HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.

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...

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Autores principales:	Wim Delva, Jeffrey W Eaton, Fei Meng, Christophe Fraser, Richard G White, Peter Vickerman, Marie-Claude Boily, Timothy B Hallett
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/d0dc4921474947008fb31e7f6f78f5d6
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spelling	oai:doaj.org-article:d0dc4921474947008fb31e7f6f78f5d62021-11-18T05:42:12ZHIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.1549-12771549-167610.1371/journal.pmed.1001258https://doaj.org/article/d0dc4921474947008fb31e7f6f78f5d62012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22802738/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676Until 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.Wim DelvaJeffrey W EatonFei MengChristophe FraserRichard G WhitePeter VickermanMarie-Claude BoilyTimothy B HallettPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 9, Iss 7, p e1001258 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Wim Delva Jeffrey W Eaton Fei Meng Christophe Fraser Richard G White Peter Vickerman Marie-Claude Boily Timothy B Hallett HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.
description	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.
format	article
author	Wim Delva Jeffrey W Eaton Fei Meng Christophe Fraser Richard G White Peter Vickerman Marie-Claude Boily Timothy B Hallett
author_facet	Wim Delva Jeffrey W Eaton Fei Meng Christophe Fraser Richard G White Peter Vickerman Marie-Claude Boily Timothy B Hallett
author_sort	Wim Delva
title	HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.
title_short	HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.
title_full	HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.
title_fullStr	HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.
title_full_unstemmed	HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.
title_sort	hiv treatment as prevention: optimising the impact of expanded hiv treatment programmes.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/d0dc4921474947008fb31e7f6f78f5d6
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HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.

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