Treatment-as-Prevention in AIDS Control: Why Communication Still Matters

Treatment-as-prevention is a term used to describe an HIV prevention method that uses antiretroviral treatment to minimize the chance of HIV transmission, with the idea that treatment can decrease the viral load of those infected to a level where transmission risk is minimal. However, for treatment-as-prevention to be a success, individuals must get tested, know their status, seek care, and adhere to their antiretroviral regimen. Communication plays a role in each of these steps, as communication can be used to create demand for health-seeking behavior and as a means to increase quality and support on the supply side, at the clinic and community level. From the demand side, communication has played a role in convincing people to get tested and obtain their results, in ensuring treatment access, linking those infected to care, and addressing stigmatizing attitudes that may prevent individuals from taking these actions. On the supply side, communication has been shown to mobilize community care and support and increase the quality of patient-provider interaction, which in turn can improve adherence. Finally, communication has played an integral role in structural issues related to treatment-as-prevention, including the assurance of adequate supplies, including HIV testing kits, anti-retrovirals, and condoms.