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Invited Commentary
August 9/23, 2010

“A Bird in the Hand . . . ”: A Commentary on the Test and Treat Approach for HIV: Comment on “Comparative Effectiveness of HIV Testing and Treatment in Highly Endemic Regions”

Author Affiliations

Author Affiliations: Center for AIDS Prevention Studies (Dr Charlebois) and HIV/AIDS Division, Department of Medicine, San Francisco General Hospital (Drs Charlebois and Havlir), University of California, San Francisco.

Arch Intern Med. 2010;170(15):1354-1356. doi:10.1001/archinternmed.2010.248

The “test and treat” strategy captured the attention of the HIV world this past year. The premise of this approach is quite simple. Identify and treat most persons living with HIV in a community with antiretroviral therapy, and HIV rates will eventually decrease because lower HIV RNA levels are associated with reduced rates of HIV transmission. Modeling of this approach was put forward by Blower et al1 and Montaner et al2 years ago with little fanfare. However, when Granich et al3 modeled this approach for the South African epidemic and predicted millions of lives saved and transition from an endemic to an elimination phase, a global debate was launched.

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