A universal testing and treatment strategy is a potential approach to reduce the incidence of human immunodeficiency virus (HIV) infection, yet previous trial results are inconsistent.
In the HPTN 071 (PopART) community-randomized trial conducted from 2013 through 2018, the authors randomly assigned 21 communities in Zambia and South Africa (total population, approximately 1 million) to group A (combination prevention intervention with universal antiretroviral therapy [ART]), group B (the prevention intervention with ART provided according to local guidelines [universal since 2016]), or group C (standard care). The prevention intervention included home-based HIV testing delivered by community workers, who also supported linkage to HIV care and ART adherence. The primary outcome, HIV incidence between months 12 and 36, was measured in a population cohort of approximately 2000 randomly sampled adults (18 to 44 years of age) per community. Viral suppression (< 400 copies of HIV RNA per milliliter) was assessed in all HIV-positive participants at 24 months.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Harries AD, Takarinda KC. F1000Prime Recommendation of [Hayes RJ et al., N Engl J Med 2019 381(3):207-218]. F1000 Prime. 2019. Available from: https://f1000.com/prime/736207432#eval793564775
Effect of Universal Testing and Treatment on HIV Incidence - HPTN 071 (PopART)
Published 11 September 2019