HIV treatment as prevention

The most significant change that has taken place in HIV prevention and in the thinking and strategies of many public health workers and prevention advocates since the last edition of Preventing HIV is a much greater emphasis on the role of HIV treatment as a method of HIV prevention. A few advocates feel that we may not even need new treatments (like vaccines) and new approaches (like pre-exposure prophylaxis) to significantly reduce HIV transmission, but may simply need to step up what we are already doing, namely treating people who have HIV. This is a minority view, but, encouraged by new evidence of the efficacy of HIV treatment as prevention, many experts and advocates now believe that the provision of ARVs may be one of the most important elements of any strategy to end the HIV epidemic. At the very least it provides another powerful reason to expand access to treatment.