Much of the gradual decline in HIV over the past decade has been attributed to expanded coverage of antiretroviral therapy (ART). An increasing number of people living with HIV are on ART and are virally suppressed, therefore unable to transmit the virus to their partners. Universal testing and treatment have been proposed as a key strategy to increase ART coverage in an attempt to achieve steeper reductions in HIV incidence. This strategy involves wide-scale delivery of HIV testing at the community level, accompanied by effective linkage to care and support for ART adherence. The HPTN 071 (PopART) trial was the largest of four community-randomized trials that were conducted to evaluate the effect of the universal testing and treatment strategy.

The study was performed in Zambia and South Africa, during from 2013-2018. Patients were randomized into 3 arms: arm A patients received a complete ART therapy and were followed more closely, including door-to-door testing; arm B patients were treated with ART according to national guidelines; arm C patients were a control arm who received the national standard of care.

The most successful approach appears to point towards follow-up with patients in their communities. “Comprehensive and sustained delivery of HIV testing in communities also provides the opportunity to offer HIV-prevention services to people who test negative for HIV, and to provide an easy route back onto ART for the increasing number of HIV-positive individuals who have dropped out of care. Finally, the model projections show that, to achieve maximal effect, community-based strategies need to be sustained and, if possible, scaled up over a wider population.”1

Continue reading here.

References

  1. Hayes, R. (2022, November 1). Lessons from the HPTN 071 (PopART) trial. The Lancet HIV. https://www.thelancet.com/action/showPdf?pii=S2352-3018(22)00304-6

Disclaimers

  • The material in these reviews is from various public open-access sources, meant for educational and informational purposes only
  • Any personal opinions expressed are those of only the author(s) and are not intended to represent the position of any organization(s)
  • No official support by any organization(s) has been provided or should be inferred