1. Go Where the Virus Is: An HIV Micro-epidemic Control Approach to Stop HIV Transmission
- Author
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Timothy D Mastro, Michael M. Cassell, Reshmie Ramautarsing, Rose Wilcher, and Nittaya Phanuphak
- Subjects
Acquired Immunodeficiency Syndrome ,Sexual transmission ,Transmission (medicine) ,business.industry ,virus diseases ,HIV Infections ,Viremia ,General Medicine ,medicine.disease ,Virus ,Men who have sex with men ,Social support ,Relative risk ,Commentary ,medicine ,Humans ,Epidemics ,business ,Viral load ,Demography - Abstract
Essentially all HIV transmission is from people living with HIV who are not virally suppressed. An HIV micro-epidemic control approach that differentiates treatment support and prevention services for people living with HIV and their network members according to viral burden could optimize the impact of epidemic control efforts., Key Messages Essentially all HIV transmission is from people living with HIV (PLHIV) who do not know their infection status or have not yet achieved viral suppression, making support for these individuals and their risk contacts a priority for treatment and prevention efforts.Proven approaches exist to reduce viral burden and interrupt HIV transmission from PLHIV who are not yet virally suppressed, but these approaches must be implemented with enhanced focus and scale to maximize benefit.Improved diagnostic approaches offer new opportunities to increase public health impact by prioritizing support for unserved or underserved individuals with the greatest viral burdens and among members of their risk networks.Policy makers should pursue the implementation and evaluation of diagnostic approaches that can focus services among individuals and networks with the greatest viral burdens.Program managers should treat viral burden as a primary consideration in the provision of differentiated HIV services, applying an HIV micro-epidemic control framework to prioritize and tailor services for PLHIV and their risk contacts along a continuum of progression to viral suppression.
- Published
- 2020