The spread, treatment, and prevention of HIV-1: evolution of a global pandemic
Cohen, M.S.; Hellmann, N.; Levy, J.A.; DeCock, K.; Lange, J.
Journal of Clinical Investigation 118(4): 1244-1254
2008
ISSN/ISBN: 0021-9738 PMID: 18382737 DOI: 10.1172/jci34706Document Number: 200485
The most up-to-date estimates demonstrate very heterogeneous spread of HIV-1, and more than 30 million people are now living with HIV-1 infection, most of them in sub-Saharan Africa. The efficiency of transmission of HIV-1 depends primarily on the concentration of the virus in the infectious host. Although treatment with antiviral agents has proven a very effective way to improve the health and survival of infected individuals, as we discuss here, the epidemic will continue to grow unless greatly improved prevention strategies can be developed and implemented. No prophylactic vaccine is on the horizon. However, several behavioral and structural strategies have made a difference - male circumcision provides substantial protection from sexually transmitted diseases, including HIV-1, and the application of antiretroviral agents for prevention holds great promise.