Universal “test and treat” approach can cut down HIVMay 9, 2019
House-to-house testing and immediate treatment can effectively reduce new HIV infections, according to the result of a large clinical trial.
New HIV infections declined by 30 percent in southern African communities where health workers conducted house-to-house voluntary HIV testing. Infected people were also referred to begin HIV treatment as per local guidelines and offered other proven HIV prevention measures to those who tested negative.
These results from the study called Population Effects of Antiretroviral Therapy to Reduce HIV Transmission (PopART), or HPTN 071, were announced recently at the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.
“The results of the PopART study suggest that conducting population-wide, home-based HIV testing and offering treatment to those diagnosed with HIV could help control the epidemic in certain settings,” said Anthony S Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), in a press statement.’
PopART study was to learn whether conducting HIV testing throughout a population and promptly offering treatment to all who test positive would reduce the rate of new infections in the population.
The study took place from 2013 to 2018 in 21 urban and peri-urban communities in South Africa and Zambia. Each community had an average of roughly 50,000 residents for a total study population of about 1 million. The communities were clustered into seven groups of three — “triplets” — matched by geographical location and estimated HIV prevalence.
The communities in each triplet were assigned at random to one of three study groups. The first group received annual house-to-house voluntary HIV testing and counselling, linkage to care for those who tested positive and the opportunity to immediately begin treatment, and the offer of a suite of proven HIV prevention measures to those who tested negative.
The second group received the same services as the first, except treatment was offered according to national guidelines. The third group served as a control and received HIV prevention and testing services according to the local standard of care as well as HIV treatment according to national guidelines.