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Antiretroviral Therapy for Prevention of HIV and Tuberculosis: A Promising Intervention but Not a Panacea

McNairy, Margaret L. MD, MSc*,†; Howard, Andrea A. MD*,‡; El-Sadr, Wafaa M. MD, MPH, MPA*,‡

JAIDS Journal of Acquired Immune Deficiency Syndromes: July 1st, 2013 - Volume 63 - Issue - p S200–S207
doi: 10.1097/QAI.0b013e3182986fc6
Supplement Article

Abstract: The demonstration of the efficacy of antiretroviral therapy (ART) for HIV prevention in heterosexual HIV serodiscordant couples has resulted in the call for widespread implementation of “Treatment as Prevention” (TasP) to confront the challenge of continued transmission of HIV. In addition, evidence of the possible effect of use of ART on decreasing the incidence of tuberculosis (TB) in persons living with HIV has also contributed further enthusiasm. Mathematical modeling studies evaluating the potential impact of TasP on the trajectory of the HIV and TB epidemics have inspired discussions about a possible future without AIDS. We present the evidence regarding the effect of ART on the incidence of HIV and TB, benefits and risks associated with embracing TasP, and the need for multicomponent prevention strategies and for further research to generate empiric data on the effect of TasP on HIV and TB at a population level.

*ICAP, Mailman School of Public Health, Columbia University, New York, NY;

Department of Medicine, Weill-Cornell Medical College, New York, NY; and

Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.

Correspondence to: Margaret McNairy, MD, MSc, ICAP at Columbia University, Mailman School of Public Health, 722 West 168th Street, 7th floor, New York, NY 10032 (e-mail:

The authors have no funding or conflicts of interest to disclose.

© 2013 Lippincott Williams & Wilkins, Inc.