Optimizing the engagement of care cascade: a critical step to maximize the impact of HIV treatment as prevention

Curr Opin HIV AIDS. 2012 Nov;7(6):579-86. doi: 10.1097/COH.0b013e3283590617.


Purpose of review: At present, data from mathematical models, ecologic studies and a clinical trial demonstrate that use of combination antiretroviral therapy (cART) can markedly reduce HIV transmission. Expansion of cART uptake (Treatment as Prevention) is a critical component of biomedical interventions to prevent HIV transmission.

Recent findings: Successful implementation is dependent on identifying undiagnosed individuals, linking and retaining them in care and initiating durable and potent cART regimens. This continuum is encapsulated within the framework of the 'Test and Treat', or 'Seek, Test, Treat and Retain' strategies. Currently only 19-28% of all HIV-infected individuals in the USA are estimated to be virologically suppressed.

Summary: Optimizing the engagement of care cascade represents a critical step to maximize the individual and societal impact of cART and therefore deliver on the promise of HIV Treatment as Prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-HIV Agents / administration & dosage*
  • Chemoprevention / methods*
  • Clinical Trials as Topic
  • Disease Transmission, Infectious / prevention & control*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Humans
  • Models, Theoretical
  • United States


  • Anti-HIV Agents