title: Clinical uncertainties, health service challenges, and ethical complexities of HIV "test-and-treat": a systematic review.
abstract: Despite the HIV "test-and-treat" strategy's promise, questions about its clinical rationale, operational feasibility, and ethical appropriateness have led to vigorous debate in the global HIV community. We performed a systematic review of the literature published between January 2009 and May 2012 using PubMed, SCOPUS, Global Health, Web of Science, BIOSIS, Cochrane CENTRAL, EBSCO Africa-Wide Information, and EBSCO CINAHL Plus databases to summarize clinical uncertainties, health service challenges, and ethical complexities that may affect the test-and-treat strategy's success. A thoughtful approach to research and implementation to address clinical and health service questions and meaningful community engagement regarding ethical complexities may bring us closer to safe, feasible, and effective test-and-treat implementation.
authors.affiliation: Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA 90005, USA. skulkarni@ph.lacounty.gov
authors.forename: Sonali P
authors.initials: SP
authors.lastname: Kulkarni
authors.forename: Kavita R
authors.initials: KR
authors.lastname: Shah
authors.forename: Karthik V
authors.initials: KV
authors.lastname: Sarma
authors.forename: Anish P
authors.initials: AP
authors.lastname: Mahajan
mesh_terms: D006678:HIV; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D006293:Health Promotion / Q000941:ethics / Q000379:methods*; D006801:Humans; D015397:Program Evaluation; D035501:Uncertainty