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HIV treatment as prevention

Roger Pebody

The demonstration in 2011 that HIV treatment reduces the risk of heterosexual transmission by 96% was hailed as a ‘game changer’ that would revolutionise HIV prevention. This briefing paper describes the scientific evidence for treatment as prevention and considers its implications for the UK. The first half of the briefing focuses on individuals and couples, before turning to possible benefits at a population level, for public health.

While antiretroviral drugs can also have prevention benefits when taken by HIV-negative people, as pre-exposure prophylaxis (PrEP) or as post-exposure prophylaxis (PEP), this briefing only covers antiretrovirals taken by people with diagnosed HIV, as treatment.

Thanks to Zheng Yin, Alison Brown and Valerie Delpech (Public Health England); Andrew Phillips, Alison Rodger, Fiona Lampe and Fumiyo Nakagawa (University College London); Ann Sullivan (Chelsea & Westminster Hospital); Cary James and Justin Harbottle (Terrence Higgins Trust); Ellen Hill (Yorkshire MESMAC); Joanna Moss (MBARC) and Jabulani Chwaula (BHA) for their advice and feedback.

This briefing paper, produced by NAM for HIV Prevention England, describes the scientific evidence for HIV treatment as prevention and considers its implications for the UK.

  • Scientific evidence

    HIV treatment reduces the risk of transmission by reducing the quantity of HIV circulating in the body. When there is so little HIV in a person’s blood...

  • Expert advice and guidelines

    In 2008, Swiss clinicians issued the ‘Swiss statement’, which asserted that the risk of sexual HIV transmission is minimal as long as the person with HIV is...

  • The public health impact

    Since treatment has prevention benefits at the individual level, it makes sense to think it may also have prevention benefits at the population level. In other words,...

  • The treatment cascade

    Diagrams of the ‘treatment cascade’ provide a useful way of visualising problems with the implementation of ‘treatment as prevention’ in specific contexts, and of identifying reasons why...

  • Key points

    HIV treatment reduces the risk of transmission by reducing the quantity of HIV circulating in the body.Under specific conditions, effective treatment is likely to be as effective...

  • Further reading

    Bernard EJ Viral load and the risk of transmission. aidsmap.com, 2013. British HIV Association (BHIVA) and Expert Advisory Group on AIDS (EAGA) Position statement on the use of antiretroviral...

HIV treatment as prevention

Published March 2014

Last reviewed March 2014

Next review March 2017

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.