Журнал СПИДа и клинических исследований

HIV Treatment as Prevention and the Role of Applied Social Science Research

Abstract

Will Small and Thomas Kerr

Utilizing highly active antiretroviral therapy (HAART) to reduce HIV transmission, commonly referred to as "treatment as prevention" (TASP), has been hailed as a valuable addition to comprehensive HIV prevention efforts [1]. Subsequent to the HPTN 052 trial [2], which established the efficacy of this approach, there have been calls to prioritize TasP within global HIV prevention efforts [3]. However, some have argued that the increasing emphasis on this form of biomedical prevention represents a "remedicalisation" of the HIV epidemic [4]. Concerns have been expressed that TasP will lead to the prioritization of biomedical solutions at the expense of other preventive approaches, detract attention from the social and material conditions that shape the epidemic, and lead to a proliferation of interventions deployed without adequate input from social scientists, community, and activists [4,5]. However, such critiques overlook growing attention to the social and structural dimensions of TasP [6], opportunities to link TasP with ongoing treatment advocacy efforts [7], as well as increasing recognition that the greatest reduction in the number of new HIV infections will be achieved by integrating biomedical, social, and structural interventions in comprehensive prevention programs