HIV treatment as prevention : optimising the impact of expanded HIV treatment programmes
Date
2012-07
Authors
Delva, Wim
Eaton, Jeffrey W.
Meng, Fei
Fraser, Christophe
White, Richard G.
Vickerman, Peter
Boily, Marie-Claude
Hallett, Timothy B.
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science (PLOS)
Abstract
Until now, decisions about how to allocate ART
have largely been based on maximising the therapeutic
benefit of ART for patients. Since the results of the HPTN
052 study showed efficacy of antiretroviral therapy (ART)
in preventing HIV transmission, there has been increased
interest in the benefits of ART not only as treatment, but
also in prevention. Resources for expanding ART in the
short term may be limited, so the question is how to
generate the most prevention benefit from realistic
potential increases in the availability of ART. Although
not a formal systematic review, here we review different
ways in which access to ART could be expanded by
prioritising access to particular groups based on clinical or
behavioural factors. For each group we consider (i) the
clinical and epidemiological benefits, (ii) the potential
feasibility, acceptability, and equity, and (iii) the affordability
and cost-effectiveness of prioritising ART access for
that group. In re-evaluating the allocation of ART in light
of the new data about ART preventing transmission, the
goal should be to create policies that maximise epidemiological
and clinical benefit while still being feasible,
affordable, acceptable, and equitable.
Description
The original publication is available at http://www.plosmedicine.org
Keywords
HIV infections -- Treatment, HIV infections -- Prevention, HIV treatment programmes
Citation
Delva, W. et al. 2012. HIV treatment as prevention: optimising the impact of expanded HIV treatment orogrammes. PLoS Med, 9(7), e1001258, doi:10.1371/journal.pmed.1001258.