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Antiretroviral therapy for the prevention of HIV transmission: what will it take?


ABSTRACT: The evidence in support of use of antiretroviral therapy (ART) for prevention of human immunodeficiency virus (HIV) transmission is encouraging and has stimulated optimism for achieving a dramatic change in the trajectory of the HIV epidemic. Yet, there are substantial challenges that, if not addressed, could be the Achilles' heel for this concept. These challenges require strengthening every step of the HIV care continuum, including expansion of HIV testing to reach all those with HIV infection, effective linkage to and retention in care, timely initiation of ART, and high levels of treatment adherence with viral load suppression. Also important is the identification of individuals with acute HIV infection whose contribution to HIV transmission may be substantial. Implementation research is needed to identify strategies that address these challenges and to determine the efficacy of ART for prevention in key populations as well as to evaluate the effectiveness of combination strategies for HIV prevention at the population level.

SUBMITTER: McNairy ML 

PROVIDER: S-EPMC3952607 | biostudies-other | 2014 Apr

REPOSITORIES: biostudies-other

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Antiretroviral therapy for the prevention of HIV transmission: what will it take?

McNairy Margaret L ML   El-Sadr Wafaa M WM  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20140114 7


The evidence in support of use of antiretroviral therapy (ART) for prevention of human immunodeficiency virus (HIV) transmission is encouraging and has stimulated optimism for achieving a dramatic change in the trajectory of the HIV epidemic. Yet, there are substantial challenges that, if not addressed, could be the Achilles' heel for this concept. These challenges require strengthening every step of the HIV care continuum, including expansion of HIV testing to reach all those with HIV infection  ...[more]

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