grinsztejn b, et al, lancet infect dis, march 4 th 2014
DESCRIPTION
PRIMARY COMBINED M&M OUTCOME. FIRST TB EVENT. DEATH. FIRST AIDS DEFINING EVENT. Grinsztejn B, et al, Lancet Infect Dis, March 4 th 2014. Impact of ART on Life Expectancy. Bor et al, Science 2013. ART and Employment. Bor et al, Health Affairs 2012. Mortality & ART C overage. - PowerPoint PPT PresentationTRANSCRIPT
Grinsztejn B, et al, Lancet Infect Dis, March 4th 2014
PRIMARY COMBINED M&M OUTCOME
FIRST AIDS DEFINING EVENT
FIRST TB EVENT
DEATH
Impact of ART on Life Expectancy
Bor et al, Science 2013
ART and Employment
Bor et al, Health Affairs 2012
Mortality & ART Coverage
Modified from A. Hill et al. IAS 2014 [LBPE29]
New HIV infections* & ART Coverage
Modified from A. Hill et al. IAS 2014 [LBPE29]* percentage growth
HIV Transmission According to Sexual Behavior Reported by HIV-Negative Partner
Rate of Couple Transmission (per 100 Couple-Years Follow-Up)
Heterosexual (Male)Vaginal sex with ejaculation
(192 CYFU)
Heterosexual (Female)Vaginal sex (272 CYFU)
MSM Receptive anal sex:
With ejaculation (93 CYFU)Without ejaculation (157 CYFU)
Insertive anal sex (262 CYFU)
0 1 2 3 4Rate (95% CI)
Overall risk = Zero through condomless sex with a partner on ART (HIV RNA <200
copies/mL
Rodger A, et al. 21st CROI. Boston, 2014. Abstract 153LB.
Key Messages
• TasP is primarily about Preventing Morbidity & Mortality, and as a byproduct, for virtually no additional investment and in a cost-saving fashion, Preventing HIV Transmission
• TasP vs Chemoprophylaxis• TasP works in all settings, including in MSM• TasP works in RLMS• 2013 WHO Guidelines• Need for Ambitious New ART Targets
– Proposed UNAIDS 90-90-90 Target
By 2020…
90%
of all people living with HIV will know their
HIV status
90% of all people
diagnosed with HIV will receive
sustained antiretroviral
therapy.
90%
of all people receiving
antiretroviral therapy will have
durable suppression.
The result
= a three-fold increase over current 2014 estimates
72%of all people living with HIV
will be virally suppressed
3
The new treatment paradigm
Single target → Cascade targetDeath → Death and transmission
Number → EquityIncremental funding→ Frontload Investments
90% 81% 73%
The objective
“Maximize the effectiveness of existing toolsto virtually eliminate progression to AIDS,
premature death and HIV transmission, and thereby transform the HIV/AIDS pandemic into a
low level sporadic endemic.”
For Further Information
• Invited Presentations• Workshop Proceedings• Evaluation
Please visit the website:
www.treatmentaspreventionworkshop.org