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Background: The long-term impact of universal home-based testing and treatment as part of universal testing and treatment (UTT) on HIV incidence is unknown. We made projections using a detailed individual-based model of the effect of the intervention delivered in the HPTN 071 (PopART) cluster-randomised trial., Methods: In this modelling study, we fitted an individual-based model to the HIV epidemic and HIV care cascade in 21 high prevalence communities in Zambia and South Africa that were part of the PopART cluster-randomised trial (intervention period Nov 1, 2013, to Dec 31, 2017). The model represents coverage of home-based testing and counselling by age and sex, delivered as part of the trial, antiretroviral therapy (ART) uptake, and any changes in national guidelines on ART eligibility. In PopART, communities were randomly assigned to one of three arms: arm A received the full PopART intervention for all individuals who tested positive for HIV, arm B received the intervention with ART provided in accordance with national guidelines, and arm C received standard of care. We fitted the model to trial data twice using Approximate Bayesian Computation, once before data unblinding and then again after data unblinding. We compared projections of intervention impact with observed effects, and for four different scenarios of UTT up to Jan 1, 2030 in the study communities., Findings: Compared with standard of care, a 51% (95% credible interval 40-60) reduction in HIV incidence is projected if the trial intervention (arms A and B combined) is continued from 2020 to 2030, over and above a declining trend in HIV incidence under standard of care., Interpretation: A widespread and continued commitment to UTT via home-based testing and counselling can have a substantial effect on HIV incidence in high prevalence communities., Funding: National Institute of Allergy and Infectious Diseases, US President's Emergency Plan for AIDS Relief, International Initiative for Impact Evaluation, Bill & Melinda Gates Foundation, National Institute on Drug Abuse, and National Institute of Mental Health., Competing Interests: Declaration of interests AC reports funding from the National Institute for Health and Care Research (NIHR), Sergei Brin Foundation, and US Agency for International Development, and from Pfizer for lecturing. CF reports funding from the US National Institutes of Health (NIH), the National Institute of Allergy and Infectious Diseases (NIAID), the US President's Emergency Plan for AIDS Relief (PEPFAR), International Initiative for Impact Evaluation (3ie), the Bill & Melinda Gates Foundation, the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). DM reports funding from NIH, 3ie, PEPFAR, and the Bill & Melinda Gates Foundation. DJD reports funding from NIH and participation on a DSMB for COVID-19 studies. EP-M reports funding from NIH. HA reports funding from NIH, 3ie, and PEPFAR. MP reports funding from the Bill & Melinda Gates Foundation. SFl reports funding from NIH, 3ie, PEPFAR, and the Bill & Melinda Gates Foundation. TS reports funding from NIAID/NIH. WJMP reports funding from Li Ka Shing Foundation and is a consultant with WHO. All other authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)