Purpose of review HIV
remains a significant global public health problem. Treatment as prevention
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
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.
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.