Treatment as prevention – ‘population viral load’

A ‘test-and-treat’ strategy in rural Uganda is having a big impact on ‘population viral load’. This is a monitoring tool that looks at different measures of viral load and related factors across a whole population.

Increased emphasis is being placed on the role of diagnosis of HIV, through HIV testing, in efforts to control the epidemic. This is central to the implementation of HIV treatment as prevention.

Testing campaigns were conducted in part of rural Uganda in May 2011 and again in May 2012.

Approximately three-quarters of adults in the area were screened in both campaigns. Approximately 8% of participants were diagnosed with HIV in 2011 and 9% in 2012.

The testing campaigns were accompanied by a big increase in the proportion of HIV-positive people with an undetectable viral load (from 37 to 55%).

There was also a substantial fall in the proportion of people who had a very high viral load, above 100,000 (from 13 to 3%).

The results of the study show that increasing testing and the use of treatment can quickly reduce the proportion of people with infectious levels of HIV.