Antiretroviral Therapy Efficacy in HIV Prevention

Antiretroviral therapy (ART) has reshaped the landscape of HIV control by not only prolonging the lives of people living with HIV but also by curbing onward transmission. By suppressing viral replication to undetectable levels, ART reduces the risk of sexual and vertical transmission to near zero, underpinning the principle of treatment as prevention. Over the past decade, advances in drug potency, tolerability and simplified dosing have supported global targets for diagnosis, treatment initiation and durable viral suppression. In diverse settings, from community-based roll-out to national treatment programmes, high coverage of ART has driven declines in HIV incidence, even in regions with hyperendemic transmission. Implementation research has elucidated barriers and enablers—from linkage to care and adherence support through primary health-care integration to differentiated service delivery—and highlighted the importance of sustaining engagement across age and gender groups. Mathematical models project that achieving and maintaining high ART coverage, alongside complementary prevention measures, will be critical to achieving epidemic control and eventual elimination of HIV as a public health threat.

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Antiretroviral Therapy Efficacy in HIV Prevention publication trend

The graph below shows the total number of articles in antiretroviral therapy efficacy in hiv prevention across all publications each year (not limited to Nature Index journals).

Technical terms

Antiretroviral therapy (ART): A regimen of drugs that inhibits HIV replication, reduces viral load and restores immune function.

Viral load suppression: Reduction of HIV RNA in the blood to levels below the threshold of detection, minimising transmission risk.

Universal Test and Treat (UTT): A strategy offering routine HIV testing to all individuals and immediate ART initiation upon diagnosis, irrespective of CD4 count.

Persistent viraemia: Continued elevation of HIV RNA above suppression thresholds despite reported ART use, often indicating adherence challenges or drug resistance.

References

1. Effect of Universal Testing and Treatment on HIV Incidence — HPTN 071 (PopART). New England Journal of Medicine (2019).
2. Temporal dynamics and drivers of durable HIV viral load suppression and persistent high‐ and low‐level viraemia during Universal Test and Treat scale‐up in Uganda: a population‐based study. Journal of the International AIDS Society (2024).
3. Future HIV epidemic trajectories in South Africa and projected long-term consequences of reductions in general population HIV testing: a mathematical modelling study. The Lancet Public Health (2024).