Published: 12:20 EST, 11 July 2014 | Updated: 15:00 EST, 11 July 2014
World Health Organisation suggests gay men take antiretroviral AIDS drugs (stock image) to protect themselves from infection, alongside condoms
Gay men, prostitutes, and prisoners have stubbornly high rates of HIV and are threatening progress in the global AIDS battle, according to the World Health Organisation (WHO).
For the first time, the organisation is ‘strongly recommending’ gay men consider taking antiretroviral AIDS drugs as an extra way of protecting themselves against infection, alongside using condoms.
Such an approach, known as pre-exposure prophylaxis or PrEP, is a way for at-risk people to protect themselves by taking a single pill.
This is usually as a combination of two antiretrovirals, taken every day.
‘Globally we are failing certain populations that have the greatest risk yet we know have universally poorer access to health services,’ said Gottfried Hirnschall, director of the WHO's department.
‘These are men who have sex with men, sex workers, transgender persons, specifically transgender women, persons who inject drugs and persons who are in prisons or other closed settings.’
AIDS experts estimate that globally, HIV incidence among gay men could be cut by 20 to 25 per cent through PrEP - averting up to one million new infections in this group over 10 years.
PrEP, when taken consistently, has also been shown to cut the risk of HIV infection in high-risk people by up to 92 percent.
‘The reason we are adding this to our prevention choices for men who have sex with men is that we have these very worrying increases in HIV incidence,’ added Rachel Baggaley, coordinator of the WHO's department for HIV/AIDS.
The WHO said studies estimate female sex workers are 14 times more likely to have HIV than other women, gay men are 19 times more likely to have HIV than the general population, and transgender women are almost 50 times more likely than other adults to have HIV.
The approach is known as pre-exposure prophylaxis or PrEP, and experts estimate PrEP could cut incidence of HIV in gay men by 20 to 25%. PrEP, when taken consistently, has also been shown to cut the risk of HIV infection in high-risk people by up to 92 per cent. Stock image of a HIV test is pictured
For injecting drug users, the risks of HIV infection can be 50 times higher than the general population.
These people are most at risk of becoming infected with the human immunodeficiency virus that causes AIDS, yet are least likely to get HIV prevention, testing and treatment services, the Geneva-based United Nations health agency said.
A Mississippi girl born with the AIDS virus and in remission for years, despite stopping treatment, is now showing signs that she still harbors HIV.
The news is a setback to hopes that very early treatment with powerful HIV drugs might reverse an infection that has seemed permanent once it takes hold.
The girl is now nearly four years old.
As recently as March, doctors said she seemed free of HIV despite not having been on AIDS drugs for about two years.
That was a medical first.
But on Thursday, doctors said tests showed that she is no longer in remission.
She is now back on treatment and is responding well, the doctors added.
‘We are seeing exploding epidemics in some of these key populations,’ Gottfried said - adding these groups account for up to 50 per cent of new cases of HIV infection.
Some 35.3 million people worldwide are infected with HIV, but the rising number of patients reflects great strides in recent years in developing sophisticated HIV tests and combination AIDS drugs and getting them to many of those who need them to stay alive.
As a result, the annual AIDS death toll is falling, dropping to 1.6 million people in 2012 from a peak of 2.3 million in 2005.
New HIV infections are also steadily declining, and dropped by a third in 2013 from 2011.
Yet figures show the key high risk populations continue to have high infection rates, and appear to be hard-to-reach in terms of getting the right prevention messages, or getting them the testing and treatment health services they need.
Hirnschall continued that in many countries, gay men, sex workers and other marginalised groups are left out of national HIV plans and excluded by discriminatory laws and policies.
‘None of these people live in isolation,’ he warned.
‘Sex workers and their clients have husbands, wives and partners. Some inject drugs. Many have children. Failure to provide services to the people who are at greatest risk of HIV jeopardises further progress against the global epidemic.’
The WHO report, released ahead of the International AIDS Conference in Melbourne, Australia on 20 July, said that by the end of 2013, around 13 million people worldwide were taking AIDS drug treatment.
This has led to a 20 per cent drop in HIV-related deaths between 2009 and 2012, it said.