HIV/AIDS Prevention and Treatment

Enormous advances in HIV/AIDS treatment regimens have fundamentally altered the natural history of the disease and sharply reduced HIV-related morbidity and mortality in countries where such treatments are accessible. The advent of anti-retroviral drugs in the late 1980s began a revolution in the management of HIV, which can be seen as analogous to the use of penicillin for treating bacterial infections in the 1940s. The most notable advance on the treatment front is the use of combination antiretroviral therapy, which is far more effective than monotherapy (zidovudine or AZT), the standard of care when the first edition of this volume was published. Recent declines in the price of combination antiretroviral therapy in developing countries from US$15,000 per year to less than US$150 in some countries have prompted numerous developing countries to introduce antiretroviral therapy through the public sector. These declines also pose difficult questions regarding the optimal allocation of limited resources for HIV/AIDS, as well as the potential impact on already strained health care infrastructures.