ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del RioTreatment as prevention trials and ending AIDS what do we know, when did we know it, and what do we do now?Granich, Reubena; Williams, Brian G.b Author Information aCoppet, Switzerland bSouth African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch, South Africa Correspondence to Reuben Granich, MD, MPH, Coppet, Switzerland. E-mail: [email protected] Current Opinion in HIV and AIDS 14(6):p 514-520, November 2019. | DOI: 10.1097/COH.0000000000000582 Buy Metrics Abstract Purpose of review HIV remains a significant global public health problem. Treatment as prevention of HIV and TB illness, death and transmission was proposed in 2006 as a means to end the HIV epidemic. We review the results of the treatment as prevention trials. Recent findings Some of the trials struggled with delivering services, however, most demonstrate that it is feasible to achieve at least the 90–90–90 target by scaling access to test-and-treat at the community level and by extension at the district or national level. Patients, if offered, will start and stay on immediate treatment even without symptoms. Community-based multidisease prevention campaigns have significant impact, especially for hard-to-reach men. Earlier treatment impacts illness and death including from HIV-associated tuberculosis. Test-and treat impacts transmission, however, some of the community cluster trials had difficulty showing an impact on incidence. Most trials showed incidence reduction in line with the level of viral suppression and suggest that achieving 95–95–95 is an important means to accelerate the end of the epidemic. Summary TasP trial findings, HIV and TB program data, and PHIA study trend data will likely confirm that reaching at least 95–95–95 is both feasible and a key element in ending the epidemic. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
