Evidence map›Paper›PMID 40137828›Full record

ReviewTropical medicine and infectious disease2025

Generalized Treatment as Prevention Plus Focused Pre-Exposure Prophylaxis Is the Key to Controlling HIV/AIDS.

Julio S G Montaner, Viviane D Lima, Kate A Salters, Junine Toy, Jeffrey B Joy, Silvia Guillemi, Rolando Barrios

Abstract readReview
In one paragraph

Review in Tropical medicine and infectious disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Julio S G MontanerBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.ORCID 0000-0002-6201-9829
Viviane D LimaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.ORCID 0000-0003-4943-091X
Kate A SaltersBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.
Junine ToyBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.
Jeffrey B JoyBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.ORCID 0000-0002-7013-1482
Silvia GuillemiBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.
Rolando BarriosBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.ORCID 0000-0003-3642-5986

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and premature AIDS-related deaths among people living with HIV (PLWH), and simultaneously renders HIV non-transmissible, thus preventing onward HIV transmission. In addition, PrEP has proven effective against HIV transmission among high-risk individuals who are adherent to the regimen. PrEP traditionally consists of two antiretrovirals given orally as one pill daily: originally, tenofovir-DF plus emtricitabine (TDF-FTC), and later, tenofovir-AF (TAF) plus FTC (more recently, other options have become available, including long-acting parenteral formulations; however, these are still of limited availability). Over the last two decades, the province of British Columbia has rolled out TasP among all PLWH, and starting in 2018, PrEP was added as a strategy to reach individuals most at risk of acquiring HIV to further accelerate progress in addressing HIV/AIDS as a public health threat. Our "generalized TasP + focused PrEP" program proved to be synergistic (or multiplicative) as it relates to reducing the HIV effective reproduction number (Re). TasP lowers HIV incidence by reducing the pool of individuals able to transmit HIV, which is dependent on the extent of community plasma viral load (pVL) suppression. Meanwhile, PrEP reduces the number of potential new infections among those most susceptible to acquiring HIV in the community, independent of viral load suppression among PLWH. Our results strongly support widespread implementation of the combination of "generalized TasP + focused PrEP" strategy and underscore the importance of long-term monitoring of Re at a programmatic level to identify opportunities for optimizing TasP and PrEP programs. This approach aligns with the United Nations goal of "Ending HIV/AIDS as a pandemic by 2030", both in Canada and globally.

Indexed as

antiretroviral therapy (ART)HIV/AIDS preventionHIV control strategiesHIV epidemiologyHIV transmission preventionHIV treatment cascadePre-Exposure Prophylaxis (PrEP)public health and HIV/AIDStargeted interventions in HIVTreatment as Prevention (TasP)

Identifiers

PMID40137828
PMCPMC11945595

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.