title: Global response to HIV: treatment as prevention, or treatment for treatment?
abstract: The concept of "treatment as prevention" has emerged as a means to curb the global HIV epidemic. There is, however, still ongoing debate about the evidence on when to start antiretroviral therapy in resource-poor settings. Critics have brought forward multiple arguments against a "test and treat" approach, including the potential burden of such a strategy on weak health systems and a presumed lack of scientific support for individual patient benefit of early treatment initiation. In this article, we highlight the societal and individual advantages of treatment as prevention in resource-poor settings. We argue that the available evidence renders the discussion on when to start antiretroviral therapy unnecessary and that, instead, efforts should be aimed at offering treatment as soon as possible.
authors.affiliation: Department of Global Health Department of Internal Medicine, Academic Medical Center, University of Amsterdam Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Kim C E
authors.initials: KC
authors.lastname: Sigaloff
authors.affiliation: Department of Global Health.
authors.forename: Joep M A
authors.initials: JM
authors.lastname: Lange
authors.affiliation: British Columbia Center for Excellence in HIV/AIDS, Vancouver, Canada.
authors.forename: Julio
authors.initials: J
authors.lastname: Montaner
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003906:Developing Countries; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control*; D006801:Humans
chemical_list: D019380:Anti-HIV Agents
keywords: HIV-1; antiretroviral therapy; resource-limited settings; treatment as prevention