Institutional members access full text with Ovid®

Share this article on:

Optimizing the engagement of care cascade: a critical step to maximize the impact of HIV treatment as prevention

Hull, Mark W.a; Wu, Zunyoub; Montaner, Julio S.G.a

Current Opinion in HIV and AIDS: November 2012 - Volume 7 - Issue 6 - p 579–586
doi: 10.1097/COH.0b013e3283590617

Purpose of review At present, data from mathematical models, ecologic studies and a clinical trial demonstrate that use of combination antiretroviral therapy (cART) can markedly reduce HIV transmission. Expansion of cART uptake (Treatment as Prevention) is a critical component of biomedical interventions to prevent HIV transmission.

Recent findings Successful implementation is dependent on identifying undiagnosed individuals, linking and retaining them in care and initiating durable and potent cART regimens. This continuum is encapsulated within the framework of the ‘Test and Treat’, or ‘Seek, Test, Treat and Retain’ strategies. Currently only 19–28% of all HIV-infected individuals in the USA are estimated to be virologically suppressed.

Summary Optimizing the engagement of care cascade represents a critical step to maximize the individual and societal impact of cART and therefore deliver on the promise of HIV Treatment as Prevention.

aDivision of AIDS, Department of Medicine, University of British Columbia, Vancouver, Canada

bNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

Correspondence to Julio S.G. Montaner, Professor, Division of AIDS, Department of Medicine, University of British Columbia, Room 667, 1081 Burrard St, Vancouver V6Z 1Y6, Canada. Tel: +1 604 806 8640; fax: +1 604 806 8527; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.