Grinsztejn B, et al, Lancet Infect Dis, March 4 th 2014 PRIMARY COMBINED M&M OUTCOME FIRST AIDS DEFINING EVENT FIRST TB EVENT DEATH

Impact of ART on Life Expectancy Bor et al, Science 2013

ART and Employment Bor et al, Health Affairs 2012

Mortality & ART Coverage Modified from A. Hill et al. IAS 2014 [LBPE29]

New HIV infections* & ART Coverage Modified from A. Hill et al. IAS 2014 [LBPE29] * percentage growth

HIV Transmission According to Sexual Behavior Reported by HIV-Negative Partner Rate of Couple Transmission (per 100 Couple-Years Follow-Up) Heterosexual (Male) Vaginal sex with ejaculation (192 CYFU) Heterosexual (Female) Vaginal sex (272 CYFU) MSM Receptive anal sex: With ejaculation (93 CYFU) Without ejaculation (157 CYFU) Insertive anal sex (262 CYFU) Rate (95% CI) Overall risk = Zero through condomless sex with a partner on ART (HIV RNA <200 copies/mL Rodger A, et al. 21 st CROI. Boston, Abstract 153LB.

Key Messages TasP is primarily about Preventing Morbidity & Mortality, and as a byproduct, for virtually no additional investment and in a cost-saving fashion, Preventing HIV Transmission TasP vs Chemoprophylaxis TasP works in all settings, including in MSM TasP works in RLMS 2013 WHO Guidelines Need for Ambitious New ART Targets – Proposed UNAIDS Target

By 2020… 90% of all people living with HIV will know their HIV status 90% of all people diagnosed with HIV will receive sustained antiretroviral therapy. 90% of all people receiving antiretroviral therapy will have durable suppression.

The result = a three-fold increase over current 2014 estimates 72 % of all people living with HIV will be virally suppressed 3

The new treatment paradigm Single target → Cascade target Death → Death and transmission Number → Equity Incremental funding→ Frontload Investments

The objective “Maximize the effectiveness of existing tools to virtually eliminate progression to AIDS, premature death and HIV transmission, and thereby transform the HIV/AIDS pandemic into a low level sporadic endemic.”

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