Original Article: bit.ly/1tGABXh
One of the key strategies involved in trying to bring an end to the HIV epidemic is to increase the proportion of HIV-positive people on antiretroviral therapy (ART), to the point where suppressing their viral load starts to reduce onward infection.
Not all models show that testing more people, and more frequently, would reduce HIV incidence because it depends on the ‘incidence density’ or frequency of infection in a population. However, one model shows that as the proportion of transmissions due to recent HIV infection rises, the proportion of people who have to be on ART with an undetectable viral load in order to ensure that the epidemic is not self-sustaining rises from 35% – as may be the case in the ANRS12249 study – to over 70%. The latter may be the case with the more concentrated epidemics such as among men who have sex with men, and people who inject drugs. In addition, people diagnosed soon after acquiring HIV would not become instantly non-infectious if they took treatment – it takes time for viral loads to fall. However post-diagnosis behaviour change should contribute to reducing onward infections too.
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