Is there a future for treatment as prevention?

Is there a future for treatment as prevention?

Using HIV treatment as prevention to tackle the global AIDS epidemic does have some advantages; it would significantly increase the number of people who are aware of their HIV status, and millions of people worldwide who are in immediate need of HIV treatment would receive it. However, for treatment as prevention to work on this level, each case needs to be assessed on its own merit. The rights of the individual to choose whether to be treated before they need to be treated, would have to be paramount.

Treatment as prevention already works (in the case of PMTCT and PEP), but only because the individual is the first consideration and the programmes are part of a comprehensive, holistic prevention strategy. Treatment as prevention on a public health level needs to be complemented with education, condom use and behaviour change - other prevention strategies that have in many cases been largely successful. As the Joint United Nations Programme on HIV/AIDS state:

"UNAIDS strongly recommend a comprehensive approach to HIV prevention that plans and delivers an evidence informed and human rights based combination of programmes and policies, tailored to meet the needs of those most at risk, and including practical programmes to reduce underlying causes of vulnerability, such as gender inequality and HIV related stigma and discrimination... Antiretroviral therapy will play several roles in combination prevention strategies, along with other key strategies."¹⁵