HIV Eliminated in a Decade? Probably Not

This study predicts HIV could be eliminated in a decade. Color me skeptical. Color me highly skeptical, that is. If there's anything the papers I've been reading on the impact of improvements in HIV treatment have convinced me of, it's that without a vaccine, improved treatment is going to increase HIV incidence. We're already seeing it. What many epidemiologists do not understand or at least downplay is that AIDS itself was a deterrent to the spread of infection. The fear of AIDS caused people to wear condoms and have fewer partners. One study by Andy Francis even finds AIDS caused homosexual men to switch to having sex with women because the risk of infection was so high (and so fatal) among gay males. As the drugs began to have a real impact - especially with the protease inhibitors - and AIDS mortality fell dramatically, people could remain HIV+ and not reach any stage of autoimmune failure. Maybe never - some HIV+ individuals have been on medications for over 15 years and still don't have AIDS. Recent economic studies, like Lakdawalla, Sood and Goldman articla as well as this paper by Mechoulan found that when these new breakthroughs in treatment came out, both infected and non-infected individuals responded by increasing their risk for transmission. Infected gay males who began receiving treatment, for instance, responded to treatments by more than doubling the number of sexual partners they had recently had. Mechoulan finds similar things among HIV- individuals, including finding them reducing their condom usage. The rise in HIV that is observable in the data shows this, too. Both due to increased survivorship and changing behavior due to changing prices, HIV seems to be at the least not going away, and at worst, increasing.