National HIV Testing Day is Wednesday, June 27 and we’re taking a look back to see all the progress that’s been made with HIV testing and treatment and the advancements yet to come. In 1984, French and American scientists discovered that a retrovirus (HIV—Human Immunodeficiency Virus) was the cause of AIDS (Acquired Immune Deficiency Syndrome). This discovery made the first HIV test possible but it was only used to test donated blood and had a high false positive rate. At the time there was a lot of fear surrounding HIV/AIDS and its transmission; because of this fear, the test was designed to be ultrasensitive. By 1985 the protocol moved from testing blood donations to testing individuals for the virus. Still, the test took some time, requiring individuals to have blood drawn and wait for days or weeks to get the results. Since the development of the first HIV test, the process has become smoother and more accurate and can be done with a much smaller blood sample or mouth swab. These tests measure antibodies that are present if HIV is in your system. If tested positive for HIV, it’s recommended to retake the test as a precaution. If negative, the test should be taken every three months.
The World Health Organization indicates that 30 percent of people with HIV aren’t aware they have the virus. Celebrities like Prince Harry and Rihanna have been tested for HIV on camera to show how simple the test is and encourage others to follow suit. Since the development of the Rapid HIV Test which only takes 20 minutes and consists of a small pinprick, testing is more accessible, but HIV testing and the virus are still shrouded in fear despite ongoing efforts to educate.
Now that the tests are more accurate the treatments and prevention methods are significantly more effective. Condoms and clean needle use are still the best way to prevent the spread of HIV but medications like Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) are widely available and target different high-risk situations. PrEP can protect individuals at risk for contracting HIV while PEP is an emergency treatment for those exposed to the virus.
PrEP is a daily medication prescribed to individuals at high risk for contracting HIV. It was approved by the FDA in July 2012 for reducing the risk of sexually transmitted HIV infection. Due to extensive research on Macaque monkeys, PrEP has been proven to diminish the risk of contracting the virus for individuals at high risk for exposure, like someone in an ongoing sexual relationship with a partner who is HIV positive.
Macaque monkeys were used in the trials testing PrEP’s efficacy in reducing the risk of HIV infection. To prepare nonhuman primates for testing the medication’s efficacy, scientists modified the HIV virus to mimic the human symptoms in monkeys; the virus is called SHIV (Infectious Simian/Human Immunodeficiency Virus). In this study, one group of five Macaque monkeys were given PrEP orally and were exposed to SHIV over 14 days. The second group of monkeys were exposed to SHIV over 14 days without receiving PrEP. The monkeys that received PrEP did not contract SHIV while the monkeys that had not received PrEP became infected.
According to the Center for Disease Control, PrEP reduces the risk of contracting HIV from sex by 90% and injectable drugs by more than 70%, when taken consistently. In 2017 the World Health Organization began The Global PrEP Coalition in hopes of fast tracking the distribution of PrEP to areas with large HIV positive populations to help diminish the spread of the virus. A bigger hurdle is the stigma surrounding HIV and the lack of education worldwide.
Another HIV preventative measure is PEP (Post Exposure Prophylaxis) which requires taking antiretroviral medicines after exposure to the virus. Another study in 2005 with macaque monkeys showed that the sooner the medication was received after exposure, the lower the chance of contracting HIV. Three groups of monkeys were exposed to SHIV and given the first dose of PEP at 12 hours, 36 hours, or 72 hours and received PEP daily for 28 days post exposure. All the monkeys dosed with PEP within 12 or 36 hours did not contract HIV. Three of the four monkeys dosed at 72 did not contract HIV, and the monkey that did contract HIV had a low viral load (a small amount of circulating HIV within bodily fluids). This medication is useful in early intervention for those who are accidentally exposed but is not recommended for high-risk individuals.
Clearly, significant progress has been made in HIV testing and treatment since 1984, a time when contracting the disease likely meant death. Today, HIV testing is easier than ever and new medications make the virus treatable. But scientists are striving for more; David Montefiori, the director of the Laboratory for AIDS Vaccine Research and Development at Duke University said in 2016, “With the extraordinary progress that’s been made just in the past six years, I’m more optimistic than ever that the field will eventually succeed in having an effective prevention measure.” Thanks to animal research, HIV is no longer a death sentence, it is treatable and preventable.
By Lauren Gustafson