Early HIV infection accounts for up to 50% of transmission events in diverse epidemics, including those among men who have sex with men, heterosexuals, and injection drug users (IDUs). Early antiretroviral treatment initiation stops disease progression and prevents onward transmissions. Eaton and Hallett model the effect of early transmission on the data from the generalized heterosexual epidemic for a 30-year period and show that in long-term perspective, the effect of early transmission prevention is low. Specifically, failure to prevent transmissions from the recently infected group under various assumptions caused only a 20% reduction in the effectiveness of antiretroviral treatment to prevent new infections after 30 year. However, the authors do not report the number of recently infected people in South Africa, which has been declining over the years and might become even lower in the long term. Knowing the proportion of recently infected in the population over time would help us understand the importance of treatment as prevention (TASP) in this group.
Prevention of early HIV transmissions might be more important in emerging or generalizing epidemics
Proceedings of the National Academy of Sciences of the United States of America, 112 (13), E1515. doi: 10.1073/pnas.1424168112. PMCID: PMC4386368.