NIH co-funded trial to evaluate population-wide testing for HIV treatment

A study in South Africa and Zambia will evaluate whether house-to-house voluntary HIV testing and early treatment for HIV infection reduces the number of new infections, the National Institutes of Health announced on Monday.

The trial, which is co-funded by the National Institute of Allergy and Infectious Diseases and the U.S. President's Emergency Plan for AIDS Relief, will build on the results of a trial that found HIV-infected individuals who start treatment early significantly reduce the risk of transmitting the virus to their heterosexual partners.

"Through this new study, we aim to learn whether the treatment of HIV-infected individuals as a form of HIV prevention, an approach previously tested in roughly 1,800 heterosexual couples where one partner was infected, will be just as effective when implemented across an entire adult population," Anthony Fauci, the director of the NIAID, said. "The study also will tell us whether this method of delivering population-wide HIV treatment as prevention is feasible and cost-effective."

The trial is called Population Effects of Antiretroviral Therapy to Reduce HIV Transmission, or PopART. PopART will be conducted in South Africa and Zambia because the HIV prevalence in those countries is among the highest in the world.

"Mathematical models indicate that if a high proportion of a population can be tested for HIV, and those found to be infected are offered treatment right away, then the rate of new HIV infections could decrease substantially over time," Richard Hayes, one of the study leaders, said. "The PopART study is assessing whether this approach works and whether the benefits outweigh the costs-information that could help guide public health policy."

The PopART study investigators will test an HIV prevention package including annual, door-to-door, voluntary HIV testing, linkage of individuals testing positive to care at local health centers, promotion of voluntary medical circumcision to men who are not HIV-infected, promotion of steps to prevent mother-to-child HIV transmission, referral of individuals with other sexually transmitted infections to treatment and provision of condoms.

The study is expected to end in 2019.

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National Institutes of Health

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