Yesterday I made a post that quoted experts as saying that we cannot treat our way out of the epidemic: http://hivinfo4mm.org/the-best-prevention-is-prevention/. Here is a response from a reader:

Reader:

The new “trend" is “combination prevention” and does not rely solely on treatments. Sure, we cannot end the epidemic only with treatments (drugs) but we can damn sure lower the HIV rate amongst MSM, gay men and transgender people and dammit we need to move quickly to do so.

Jamie

Humankind has never treated its way out of any epidemic.

The term "combination prevention" needs to be examined carefully as the concept originated in PEPFAR five years ago and PEPFAR has largely been a failure in prevention. Adding adult circumcision and pre-exposure prophylaxis to some national programmes may contribute to a decline in overall new infections. ART might, too.

And I fully agree that there has been an ongoing public health emergency for the last few years in many of the cities of Southeast Asia. New infections among men who have sex with men and transgender women must be decreased as soon as possible. Changes in behaviour, condoms, and lube are necessary. ART and PREP, if they can be scaled up quickly, would probably help. There is no evidence for circumcision is effective in decreasing HIV incidence in men who have sex with men.

Jamie