In Danimarca sparisce l’HIV ma non il sesso

In Danimarca sparisce l’HIV ma non il sesso
Sconfiggere l’HIV si può. Vedere lo straordinario caso della di questo stato  per credere.

Qui  in Danimarca ogni anno solo 1 persona su 1000 contrae il virus. Un successo che viene da lontano. Quando vent’anni fa il governo danese decise di lanciare un maxi piano anti-AIDS basato su tre pilastri: prevenzione, trattamento medici di ultima generazione e senso civico.

Si perché questi invidiabili risultati della Danimarca derivano non solo da campagne informative, screaning e accesso a terapie sanitarie efficaci che, sulla lunga distanza, rendono i malati meno infetti. Ma anche da una cultura e coscienza collettiva che col passare del tempo ha spinto la popolazione ad abbandonare comportamenti a rischio.

Insomma in Danimarca non inventando nulla e attenendosi a quanto continuamente indicato da fior fiore di specialisti “i danesi hanno fatto ciò che nessun altro al mondo è stato in grado di fare”, ha detto Sally Blower, direttrice del Center for Biomedical Modeling presso la UCLA e autrice della ricerca su questo caso più unico che raro.

Fonte: west-info.eu

Articolo originale in inglese:

Testing the hypothesis that treatment can eliminate HIV: a nationwide, population-based study of the Danish HIV epidemic in men who have sex with men

Background

Worldwide, approximately 35 million individuals are infected with HIV; about 25 million of these live in sub-Saharan Africa. WHO proposes using treatment as prevention (TasP) to eliminate HIV. Treatment suppresses viral load, decreasing the probability an individual transmits HIV. The elimination threshold is one new HIV infection per 1000 individuals. Here, we test the hypothesis that TasP can substantially reduce epidemics and eliminate HIV. We estimate the impact of TasP, between 1996 and 2013, on the Danish HIV epidemic in men who have sex with men (MSM), an epidemic UNAIDS has identified as a priority for elimination.

Methods

We use a CD4-staged Bayesian back-calculation approach to estimate incidence, and the hidden epidemic (the number of HIV-infected undiagnosed MSM). To develop the back-calculation model, we use data from an ongoing nationwide population-based study: the Danish HIV Cohort Study.

Findings

Incidence, and the hidden epidemic, decreased substantially after treatment was introduced in 1996. By 2013, incidence was close to the elimination threshold: 1·4 (median, 95% Bayesian credible interval [BCI] 0·4–2·1) new HIV infections per 1000 MSM and there were only 617 (264–858) undiagnosed MSM. Decreasing incidence and increasing treatment coverage were highly correlated; a treatment threshold effect was apparent.

Interpretation

Our study is the first to show that TasP can substantially reduce a country’s HIV epidemic, and bring it close to elimination. However, we have shown the effectiveness of TasP under optimal conditions: very high treatment coverage, and exceptionally high (98%) viral suppression rate. Unless these extremely challenging conditions can be met in sub-Saharan Africa, the WHO’s global elimination strategy is unlikely to succeed.

Funding

National Institute of Allergy and Infectious Diseases.

Per altri dettagli vai all’articolo originale: thelancet.com/journals

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