After stirring up enthusiasm and hope that the end of the AIDS epidemic may finally be possible, scientists, policymakers and others at the International AIDS Conference today turned their focus to the challenges -- and potential solutions -- that lie ahead in the fight against HIV.
There remain more than 50,000 new HIV infections each year in the United States, and new data from the HIV Prevention Trials Network presented this week showed that the rate of HIV among black gay men under age 30 is nearly 6 percent -- a rate as high as that in Sub-Saharan countries in Africa most affected by the virus.
"In the U.S., the burden of HIV is not shared equally by population or region," said assistant Health and Human Services (HHS) secretary Dr. Howard Koh.
Addressing HIV-related health disparities is one of three overarching goals of the the U.S. National HIV/AIDS Strategy, along with reducing new infections and increasing access to HIV care. Such a strategic national approach is critical in addressing the HIV epidemic, Koh said.
Launched in 2010, the strategy outlines a list of specific goals, including decreasing the number of yearly HIV infections by 25 percent by the year 2015.
"We are making important progress," Koh said. For example, he noted, among the more than 8,000 publicly funded community health centers in the United States there has been a 13 percent increase in people tested for HIV in the past year.
He also cited a national campaign to decrease HIV-related stigma, as well as nearly $80 million in new grants to expand HIV care announced by HHS Secretary Sebelius earlier this week. New data, however, is not yet available to assess the impact of these initial steps.
As policymakers grappled with how best to stem the spread of HIV, scientists considered the progress in a search for an HIV cure.
"The field is quickly advancing," said AIDS researcher Dr. Javier Martinez-Picado, senior investigator at the IrsiC-aixa AIDS Research Institute in Spain. Yet, Martinez-Picado said he foresees several more years of laboratory research to advance basic science knowledge before considering clinical trials.
Last week, the International AIDS Society issued a comprehensive roadmap for HIV cure research to coordinate and support scientists' efforts to find a cure.
"Any successful intervention needs to be safe, affordable and scalable," Martinez-Picado said. "Intellectual, financial and social coordination will be essential."
But as the world waits for science to progress in research labs, doctors need to use the tools available now in the most efficient way possible, said Dr. Nelly Mugo of the University of Nairobi and Kenyatta Hospital in Kenya.
Mugo stressed that with the advent of a new set of proven prevention strategies -- antiretroviral therapy early in the course of disease, pre-exposure prophylaxis and voluntary male circumcision -- it is critical to tailor packages of HIV interventions to specific populations.
"The interventions and the things that work for men who have sex with men in Cambodia may be very different for heterosexual individuals in Africa," she said, adding that the world needs to "be ready to get rid of those policies and approaches that do not work," in order to "focus resources and efforts on what is proven and impactful."