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27 May 2015

START study results released

Australia’s peak organisation representing people with HIV has welcomed the announcement from the international START (Strategic Timing of AntiRetroviral Treatment) research study team of its conclusive findings that immediate treatment of HIV is clinically superior compared with deferred treatment among people with HIV infection.

NAPWHA President Robert Mitchell described the START study results as “a pivotal development” in the global response to HIV.  “These study results will influence how HIV is treated and prevented around the world, in both developed and developing countries,” said Mitchell.

“The START results confirm that starting HIV treatment as early as possible confers significant health benefits for people with HIV.  Many researchers, clinicians and advocates have held this view, but the evidence to support it came mostly from smaller studies and expert opinion.  It was argued that we lacked a large, definitive, randomised clinical study to prove the early treatment strategy. So START has provided that using the highest standard of evidence – a randomised ,controlled clinical trial.”

START was conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) in 35 countries and enrolled more than 4,500 people. NAPWHA has been involved in the START study from its beginning in 2009, with former executive director Jo Watson serving on the INSIGHT international coordinating group.

NAPWHA warmly congratulates Professor David Cooper and Professor Sean Emery for their outstanding leadership of Australia’s Kirby Institute in making such an important contribution to the START study.  “Once again, though our participation in START, Australia has shown exceptional global leadership in HIV research,” said Mitchell.

NAPWHA believes there are three key messages from the START study results:

  •  If you are at risk of HIV, then get tested and test often.
  • If you have HIV and aren’t taking HIV treatment, you are recommended to consider starting treatment immediately.
  • If you are a doctor caring for people with HIV, you should discuss the implications of the START study with patients as early as possible.

“It is critically important that Australian governments and non-government organisations involved in HIV get the message out now about START’s findings and its implications for HIV treatment and prevention,” said Mitchell. “Implementing Australia’s new National HIV Strategy is a very appropriate starting point, so Australia should use the new Strategy to mobilise the clinical  workforce and affected communities around early uptake of HIV treatment.”

NAPWHA would also like to see the Australian government remove any barriers to starting treatment, including burdensome HIV treatment co-payments which can be prohibitive for some people with HIV.