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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: Delva, Wim, Eaton, Jeffrey W., Meng, Fei, Fraser, Christophe, White, Richard G., Vickerman, Peter, Boily, Marie-Claude, Hallett, Timothy B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393661/
https://www.ncbi.nlm.nih.gov/pubmed/22802738
http://dx.doi.org/10.1371/journal.pmed.1001258
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author Delva, Wim
Eaton, Jeffrey W.
Meng, Fei
Fraser, Christophe
White, Richard G.
Vickerman, Peter
Boily, Marie-Claude
Hallett, Timothy B.
author_facet Delva, Wim
Eaton, Jeffrey W.
Meng, Fei
Fraser, Christophe
White, Richard G.
Vickerman, Peter
Boily, Marie-Claude
Hallett, Timothy B.
author_sort Delva, Wim
collection PubMed
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.
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spelling pubmed-33936612012-07-16 HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes Delva, Wim Eaton, Jeffrey W. Meng, Fei Fraser, Christophe White, Richard G. Vickerman, Peter Boily, Marie-Claude Hallett, Timothy B. PLoS Med Review 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. Public Library of Science 2012-07-10 /pmc/articles/PMC3393661/ /pubmed/22802738 http://dx.doi.org/10.1371/journal.pmed.1001258 Text en Delva et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Review
Delva, Wim
Eaton, Jeffrey W.
Meng, Fei
Fraser, Christophe
White, Richard G.
Vickerman, Peter
Boily, Marie-Claude
Hallett, Timothy B.
HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes
title 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_short 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
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393661/
https://www.ncbi.nlm.nih.gov/pubmed/22802738
http://dx.doi.org/10.1371/journal.pmed.1001258
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