no conclusions can be drawn. There are a number of important differences, from the strain of HIV most prevalent in Thailand and Asia versus the U.S. versus Africa, to the high-risk factors for HIV in different populations and across different regions. The news of some effectiveness from a vaccine regimen is undeniably hopeful and exciting, but it remains to be seen how that success can be replicated broadly and efficiently.

For more information about Thailand’s work to reduce HIV, please see the BBC and Wikipedia.

-Until There’s A Cure


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