HIV Prevention MethodsViewpoints

Forgotten Negatives: The Limits of Treatment as Prevention

The CDC's High-Impact Prevention Strategy Takes Aim at the Stubborn HIV Incidence Rate in the United States. The Only Problem: It Doesn't Include an Ambitious Plan for Those at Risk for the Virus.

    Figure. A Double-Helix HIV Prevention and Care Continuum
    Figure. A Double-Helix HIV Prevention and Care Continuum A work in progress by TAG staff, the above schematic depicts key components of successful engagement in care to achieve critical outcomes required to foster disease-free survival and to ultimately end the HIV/AIDS epidemic. The continuum of care for people living with HIV (top half of the graphic) has been well described and embodies health care delivery and the coordination of essential services to fully support linkage to and retention in care, the commencement of antiretroviral therapy, and maintenance of viral-load suppression. A continuum of care for those who test negative for HIV, particularly those being screened for the virus through AIDS service organization and Department of Health programs, does not exist. Under the Affordable Care Act, testing for HIV should be seen as a critical point of care within the health care system, whereby linkage to affordable health insurance and culturally sensitive care is a priority for those who test negative but potentially remain at risk for the virus. Mirroring the HIV care continuum, an HIV prevention continuum (bottom half of the graphic) details some of the core components of HIV risk reduction and maintained wellness made possible through consistent primary care and the coordination of social support and other ancillary services.

    Jeremiah Johnson

    Treatment Action Group

    Treatment Action Group