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HIV drugs may curtail spread, but health and ethics questions remain

May 23, 2011|By Marissa Cevallos, HealthKey / For the Booster Shots blog
  • Though new research finds that antiretrovirals reduce the spread of HIV, drug assistance programs are cash-strapped and doctors aren't sure it's ethical to force infected persons to use such drugs to protect their sexual partners.
Though new research finds that antiretrovirals reduce the spread of HIV,… (Mark Boster / Los Angeles…)

A recent, and much-heralded, study on how to reduce the spread of HIV and AIDS appears to be raising more health- and ethics-related questions than the dramatic findings might first suggest. 

First, the news: Giving antiretroviral drugs to HIV-positive people reduced the transmission of the virus to their partners by 96%.

But the research doesn’t mean all HIV-positive people will be taking the cocktail of drugs used in the study. Even now, states are finding themselves unable to provide HIV drugs to everyone who needs help getting them. And some doctors, meanwhile, are questioning whether it’s ethical to force infected yet healthy AIDS patients to take the drugs to protect their partners.

The Washington Post reports that some cash-strapped states are already restricting the ability of low-income HIV patients to get antiretrovirals and drugs for AIDS-related illnesses. More than 8,300 people are on waiting lists in 13 states, according to the article.

It states:

“Advocacy groups say the pullback by states is shortsighted: HIV patients who get the antiretroviral drugs are generally able to manage their disease, allowing them to continue working and keeping long-term medical costs down for the state. New research even suggests that people put on medication immediately after being diagnosed are less likely to spread the disease.”

Then there's the matter of personal choice. Yes, the drugs appear to reduce the spread of infection. And as this New York Times article summarizes:

“This is good news for the infected and their lovers. But it is a moral dilemma for doctors whose infected patients do not want to start taking drugs immediately, usually because they do not yet feel sick and have heard exaggerated rumors about side effects.

What does a responsible doctor do with a patient who is sexually active and teeming with a fatal and incurable virus? Advise him to use condoms and trust him to act decently? Beg?”

Several doctors said they would never force a patient into treatment -- especially when thousands of Americans are still on waiting lists for such drugs.

As with most research, the dramatic findings are but the beginning, not the end, of the discussion.

healthkey@tribune.com

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