Posted by Michael Specter
There are no shortcuts to preventing or treating AIDS. In theory, abstinence works, and, when people prove to be only human, there are condoms. But humans are not always rational and condoms are never going to provide a permanent solution. That leaves drugs, and since the mid-nineteen-eighties those have proven increasingly effective at stopping H.I.V. from ravaging the immune system. In rich countries, at least, antiretroviral medicine has helped turn AIDS into a complicated but chronic disease.
Still, until today, it has never been clear whether people who take antiretrovirals are less likely to infect their sexual partners. That question has now been answered definitively. A new study, of eighteen hundred couples on four continents, has shown that H.I.V.-positive people on antiretrovirals are ninety-six per cent less likely to infect their sexual partners than H.I.V.-positive people who are not on those drugs. Intuitively, that makes sense, because antiretrovirals lower the amount of virus in the bloodstream. Yet hunches, even smart hunches, often prove false. That is why there are clinical trials. In this trial, half of those who were infected received antiretroviral medication and half did not. The results, released today by U.S. federal health officials, were so unequivocal that the study has been stopped four years early.
This is the best evidence yet that the AIDS epidemic could be defeated by comprehensive use of antiretroviral drugs. Still, the Internet has already been crowded with people who can turn any silver lining into a cloud. "How do we continue to emphasize that it's still unsafe to have sex when you have HIV?" one person commented on a health blog. "I can just see it now: Thousands of people with HIV, running around thinking they are 'cured' because of early treatment."
This is certainly an issue worth considering. (The medical term for it is "disinhibition," which in English means the absence of fear.) But let's step back for a moment. Try telling millions of H.I.V.-positive Africans that today's news will only encourage careless behavior. It ought to be of greater concern that so many of them are dying.
Sent from my BlackBerry® smartphone from Zain Kenya