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An End in Sight: Dr. Diane Havlir’s Perspective

, by San Francisco AIDS Foundation

Nearly 30 years ago, at a time when hospitals around the country were turning away AIDS patients, Diane Havlir leapt at the chance to join an internal medicine residency program in the heart of San Francisco’s epidemic.

Today, Dr. Havlir is chief of the HIV/AIDS division and Positive Health Program at San Francisco General Hospital and professor of medicine at the University of California, San Francisco (UCSF). She has advised the World Health Organization on guidelines for treatment of HIV and tuberculosis, and at UCSF, she is the principal investigator of the AIDS Clinical Trials Group, director of the HIV Translational Research Training Program, and director of SEARCH, a program to prevent and treat HIV and improve community health in Africa. Last summer, Dr. Havlir co-chaired the 2012 International AIDS Conference in Washington, DC, and was instrumental in launching the DC Declaration, an action plan mapping the way forward to the end of AIDS.

In this excerpt from her chapter in How AIDS Ends, San Francisco AIDS Foundation’s new anthology, Dr. Havlir explains why now is the time to accelerate our efforts to end this epidemic once and for all.

Within Reach

By Dr. Diane Havlir

…Why now can we begin to map out the path to ending AIDS? The answer is quite simple. Over the past several years, a series of breakthroughs has provided the tools we can use to begin to end AIDS.

Arguably, the most important breakthrough was the HPTN 052 study that definitively showed that effective HIV treatment not only saves lives but reduces the risk of HIV transmission in couples—by an astounding 96%. Second, pre-exposure prophylaxis (PrEP), in which HIV-negative people follow an antiretroviral drug regimen to avoid acquiring HIV, gave us another new tool to reduce the number of new infections. We also now know that voluntary adult male circumcision works, reducing the risk of HIV acquisition for men in heterosexual relationships by approximately 50%. And for women, microbicides appear promising for protection against HIV acquisition.

The critical questions now for the AIDS community revolve around how we efficiently and effectively deploy this new knowledge. We have some real challenges. First, we must better address prevention and treatment strategies in key affected populations such as men who have sex with men, commercial sex workers, and injection drug users. Second, we must dramatically expand HIV testing, and fix the “care cascade”—the steps that patients must navigate between HIV diagnosis and long-term retention in care. We need to ensure patients receive therapy in a way that minimizes drug resistance. And we need to continue to work towards sustainable global financing approaches that turn our aspirations into reality….

To read Dr. Havlir’s full chapter, head over to Amazon.com or KoboBooks.com to purchase the digital book. All profits from sales of the book go to support San Francisco AIDS Foundation’s free services for HIV prevention and care in communities hardest hit by HIV.

How AIDS Ends features a foreword by President Bill Clinton and chapters by Timothy Ray Brown, Jeanne White Ginder, Cleve Jones, Barbara Lee, Mark Dybul, Paul Farmer, Robert Gallo, Mervyn Silverman, Diane Havlir, Scott Wiener, LZ Granderson, Hank Plante, Eduardo Xol, and Neil Giuliano. Read more about the book here.



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