World AIDS Day: The Role of Clinical Trials

In the United States, more than 1.1 million people are living with HIV (human immunodeficiency virus), although one in seven doesn't know it. There are two large challenges in facing the HIV epidemic today. The first challenge is finding those who are infected with HIV and bringing them into care. These undiagnosed but often highly infectious individuals have been responsible for up to half of the new infections every year. While some individuals can be at a higher risk of infection, it is important for all individuals ages 15 to 65 get tested for HIV regularly.

The second major challenge is keeping those who have HIV infection consistently engaged in care. Some proportion of those individuals who are known to have HIV and has been engaged in care fall out of care and are consequently not on medications that could keep them healthy and also prevent transmission to others. HIV transmission from those individuals who actually do know their status but are not connected to care is becoming an increasing driver of the epidemic.

Testing is available at your doctor’s office. Once tested a patient can be linked to care at the Regional Center for Infectious Disease.

The role of clinical trials is critical, helping HIV go from an untreatable virus that conferred a premature death sentence to a highly treatable easily controllable, if not yet curable infection. Now we know how to treat HIV with powerful drugs, many of them in “all-in one,” single tablet regimens that are easy to take and to tolerate.

Clinical trials have further shaped healthcare policy including the modern one of treating everyone who has HIV infection for the benefit of those individual’s health and also for the benefit of preventing transmission to others rendering those individuals essentially uninfectious (treatment as prevention).

Clinical trials have started to test new prevention methods for those at highest risk for contracting HIV including injectable long-acting medications for Pre-Exposure Prophylaxis (PrEP), compared to the current standard of care Truvada pills for PrEP. Currently, the Cone Health Regional Center for Infectious Disease is participating in a clinical trial and comparing an established daily prevention pill, Truvada to a novel long-acting intramuscular injectable anti-retroviral.

We need strong partnerships with our communities to pierce through obstacles such as stigma, poverty, and ignorance to reach out to and test those who are at the highest risk of becoming infected with the HIV virus. People with HIV infections are now living long, normal, healthy and productive lives if treated properly.  Once a person receives an HIV diagnosis, it is important that they seek advice and care from an infectious disease specialist to begin an effective, individualized treatment plan to suppress their virus and maintain a healthy immune system. Furthermore, those who are highest risk for HIV infection need to be engaged with healthcare providers who can provide a comprehensive prevention program that should include pre-exposure prophylaxis medications. (PrEP)

People living with HIV in our community have the resources they need to receive truly exceptional and comprehensive care: The Regional Center for Infectious Disease at Cone Health.  By partnering with other HIV/AIDS providers, RCID offers multiple services for patients in one convenient setting—an exceptional team of infectious disease physicians and healthcare professionals, case managers, social workers/counselors and financial assistance.

Cone Health is also providing PrEP via our research trial and via prescriptions from our team of doctors and pharmacists.

Spokesperson Background:

Dr. Cornelius “Kees” Van Dam is an infectious disease specialist and the director of research at the Regional Center for Infectious Disease at Cone Health.  Van Dam is a 2002 graduate of Medical College of Wisconsin.  He completed his residency in internal medicine at University of Utah and completed his fellowship in infectious disease at University of North Carolina at Chapel Hill.