Antiretroviral Therapy to Reduce the Transmission of HIV
The advent of antiretroviral therapy (ART) in the early 1980s and highly active antiretroviral therapy (HAART) regimens have dramatically reduced the morbidity and mortality associated with HIV infection through sustained reduction in HIV viral replication. This sustained suppression of viral load has led researchers to consider ARVs as a prevention tool; ARVs would lower the viral load and, thus, the infectiousness of an HIV-infected person to an uninfected partner. This research is particularly relevant for prevention among serodiscordant couples, many of whom will continue to be sexually active despite their differing infection status.
Additionally, researchers are considering the possibility that antiretroviral drugs might be used by uninfected, at-risk persons before exposure to HIV and that these drugs might be able to block or prevent infection from occurring. This potential strategy, called Pre-Exposure Prophylaxis (PREP), does not require participation of a sexual partner (as does condom use), could be highly complementary to other prevention strategies, and empowers women who wish to protect themselves from HIV. As such, NIAID is supporting research to determine whether PREP can be a viable HIV prevention strategy.