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To the Editor: In their Commentary, Drs Dieffenbach and Fauci¹ examined the untested assumptions and implications of the "test and treat" human immunodeficiency virus (HIV) prevention strategy modeled in the study by Granich et al.² I believe that the Commentary did not address several points relevant to considering this strategy for the United States.

First, the study by Granich et al compared a particular intervention strategy (universal annual testing and immediate HIV treatment) with the absence of that strategy.² Because many HIV prevention strategies are effective and cost-effective, it is important to identify those intervention options that will most rapidly influence the course of the epidemic. Mathematical models are likely to provide more policy guidance if a variety of intervention strategies are compared with each other.

Second, while the model in Granich et al focused on South Africa, some relevant information about the effect of such a strategy in the . . . [Full Text of this Article]

David R. Holtgrave, PhD
dholtgrave@jhsph.edu
Department of Health, Behavior and Society
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland

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