Sep 24, 2009

HIV vaccine is encouraging but avoiding another kind of injection is key to stopping Baltimore's HIV/AIDS epidemic



If only there was a vaccine against IV drug use (image source)
According to the National Institutes of Health, every eight hours, someone in Baltimore is infected with HIV and it is the number one cause of death in 25 to 44 year-old people. Most of the infections in Baltimore occur from the use of infected needles for IV drug use. Also, more than half of new infections in Baltimore occur from IV drug use. Clearly, it will take more than an experimental vaccine to really get the hopes up of Public Health officials in Maryland when it comes to HIV/AIDS prevention.
The United States Army, in collaboration with the Government of Thailand, conducted a controlled HIV vaccine trial in over 16,000 Thailand residents. Half of the participants received the vaccine. The other half received a placebo (a non-functioning substance, like water). In the group that received the vaccine, 51 acquired HIV after being vaccinated. In the group that received the placebo, 74 acquired HIV after receiving the placebo. The difference between the two groups is 31%.
Care must be taken when interpreting the information. Yes, there was a difference of 23 people between the two groups, but HIV is as much an infection of human habits as it is a viral infection. That is, there is no way of guaranteeing that the vaccinated group reduced their risky behavior and/or that the placebo group increased theirs. However, with 16,000 participants, the study was large enough that small effects are "diluted" amongst all the participants.
As more is understood about why there was this difference, how the vaccine contributed to it, and how new advances in medical technology will contribute to the creation of better vaccines, HIV may very well go the way of other vaccine preventable diseases. Yet, much like influenza and measles, it would be foolish to rely only on a vaccine for preventing HIV. Prevention requires action on other fronts.

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