The spread, treatment, and prevention of HIV-1: evolution of a global pandemic.
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.
Cohen
Myron S
MS
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, USA. mscohen@med.unc.edu
Hellmann
Nick
N
Levy
Jay A
JA
DeCock
Kevin
K
Lange
Joep
J
D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004196:Disease Outbreaks / Q000517:prevention & control*; D016679:Genome, Viral / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1 / Q000235:genetics / Q000472:pathogenicity; D006801:Humans
D000998:Antiviral Agents