PopART - reducing HIV transmission at a population level

The PopART clinical trial is testing an innovative combination of strategies to prevent HIV infections in African populations bearing a disproportionate burden of the epidemic.

PopART's combination HIV prevention strategy combines community-wide house-to-house voluntary testing for HIV, the offer of medical circumcision to men who test HIV-negative and immediate initiation of antiretroviral therapy for all those testing HIV-positive. The multi-national, $37 million, 5-year project will be carried out from January 2012 until December 2016.

Why is PopART important?

Stopping the spread of HIV

An estimated 33 million people worldwide are living with HIV. With 2.5 new infections for every HIV-positive patient commencing ART, current approaches to treatment and prevention are struggling to contain the spread of the infection. Unless the incidence of HIV can be steeply reduced, forecasts predict that the number of HIV-infected individuals will continue to grow so that by 2030 about $35 billion per year will be needed to deliver ART to HIV-positive patients in these resource-limited settings.

Combination prevention: costs vs benefits

Combination prevention approaches like PopART may be initially more expensive than current approaches, but estimates suggest that if HIV incidence is not reduced significantly, the financial impact of an ever-increasing number of patients in need of treatment and hospitalisation will be far greater.

Need for evidence

Mathematical modelling has shown that the PopART intervention should lead to a steep reduction in new HIV infections. PopART, a rigorously designed trial, is now needed to test whether such interventions can be effectively implemented in resource-poor settings in Africa, and to measure the actual impact on HIV at population level.