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Behavioral Factors in Assessing Impact of HIV Treatment as Prevention

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Abstract

The recent NIH HPTN 052 study of using HIV treatment to prevent HIV transmission in serostatus discordant heterosexual partnerships has garnered much attention. In subsequent discussions, however, the topic of HIV-related risk behavior has been nearly absent. Here, we identify the critical roles that HIV-related risk behavior plays in determining the unmet needs, optimal targeting, and ultimate impact of treatment as prevention. We describe the size of the population at risk of HIV and three subgroups of persons living with HIV (PLWH) based on awareness of serostatus and risk behavior, and the corresponding HIV transmission rates to seronegative partners. For each of the subgroups of PLWH, we identify which approach is most relevant (“testing and linkage to care,” “treatment as prevention,” and/or “treatment as clinical care”). We observe that the impact of “treatment as prevention” on HIV incidence will depend heavily on which subgroup of PLWH is targeted for services.

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Acknowledgments

This manuscript was prepared as part of Government work (HIH) and there are no other funding sources to declare (DRH, CM, LW)

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The findings and conclusions in this study are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA

    David R. Holtgrave, Cathy Maulsby & Laura Wehrmeyer

  2. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control & Prevention, Atlanta, GA, USA

    H. Irene Hall

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  1. David R. Holtgrave
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Correspondence to David R. Holtgrave.

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Holtgrave, D.R., Maulsby, C., Wehrmeyer, L. et al. Behavioral Factors in Assessing Impact of HIV Treatment as Prevention. AIDS Behav 16, 1085–1091 (2012). https://doi.org/10.1007/s10461-012-0186-1

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