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

(2012) PLOS MEDICINE. 9(7).
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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.
Keywords
TO-CHILD TRANSMISSION, FEMALE SEX WORKERS, ACTIVE ANTIRETROVIRAL THERAPY, SEXUALLY-TRANSMITTED DISEASES, RESOURCE-LIMITED SETTINGS, INJECTING DRUG-USERS, SUB-SAHARAN AFRICA, SOUTH-AFRICA, RISK BEHAVIOR, VIRAL LOAD

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Citation

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Chicago
Delva, Wim, Jeffrey W Eaton, Fei Meng, Christophe Fraser, Richard G White, Peter Vickerman, Marie-Claude Boily, and Timothy B Hallett. 2012. “HIV Treatment as Prevention : Optimising the Impact of Expanded HIV Treatment Programmes.” Plos Medicine 9 (7).
APA
Delva, W., Eaton, J. W., Meng, F., Fraser, C., White, R. G., Vickerman, P., Boily, M.-C., et al. (2012). HIV treatment as prevention : optimising the impact of expanded HIV treatment programmes. PLOS MEDICINE, 9(7).
Vancouver
1.
Delva W, Eaton JW, Meng F, Fraser C, White RG, Vickerman P, et al. HIV treatment as prevention : optimising the impact of expanded HIV treatment programmes. PLOS MEDICINE. 2012;9(7).
MLA
Delva, Wim et al. “HIV Treatment as Prevention : Optimising the Impact of Expanded HIV Treatment Programmes.” PLOS MEDICINE 9.7 (2012): n. pag. Print.
@article{3002851,
  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.},
  articleno    = {e1001258},
  author       = {Delva, Wim and Eaton, Jeffrey W and Meng, Fei and Fraser, Christophe and White, Richard G and Vickerman, Peter and Boily, Marie-Claude and Hallett, Timothy B},
  issn         = {1549-1676},
  journal      = {PLOS MEDICINE},
  keywords     = {TO-CHILD TRANSMISSION,FEMALE SEX WORKERS,ACTIVE ANTIRETROVIRAL THERAPY,SEXUALLY-TRANSMITTED DISEASES,RESOURCE-LIMITED SETTINGS,INJECTING DRUG-USERS,SUB-SAHARAN AFRICA,SOUTH-AFRICA,RISK BEHAVIOR,VIRAL LOAD},
  language     = {eng},
  number       = {7},
  pages        = {12},
  title        = {HIV treatment as prevention : optimising the impact of expanded HIV treatment programmes},
  url          = {http://dx.doi.org/10.1371/journal.pmed.1001258},
  volume       = {9},
  year         = {2012},
}

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