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June 10, 2009

Universal Voluntary Testing and Treatment for Prevention of HIV Transmission

Author Affiliations

Author Affiliations: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

JAMA. 2009;301(22):2380-2382. doi:10.1001/jama.2009.828

Antiretroviral therapy (ART) can suppress the level of human immunodeficiency virus (HIV) viremia (or “viral load”) to undetectable levels in the plasma of a substantial proportion of individuals infected with HIV and has greatly reduced HIV-related morbidity and mortality.1 In addition, the efficiency of HIV transmission is directly proportional to the viral load in the transmitting individual.2 Given the dramatic effect of ART on viral load, it is reasonable to consider using treatment of individuals infected with HIV as a means of preventing HIV transmission. The notion of treating individuals who are infected in the general population as a means of controlling the HIV/AIDS pandemic by decreasing the rate of HIV transmission—and thus lessening the societal spread of HIV—is not new.3

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