Treatment as Prevention enrolling at least 75 percent of individuals on ART will be needed to significantly reduce HIV prevalence in a HIV cohort

Abstract Background “Treatment as Prevention” (TasP) aims to reduce new HIV infections through higher enrolment on suppressive antiretroviral therapy (ART). Objectives We studied the current epidemic and possible impact of TasP in a French HIV cohort including MSM and migrant subjects. Study design Socio-demographic, clinical and laboratory variables were collected during the follow-up of 6995 HIV-infected patients. The numbers of individuals living with HIV in each year were estimated from diagnoses up to that year minus recorded deaths. Patients were classified according to gender, transmission mode, country of birth and treatment status. Results The cohort includes 6995 individuals diagnosed from 1985 to 2015, of whom 72% were men. Unprotected sexual intercourse was the main mode of transmission. Women were more likely to be migrants (45% versus 13%), whereas men were more likely to have been born in France (52% versus 27%). Diagnoses were more correlated with untreated than treated prevalence in each group. MSM diagnoses was strongly correlated to untreated prevalence whatever the country of birth (p  Conclusions Enrolling at least 75% of individuals on ART is necessary to substantially impact numbers of new HIV infections in this cohort. Treatment as prevention will actually be effective to reduce HIV prevalence.