The most important study examining whether test and treat
approaches have an impact on new HIV infections was the large randomised trial,
PopART.
But the conference also heard observational data on this issue from Mozambique.
Since 2014, lay counsellors have been visiting households in
the rural district of Chokwe annually. As well as offering HIV testing, they
provide up to five follow-up sessions with people with HIV, to support them
with psychosocial issues, linkage to HIV care and taking ART. Health facilities offering ART have also been improved, multi-month
prescriptions are available, and more lay counsellors are available to support
patients.
Surveys of random samples of the population show that between
2014 and 2017, the proportion of people with HIV who knew their status has gone
up from 67% to 88%, the proportion of those taking ART has increased from 60%
to 79% and the prevalence of viral suppression has risen from 41% to 66%.
HIV prevalence appears to be stable or even falling slightly
(27.8% to 25.6%, a difference that is not statistically significant).
Incidence was calculated to be 1.9% per year in the first
survey, halving to 0.9% in the most recent survey (incident rate ratio 0.46,
95% confidence interval 0.22-0.94).