AIDS and Behavior

, Volume 16, Issue 5, pp 1085–1091 | Cite as

Behavioral Factors in Assessing Impact of HIV Treatment as Prevention

  • David R. HoltgraveEmail author
  • Cathy Maulsby
  • Laura Wehrmeyer
  • H. Irene Hall


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.


HIV Behavior Treatment Prevention Unmet needs 



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


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.

Conflict of interest

No conflicts of interest to declare


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • David R. Holtgrave
    • 1
    Email author
  • Cathy Maulsby
    • 1
  • Laura Wehrmeyer
    • 1
  • H. Irene Hall
    • 2
  1. 1.Department of Health, Behavior & SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Division of HIV/AIDS PreventionNational Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control & PreventionAtlantaUSA

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