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Grinsztejn B, et al, Lancet Infect Dis, March 4 th 2014

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.

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Grinsztejn B, et al, Lancet Infect Dis, March 4 th 2014

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  1. PRIMARY COMBINED M&M OUTCOME FIRST TB EVENT DEATH FIRST AIDS DEFINING EVENT Grinsztejn B, et al, Lancet Infect Dis, March 4th 2014

  2. Impact of ART on Life Expectancy Bor et al, Science 2013

  3. ART and Employment Bor et al, Health Affairs 2012

  4. Mortality & ART Coverage Modified from A. Hill et al. IAS 2014 [LBPE29]

  5. New HIV infections*& ART Coverage * percentage growth Modified from A. Hill et al. IAS 2014 [LBPE29]

  6. HIV Transmission According to Sexual Behavior Reported by HIV-Negative Partner Rodger A, et al. 21st CROI. Boston, 2014. Abstract 153LB. 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) Overall risk = Zero through condomless sex with a partner on ART (HIV RNA <200 copies/mL 0 1 2 3 4 Rate (95% CI)

  7. 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 • TasPvs 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

  8. 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.

  9. The result 72% 3 of all people living with HIV will be virally suppressed = a three-fold increase over current 2014 estimates

  10. The new treatment paradigm Single target → Cascade target Death → Death and transmission Number → Equity Incremental funding→ Frontload Investments

  11. 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.”

  12. For Further Information • Invited Presentations • Workshop Proceedings • Evaluation Please visit the website: www.treatmentaspreventionworkshop.org

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