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Giving treatment to specific high-risk people may bring down HIV faster than distributing it equally
Gus Cairns, 2014-04-08 10:30:00
In a concentrated epidemic, HIV is mainly restricted to – or at least more common in – specific risk groups. In this situation, and if universal antiretroviral treatment (ART) cannot be provided, it may have more effect in public health terms to give ART to people at high risk of acquiring and transmitting HIV.
If the correct risk group is targeted, suppressing viral load in that group may reduce HIV prevalence in other groups they are connected to; on the other hand, targeting ART to a group that is larger but more peripherally connected to the epidemic may not help to reduce prevalence and incidence within other populations.
These are the implications of a model developed by Brian Williams of the South African Centre for Epidemiological Modelling and Analysis (SACEMA) and presented to the 2014 Treatment as Prevention Workshop in Vancouver last week.
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