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Treatment as Prevention—Where Next?

  • Treatment as Prevention (RM Granich, Section Editor)
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Abstract

Uptake of antiretroviral regimens with associated durable virologic suppression has been shown to reduce the risk of HIV transmission. Expanding antiretroviral therapy (ART) programs at a population level may serve as a vital strategy in the elimination of the AIDS epidemic. The global expansion of ART programs has greatly improved access to life-saving therapies and is likely to achieve the target of 15 million individuals on therapy set by UNAIDS. In addition to the incontrovertible gains in terms of life expectancy, growing evidence demonstrates that durable virologic suppression is associated with significant reductions in HIV transmission amongst heterosexual couples and men who have sex with men. Expansion of successful ART programs, best monitored by a program-level continuum of care cascade to assess progress in diagnosis, retention in care, and virologic suppression, is associated with reductions in HIV incidence at a population level. Expanding and sustaining successful ART delivery at a global level is a key component in a comprehensive approach to combating the HIV epidemic over the next two decades.

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Compliance with Ethics Guidelines

Conflict of Interest

Mark Hull receives support from the US National Institute on Drug Abuse (grant number R01DA031043-01). He has served on speakers bureau or advisory boards of Merck, Janssen, Vertex, Bristol-Myers-Squibb, ViiV Healthcare, and Pfizer.

Julio S. G. Montaner is supported, with grants paid to his institution, by the British Columbia Ministry of Health. He has also received financial support from the US National Institutes of Health, International AIDS Society, United Nations AIDS Program, World Health Organization, France Recherche Nord & Sud SIDA HIV Hépatites (ANRS), International Association of Providers of AIDS Care (IAPAC), UNICEF, MAC AIDS Fund, and Open Society Foundation. He has received grants from Abbvie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, and ViiV Healthcare.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. BC Centre for Excellence in HIV/AIDS, Room 667, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Mark Hull & Julio S. G. Montaner

  2. University of British Columbia, Vancouver, Canada

    Mark Hull & Julio S. G. Montaner

  3. University of Amsterdam, Amsterdam, The Netherlands

    Joep Lange

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  1. Mark Hull
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Correspondence to Julio S. G. Montaner.

Additional information

Dr. Joep Lange was murdered in the tragic MH17 bombing while this manuscript was being developed.

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Hull, M., Lange, J. & Montaner, J.S.G. Treatment as Prevention—Where Next?. Curr HIV/AIDS Rep 11, 496–504 (2014). https://doi.org/10.1007/s11904-014-0237-5

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