SEATTLE, WASHINGTON—The recipe for ending HIV epidemics seems straightforward. Introduce widespread testing. Immediately put those who test positive on antiretroviral (ARV) drugs, which suppress the virus to undetectable levels so those people won’t infect others. The number of new infections will drop, and the epidemic will peter out.
But massive, costly studies done in the past few years have failed to show this strategy can reliably curb the spread of the virus, to the frustration of researchers. The latest and largest ever study presented here last week at the Conference on Retroviruses and Opportunistic Infections did show a modest benefit. But confusingly, there was almost no decline in infections in the study group where it was most expected.
Ending the HIV/AIDS epidemic may be harder than anticipated, it seems. “ARVs on their own are not the magic bullet,” says Collins Iwuji, an epidemiologist at Brighton and Sussex Medical School in the United Kingdom who helped run one of the earlier studies, a South African treatment as prevention (TasP) trial.