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Title: HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes
Authors: DELVA, Wim 
Eaton, Jeffrey W.
MENG, Fei 
Fraser, Christophe
White, Richard G.
Vickerman, Peter
Boily, Marie-Claude
Hallett, Timothy B.
Issue Date: 2012
Source: PLOS MEDICINE, 9 (7), p. e1001258
Abstract: 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.
Notes: [Delva, Wim] Univ Stellenbosch, Natl Res Fdn, Ctr Excellence Epidemiol Modelling & Anal, S African Dept Sci & Technol, ZA-7600 Stellenbosch, South Africa. [Delva, Wim; Meng, Fei] Univ Ghent, Int Ctr Reprod Hlth, B-9000 Ghent, Belgium. [Eaton, Jeffrey W.; Fraser, Christophe; Boily, Marie-Claude; Hallett, Timothy B.] Univ London Imperial Coll Sci Technol & Med, Dept Infect Dis Epidemiol, London, England. [Meng, Fei] Hasselt Univ, Ctr Stat, Diepenbeek, Belgium. [White, Richard G.] Univ London London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London WC1E 7HT, England. [Vickerman, Peter] Univ London London Sch Hyg & Trop Med, Dept Global Hlth & Dev, London WC1E 7HT, England.
Keywords: Medicine, General & Internal
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ISSN: 1549-1277
e-ISSN: 1549-1676
DOI: 10.1371/journal.pmed.1001258
ISI #: 000307106400014
Category: A1
Type: Journal Contribution
Validations: ecoom 2013
Appears in Collections:Research publications

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