Strategies for Preventing HIV Transmission—Reply
- Carl W. Dieffenbach, PhD cdieffenba@niaid.nih.gov;
- Anthony S. Fauci, MDNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, Maryland
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ANTI-RETROVIRAL AGENTS
- COSTS AND COST ANALYSIS
- DISEASE TRANSMISSION, INFECTIOUS
- DRUG THERAPY
- HEALTH POLICY
- HIV INFECTIONS
- MASS SCREENING
- PREVENTIVE HEALTH SERVICES
- PUBLIC HEALTH
- SEXUAL BEHAVIOR
In Reply: These letters provide additional commentary on the publication by Granich et al1 and accurately point out specific scientific challenges and issues with the universal voluntary HIV testing and immediate treatment for the prevention of HIV transmission known as the test and treat strategy. The purpose of our Commentary was to identify pivotal areas of research that need to be addressed as the scientific community debates and evaluates this strategy.
We agree that much more research is needed to understand the limitations of both ART as prevention and the overall test and treat approach. As the Commentary discussed, these include (1) the relationship between stage of infection and transmission, (2) efficacy of ART in prevention of transmission, (3) development of drug resistance, (4) behavioral disinhibition, (5) the benefit of early treatment to the individual, (6) cost-effectiveness, and (7) the ability to reach target populations and implement annual universal …
