Study shows community-wide HIV prevention strategy can reduce new infections

Washington: A new study, presented at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle show delivery of an HIV prevention strategy that includes offering in-home HIV testing to everyone, with immediate referral to HIV care, and treatment for people living with HIV based on prevailing in-country guidelines, can substantially reduce new HIV infections.

The HPTN 071 (PopART) study examined the impact of a package of HIV prevention interventions on community-level HIV incidence in urban and peri-urban communities in Zambia and South Africa.

Study author Richard Hayes said, “We saw a highly significant 30 percent decrease in new HIV infections with a prevention strategy where HIV treatment was started according to in-country guidelines,” adding, “We did not see a similar reduction in new HIV infections with another strategy where universal HIV treatment was offered from the beginning of the study. Additional analyses are underway to explore the reasons for this finding.”

The HPTN 071 (PopART) study involved more than one million people living in 21 communities in Zambia and South Africa, making it the largest HIV prevention trial to date.

The study measured the effects of two HIV combination prevention strategies offering HIV testing to people in their homes annually, with linkage to HIV care and treatment at the local health facility for those living with HIV.

“Overall, both strategies improved knowledge of HIV status and uptake of treatment,” said co-author Wafaa El-Sadr adding, “These findings show that a combination prevention strategy similar to PopART may be an effective tool to slow the global HIV epidemic.”

HPTN 071 (PopART) researchers are currently examining the effects of the interventions on other study outcomes including herpes simplex virus-2 incidence, tuberculosis and HIV-related stigma. Work is also in progress to estimate the cost-effectiveness of the interventions.

“While the findings from the study are very encouraging, testing and treatment coverage fall short among young people and men necessitating the need for further research on how to fill these important gaps,” said Sarah Fidler, MBBS, PhD, HPTN 071 (PopART) protocol co-chair and professor of medicine at Imperial College, London.