statistically significant reductions in HIV incidence) necessary to warrant taking UTT interventions to scale are obtained only when very high levels of uptake of the two key components of the UTT strategy are achieved and sustained – as high as 90% of HIV-negative people tested for HIV every year and 90% of HIV-infected people starting ART .
Yet data published so far, highlight the challenge of reaching such high uptake rates of HIV testing and HIV care, even before considering a UTT strategy itself.
We constructed a multi-disciplinary research programme implemented as part of the ANRS 12249 Treatment-as-Prevention (Tas P) trial in South Africa.
In this paper, we first briefly present the overall trial design.
In summary, the main hypothesis of the Tas P trial is that HIV testing of all adult members of a community, followed by immediate ART initiation of all, or nearly all, HIV-infected participants regardless of immunological or clinical staging, will prevent onward transmission and reduce HIV incidence in this population.
The Tas P trial is a cluster-randomised trial implemented in the Hlabisa sub-district, in rural northern Kwa Zulu-Natal in South Africa, an area with approximately 228 000 Zulu-speaking inhabitants.
We then outline the research questions and objectives that each component of our multi-disciplinary research programme aims to address.
We describe in detail the research methods and specific data collection tools being implemented.
In this context, and with UTT not being a single intervention of HIV testing or initiation of ART, but rather a complex combination, considerable barriers to the implementation and uptake throughout the UTT cascade can be anticipated [17,18].
As much as UTT represents a challenge for scientists, public health authorities and health care providers, it is also likely to be a challenge for individuals and societies.