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Annual testing and scale-up of PrEP could slow the Dutch gay HIV epidemic
Roger Pebody, 2016-01-07 22:10:00

Phylogenetic analysis of the source of HIV infections in Dutch gay men over more than a decade shows that 71% acquired HIV from a man who was himself not yet diagnosed and only 6% from a man who was taking treatment, Oliver Ratmann and colleagues report in this week’s issue of Science Translational Medicine.

Examining what could have been different if prevention activities were scaled up, the researchers estimate that a combination of annual HIV testing, PrEP for half of all HIV-negative gay men and immediate HIV treatment for those testing positive could have averted two thirds of these transmissions. They say the results highlight the importance of combining the interventions – singular approaches would have much less impact.

Understanding which interventions could make a difference to the Dutch gay epidemic is an important case study, they say. The substantial scale-up of HIV treatment there has not stemmed new HIV infections. Although 90% of diagnosed men are on treatment, 91% of those on treatment are undetectable and 95% of diagnosed men are retained in care, HIV incidence is stable or increasing. Other developed countries, including the UK, have a similar problem.