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Separate Goals, Converging Priorities

On the Ethics of Treatment as Prevention

Bibliographic Data

ID19516808
AuthorsFlorian Ostmann (0000-0002-1546-1630, University College London), Carla Saénz (0000-0002-2040-9423, corresponding author)
Year2013
Volume13
Issue2
Pages57-62
Publication date2013-08-01
Open AccessYes
TypeARTICLE
VenueDeveloping World Bioethics (JOURNAL)
Journal identifiersISSN: 1471-8731 • E-ISSN: 1471-8847
PublisherWiley (PUBLISHER • GB)
DOI10.1111/dewb.12021
PMID23800304
OpenAlexW1572364383
LanguageEN
References cited11

Recent evidence confirming that the administration of antiretroviral drugs ( ARVs ) to HIV ‐infected persons may effectively reduce their risk of transmission has revived the discussion about priority setting in the fight against HIV / AIDS . The fact that the very same drugs can be used both for treatment purposes and for preventive purposes (Treatment as Prevention) has been seen as paradigm‐shifting and taken to spark a new controversy: In a context of scarce resources, should the allocation of ARVs be prioritized based on the goal of providing treatment, or on the goal of preventing the spread of the HIV epidemic? Contributions to this discussion tend to assume that treatment and prevention constitute two divergent goals that entail conflicting priorities. We challenge that assumption on the basis of both conceptual and empirical examination. We argue that, as far as the provision of ARVs to HIV‐infected persons is concerned, the goals of treatment and prevention do not entail conflicting priorities; to the contrary, they dictate converging strategies for the optimal allocation of ARVs. In light of the current evidence, the concept of Treatment as Prevention can indeed be seen as paradigm‐shifting, yet in a novel way: Rather than extending the tension between the goals of treatment and prevention to the level of drug‐allocation, it dissolves this tension by providing a rationale for a unified strategy for allocating ARVs

Antiretroviral therapy · Law and economics · Political science · Public relations · Sociology · Treatment as prevention · Viral load · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Immunology

  • Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission

    Open Access•Reuben Granich, Reuben M Granich et al.•The Lancet•2009

  • Heterosexual HIV-1 transmission after initiation of antiretroviral therapy

    Open Access•Deborah Donnell, Jared M Baeten et al.•The Lancet•2010

  • Prevention of HIV-1 Infection with Early Antiretroviral Therapy

    Myron S Cohen, Ying Qing Chen et al.•New England Journal of Medicine•2011

Highly citedNo

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