The research and advocacy agenda

A number of pilot and feasibility studies are underway. For example, two high-prevalence sites in the United States (the Bronx and Washington DC) have been chosen by the US Federal Government for a pilot study for an approach that combined improved testing and diagnosis rates with improved linkage to care. 

Truly universal ‘test and treat’ models, as proposed in the mathematical model by WHO staff, will be tested in two feasibility studies currently in preparation: PopART (visit Imperial College website for more information) in Uganda and Zambia and TasP in South Africa. These cluster-randomised trials to ‘test and treat’ entire communities and begin ART at any CD4 count will examine the impact on reducing community viral load, incidence of new infections, cost-effectiveness and safety.

One trial that is not intended as an HIV-prevention trial, but which will give researchers vital information as to the safety of the universal test-and-treat concept, is the START Study, (visit the Insight website for more information) which will randomise 900 HIV-positive participants who have CD4 counts over 500 cells/mm3 either to start treatment immediately or to wait till their CD4 count has dropped below 350. START aims to quantify whether ARV treatment produces better health outcomes regardless of CD4 count or whether, at very high CD4 counts, drug-related adverse events begin to outweigh those caused by HIV.

If START indicates that being on ARVs produces better health outcomes at all CD4 counts, it will give a green light to treatment as prevention initiatives as it means there will not be an ethical dilemma between treating people for public health reasons with drugs that are going to have net harmful effects on some groups.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.