HIV treatment adherence still a challenge



It’s hard to believe that it was 30 years ago that HIV was discovered as the cause of AIDS by Dr. Robert Gallo and Dr. Luc Montagnier. Since then, the medical community has focused on preventing and eradicating the virus and its transmission. Despite the advent of highly efficacious antiretroviral therapy, and education efforts to prevent transmission, the disease continues to cause significant morbidity and mortality.

Surveillance data from the Centers for Disease Control and Prevention have indicated that screening and prevention efforts led to a decline in perinatally acquired HIV and AIDS by 80% and 93%, respectively. However, we still have far to go.

Dr. E. Albert Reece

The CDC estimated that in 2010 more than 1 million people over age 13 were living with HIV, and approximately 50,000 new cases of HIV occur each year in the United States.

President Obama’s National HIV/AIDS Strategy for the United States, released in 2010, set ambitious goals for eradicating the disease in our country. We can only hope to achieve the President’s aims if the fight against the disease is taken up by all health care professionals, on multiple fronts, and throughout the many stages of a patient’s health.

In a 2011 Master Class, we addressed the importance of ob.gyns. testing nonpregnant women for HIV, as well as employing HIV prevention strategies to keep our female patients healthy, and prevent potential mother-to-baby transmission of the virus. Although transmission has decreased significantly, helping patients follow their treatment regimens remains a major barrier to eradicating the disease.

Ob.gyns. may be the only physicians who many women see throughout their lives. Therefore, we have a unique opportunity to educate our patients about seeking appropriate care and the need for adhering to treatment regimens.

Our guest author this month is Dr. Robert R. Redfield Jr., a distinguished professor in the department of medicine at the University of Maryland, Baltimore, and associate director of the university’s Institute of Human Virology, with clinical and research programs in virtually all countries in the continent of Africa. Dr. Redfield will discuss the role that physicians can play in terms of linking patients to care as a means of treating those with HIV and reducing the burden of disease. Dr. Redfield’s expertise in the area of novel therapeutics for the treatment of the virus, and his clinical experience in treating patients, provides a unique perspective into this important public health issue.

Dr. Reece, who specializes in maternal-fetal medicine, is vice president for medical affairs at the University of Maryland, Baltimore, as well as the John Z. and Akiko K. Bowers Distinguished Professor and dean of the school of medicine. Dr. Reece said he had no relevant financial disclosures. He is the medical editor of this column. Contact him at [email protected]

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