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Of guidelines, targets and resources: the documents that defined the 2014 International AIDS Conference
Gus Cairns, 2014-07-26 14:40:00
If there was a phrase that defined the 20th International AIDS
Conference, one that surfaced in every few presentations and kept turning up in
documents, it was “Key Affected Populations”.
The World Health Organization (WHO) actually released its new Consolidated guidelines on HIV prevention,
diagnosis, treatment and care for key populations on 11 July, nine days
before the conference started.
The primary attention it garnered then was a couple of
inaccurate reports in The Age (since
corrected) and Time that the WHO was saying that “All
men who have sex with men should take antiretroviral drugs”.
In fact, the WHO says something a lot more cautious and
tentative, namely that the evidence suggests quite strongly that, for men who
have sex with men (MSM), “PrEP is recommended as an additional HIV prevention
choice within a comprehensive HIV prevention package”. (This also does not say
that the ‘comprehensive HIV prevention package’ must include a recommendation
only to use PrEP with condoms, as has also been alleged.)
The change from the previous guidelines is that they suggested
that PrEP should only be offered as part of the ongoing research programme into
this still new and hardly-used method of HIV prevention. Now the WHO is
suggesting , quite radically, that the evidence is sufficient for the world to
consider how it could move to enabling gay men to take PrEP. (It also adds that
PrEP should be considered for the negative partner in couples of different HIV
status, but this is not a new recommendation).
Brazilian HIV and STI health director Fabio Mesquita was in
charge of the re-evaluation of the evidence for PrEP that found its way into
the new guidelines. He told a press conference at Melbourne: “The question no
longer is whether PrEP works, but whether we can make it available.”