Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, death and transmission was first proposed in 2000 by Garnett et al.
The term is often used to talk about treating people that are currently living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) to prevent illness, death and transmission.
Such medications are used as a preventative for infected individuals to not only spread the HIV virus to their negative partners but also improve their current health to increase their lifespans.
Evidence through observational, ecological and clinical trials reveal positive results in regards to the implementation of antiretroviral drugs as preventative measures against HIV transmission.
[7] The diminished rate of new HIV infections brought about by these strategies are marked progress towards UNAIDS' 90-90-90 and 95-95-95 target to eliminate HIV/AIDS as a public health crisis by 2030.
[9] Understanding whether marginalized groups have access to testing and treatment are often hampered by harsh laws that do not allow for the accurate collection of data regarding these communities.
In August 2011, the HIV Prevention Trials Network concluded that the likelihood of transmission between the couples who were provided early antiretroviral therapy reduced by 96%.
[15] A program for offering ARVs for life to any HIV-positive pregnant woman called "Option B+" served as a precursor to the "test and treat" strategy that is now being rolled out in various countries.
Many of the most vulnerable populations may not be seeing these benefits as a result of a social and political climate that is deterrent to seeking testing and treatment, in addition to making it difficult to stick with the ARV regimen.
In addition, individuals with low incomes in United States struggle to pay high prices set by pharmaceutical companies for antiretroviral drugs.
As a result, it was implausible for a global treatment system or policy to be put into place since no universal HIV/AIDS test and medication regimen existed and due to technology and wealth disparities worldwide.
In the past antiretroviral drugs can also cause patients to experience various side effects including becoming nauseated or developing gastrointestinal pains and issues, as a results of medications at times being too toxic for a specific individual.
[6][30][31][32] In the case of resistance to the first-line of combination medications for the HIV-1 virus, mutations occurred within genes of HIV-1 viral RNA that enters T-cells within the human body.
In addition, studies that were conducted within these regions revealed a correlation between the length of time ART was implemented as a method of treatment and the likelihood of the establishment of TDR.
[48] Through their initiatives in combination with pharmaceutical companies in Brazil, individuals in third-world countries are being provided access to antiretroviral treatment regimens that they could not afford before.
With this, the future of price reduction in the United States depends on pharmaceutical competition and negotiation to make antiretroviral drugs available to all low- and middle-income individuals despite where they may live in the world.
[52][53] There have been studies of key populations in communities like Cape Town, South Africa that assert the benefits of community-based approaches, like adherence "clubs", where participants meet every two months for group counseling and the distribution of their ARV treatments.
[54] In South Africa and India, a clinical trial was completed to determine the cost-effectiveness of administering antiretroviral drugs early to treat HIV.
Single-tablet regimens are only available at specific clinics around the world—meaning there is limited access to these regimens—and are only prescribed if a doctor feels a patient will struggle with the treatment schedule of antiretroviral therapy.
The implementation of STRs worldwide could serve as a replacement for the triple-drug antiretroviral therapy and allow patients to have a less strict ART schedule to abide by.
In July 2017, The Lancet released an article revealing the results of a study conducted involving an injectable HIV-1 treatment to serve as a future replacement for the three-drug oral combination therapy.
[61][62][63][64] In August 2018, ViiV Healthcare, a collaboration between GlaxoSmithKline and Pfizer revealed the findings of a study that found that receiving monthly injections of two long-acting ARVs over a course of 48 weeks is just as effective as taking daily pills.
[66] The success of TasP is contingent upon innovation in strategies to increase the rate of HIV testing, along with exploring other dimensions of improving adherence, such as including cognitive and emotional support in those efforts.